Peer-reviewed article
Armed conflict and nutritional vulnerability: A cross-sectional analysis of child wasting and stunting in conflict-affected regions of northern Ethiopia
Zerai Gebrehiwot ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A study of 1,152 children under five in northern Ethiopia found very high rates of malnutrition following the 2020–2022 Tigray war. Wasting affected 25.8% of children and stunting affected 48.5%, both at emergency levels. Displacement, severe food insecurity, low maternal education, and lack of recent immunization were the main risk factors. The findings show that armed conflict severely damaged children's nutrition and health.
Key points
- Wasting prevalence was 25.8% (severe: 7.9%) and stunting prevalence was 48.5% (severe: 20.7%) in post-conflict Tigray
- Displacement affected 45.1% of households and was associated with 2.81 times higher odds of wasting
- Severe food insecurity affected 65.0% of households and was associated with 3.48 times higher odds of wasting
- Low maternal education and lack of recent immunization were associated with stunting
- Malnutrition prevalence exceeded national averages and remained at emergency levels
Limitations
This is a cross-sectional study conducted at a single timepoint (March 2025), so it cannot show how malnutrition trends changed over time or establish causation. The study was limited to selected zones in central and eastern Tigray and may not represent all conflict-affected areas.
Abstract
Objectives: The 2020–2022 Tigray war in northern Ethiopia disrupted food systems, healthcare, and livelihoods, heightening child malnutrition risks. Limited post-conflict data exist on the prevalence of wasting and stunting. The objectives of the study are to assess the prevalence of wasting and stunting among children under five in selected zones of Tigray and identify sociodemographic and environmental risk factors. Material and Methods: We conducted a community-based cross-sectional study from March 1 to 31, 2025, in ten woredas across central and eastern Tigray. Using multistage probability proportional to size (PPS) cluster sampling, we enrolled 1,152 children aged 6–59 months (96% response rate). Anthropometric measurements followed the World Health Organization (WHO) protocols, including assessment for bilateral pitting edema; z-scores were calculated using WHO Anthro v3.2.2. Wasting was defined as weight-for-height z-score < −2 or edema and stunting as height-for-age z-score < −2. Covariates included displacement, household food insecurity access scale, maternal education, sanitation (Joint monitoring programme unimproved/limited), and immunization status. Survey-weighted prevalence estimates and multivariable logistic regression were computed in STATA v17 using svy commands. Results: Among 1,152 children (mean age 28.4 ± 14.2 months; 51% male), survey-weighted wasting prevalence was 25.8% (95% confidence interval [CI]: 23.1–28.5; severe: 7.9%) and stunting prevalence was 48.5% (95% CI: 45.5–51.5; severe: 20.7%). Displacement affected 45.1% (519/1,152) of households; severe food insecurity affected 65.0% (749/1,152). In multivariable analysis, displacement (adjusted odds ratios [aOR] 2.81, 95% CI: 2.03–3.89) and severe food insecurity (aOR 3.48, 95% CI: 2.58–4.70) were associated with wasting; low maternal education (aOR 2.15, 95% CI: 1.60–2.89) and no recent immunization (aOR 1.85, 95% CI: 1.36–2.51) were associated with stunting. Conclusion: Malnutrition prevalence in post-conflict Tigray remains at emergency levels, exceeding national averages. Findings support integrating nutrition screening into routine immunization services and targeting food and health assistance to displaced households.