Peer-reviewed article
Factors Associated With Childhood Undernutrition in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.
Hannah Ricci, Daniela Schmid, Salome Kruger, Stefano Terzoni, Cristian Ricci ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examined what causes undernutrition in infants and young children under five across Sub-Saharan Africa, reviewing 49 studies. Diarrhoea significantly increased the risk of malnutrition, low birthweight strongly predicted stunting, and maternal education was linked to children's weight. The findings point to the need for targeted interventions addressing infectious disease, maternal and early life factors, and household conditions to reduce undernutrition in the region.
Key points
- Diarrhoea was associated with 77% increased risk of overall undernutrition and 92% increased risk of wasting
- Low birthweight showed a two-fold increased risk of stunting
- Low maternal education was associated with higher risk of underweight in children
- Meta-analysis pooled data from 49 studies after screening 1,992 articles
- The review examined child-related, household, hygiene and sanitation factors affecting children aged 0-59 months
Limitations
As a systematic review of observational studies, this work identifies associations but cannot establish causation. The review does not evaluate interventions to address these factors, so it cannot indicate which programmes or policies would be most effective in reducing undernutrition.
Abstract
Undernutrition increases the risk of morbidity and mortality, making it essential to identify and address its key determinants. This systematic review and meta-analysis examines the impact of selected child-related, household and hygiene, and sanitation factors on the nutritional status of infants and young children aged 0-59 months in Sub-Saharan Africa. We conducted a comprehensive search of online databases using defined Medical Subject Headings and keyword search terms. Nutritional status was assessed using the WHO child growth Standards Z-scores for stunting, underweight and wasting. A meta-analysis was performed to estimate pooled associations, and heterogeneity was assessed using the Cochrane Q and I2 statistic. Sensitivity analyses were conducted, and publication bias was evaluated. Out of 1, 992 articles identified, 49 studies met the inclusion criteria. Our findings indicated that diarrhoea was associated with 77% increased risk of overall undernutrition (odds ratio (OR) = 1.77; confidence interval [Cl] = 1.52, 2.06), and 92% increased risk of wasting (OR = 1.92; 95% Cl = 1.48, 2.48). Low birthweight was linked to a two-fold increased risk of stunting (OR = 2.35; 95% Cl = 1.84, 3.00), while low maternal education was associated with a higher risk of underweight (OR = 1.55; 95% Cl = 1.17, 2.04). These findings highlight the need for targeted interventions to reduce childhood undernutrition in the region.