Childhood undernutrition in North Africa: systematic review and meta-analysis of observational studies
Nagwa Farag Elmighrabi1,2,3, Catharine A K Fleming1,4, Mansi Vijaybhai Dhami4,5
1School of Health Science, Western Sydney University, Penrith, NSW, Australia.
Insights
Maternal education is key to reducing child undernutrition in North Africa. Factors like young child age, rural living, and poverty also increase risks for stunting and wasting.
Area of Science:
- Public Health
- Pediatrics
- Global Health
Background:
- Undernutrition is a critical public health challenge in low- and middle-income countries.
- This study identifies key factors contributing to undernutrition in children under five in North Africa.
Approach:
- A systematic meta-analysis of 14 observational studies published after 2006 was conducted.
- Data were pooled using random-effects models and STATA 17 software to determine odds ratios for associated factors.
Key Points:
- Uneducated mothers were the most significant factor associated with undernutrition.
- Children aged 0-23 months, rural residency, and lower wealth index increased odds of stunting and wasting.
- Low maternal nutritional health, uneducated fathers, and low birth weight were also linked to stunting.
Conclusions:
- A multidisciplinary approach is essential for addressing undernutrition in North Africa.
- Prioritizing mothers and young children, particularly in underprivileged areas, is crucial for effective interventions.
Background:
Undernutrition remains a major public health issue in low- and middle-income countries. Objective Our aim for this study was to identify the factors contributing to undernutrition in children under five years old in North Africa.
Methods:
We searched five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest, and CINAHL) for eligible observational studies published after 2006. STATA version 17 software was used to calculate the odds ratios between associated factors and indicators of undernutrition, with 95% confidence intervals. For each factor, the overall odds were pooled using a forest plot. Due to the significant heterogeneity among the studies (I2 > 50%), a random-effects model was used, and sensitivity analysis was conducted to examine the effect of outliers.
Results:
Out of 1093 initially identified studies, 14 met the selection criteria. Our meta-analysis revealed that uneducated mothers were the most common factor associated with undernutrition in North African children. Children aged 0-23 months were significantly associated with stunting (odds ratios (OR) = 1.27; 95% CI: 1.18; 1.37) and wasting (OR = 1.68; 95% CI: 1.42; 1.99). Children living in rural areas were also at higher odds of being stunted (OR = 1.74; 95% CI: 1.64; 1.84) and underweight (OR = 1.59; 95% CI: 1.35; 1.88). These analyses also indicated that a lower wealth index, mothers' nutritional health, uneducated fathers, and low birth weight were other factors significantly associated with stunting.
Conclusion:
Addressing undernutrition in Northern Africa requires a multidisciplinary approach prioritising mothers and young children, especially families in underprivileged areas.
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