Peer-reviewed article
Double burden of malnutrition among households in Ethiopia: a systematic review and meta-analysis.
Mahider Awoke Belay, Eyob Ketema Bogale, Mitiku Tefera Haile, Solomon Ketema Bogale, Eyob Getachew et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examined the prevalence of double burden of malnutrition (DBM) in Ethiopian households, where mothers are overweight or obese while their children are undernourished. Analysing seven studies covering over 43,000 mother-child pairs, the pooled prevalence of DBM was 8.3%. The review found that residence, household wealth, food security, and mother's education are key factors associated with DBM, and concludes that targeted double-duty interventions are needed to address this emerging problem in Ethiopia.
Key points
- The pooled prevalence of double burden of malnutrition among mother-child pairs in Ethiopia is 8.30% (95% CI: 1.51, 15.09)
- Prevalence was higher in studies with smaller sample sizes (11.69% for fewer than 1,000 pairs)
- Multiple household-level factors influence DBM including residence, household size, housing quality, wealth index, food security status, mother's age and education, and child's age
- The analysis included data from 56,877 mother-child pairs across seven publications
- Extremely high heterogeneity was found between studies (I² = 99.91%), indicating substantial variation in estimates
Limitations
The extremely high heterogeneity (I² = 99.91%) suggests substantial differences between included studies that are not fully explained, limiting the precision of the pooled estimate. The review does not provide detailed information about the quality or design of individual studies included, and the wide confidence interval around the prevalence estimate reflects considerable uncertainty.
Abstract
INTRODUCTION: The double burden of malnutrition (DBM) at the household level has increased in sub-Saharan African countries as a result of rapid changes in global food systems and growing urbanization. The presence of overweight or obese mothers with undernourished (stunted, wasted, or underweight) children within the same household holds particular significance. However, no comprehensive study or meta-analysis has been conducted to summarize the national evidence of the double burden of malnutrition in mother-child pairs. Therefore, the purpose of this study was to determine the pooled prevalence of the double burden of malnutrition at the household level in Ethiopia in 2024. METHODS: This systematic review and meta-analysis was conducted on the prevalence of the double burden of malnutrition and associated factors among households in Ethiopia, using an advanced search of electronic databases and search engines. The standardized Joanna Briggs Institute (JBI) method was used to extract data from a Microsoft Excel spreadsheet and evaluate the quality of each article. The analysis was performed using STATA V.17. A random-effects model was used to conduct the meta-analysis. Heterogeneity was assessed using the I2 and Q tests. RESULTS: A total of seven publications met the inclusion criteria, including data from 56,877 and 43,770 mother-child pairs for the systematic review and meta-analysis, respectively. The pooled prevalence of the double burden of malnutrition among the mother-child pairs was 8.30% (95% confidence interval (CI): 1.51, 15.09). The heterogeneity test revealed extremely high heterogeneity (I2 = 99.91%; p = 0.00). In the subgroup analysis based on sample size, the pooled estimated prevalence of the double burden of malnutrition was high for a sample size of fewer than 1,000 mother-child pairs (11.69% (95% CI: 3.11, 20.28)). The pooled estimate from the subgroup analysis of the data collected 8 years ago was 8.61% (95% CI: 1.11, 22.33). Residence, household size, housing quality, wealth index, household food security status, mother's age and educational status, and child's age are some of the factors that influence the double burden of malnutrition among mother-child pairs. CONCLUSION: In Ethiopia, the double burden of malnutrition among mother-child pairs is rapidly emerging. As a result, double-duty interventions should be implemented to address this issue, taking into account multiple factors at the household level. SYSTEMATIC REVIEW REGISTRATION: The protocol for the systematic review and meta-analysis was registered under the registration ID CRD42024517778 with the PROSPERO (International Prospective Register of Systematic Review and Meta-analysis).