The Prevalence and Determinants of Undernutrition Among Infants and Children Aged 6 Months to 5 Years in Sub-Saharan African Countries: A Systematic Scoping Review
Francis P Riwa1, Kate Odgers-Jewell1, Mark A Jones2
1Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4229, Australia.
Insights
Childhood undernutrition in sub-Saharan Africa is prevalent, with primary studies often reporting higher rates than national surveys. Key determinants include child
Area of Science:
- Global Health
- Pediatrics
- Nutrition Science
Background:
- Undernutrition remains a critical global health issue, particularly in sub-Saharan Africa (SSA).
- SSA is the only region experiencing a rise in stunting among children under five.
- This study addresses the urgent need for updated evidence on childhood undernutrition in SSA.
Purpose of the Study:
- To determine the prevalence of undernutrition (stunting, wasting, underweight) in children aged 6 months to 5 years in SSA.
- To identify the key determinants contributing to childhood undernutrition in the region.
Main Methods:
- A systematic scoping review was performed adhering to PRISMA guidelines.
- Searched five databases (December 14, 2022) without date or language restrictions.
- Included primary studies on undernutrition prevalence and determinants, comparing findings with national data.
Main Results:
- 59 publications from 11 SSA countries were analyzed, with a focus on Ethiopia and Tanzania.
- Prevalence rates varied: stunting (8-64%), wasting (1-58%), underweight (2-63%).
- Common determinants included child's age, male sex, maternal illiteracy, recent illness, low socioeconomic status, and larger household size.
Conclusions:
- Primary research indicates higher undernutrition prevalence than national surveys in SSA.
- Childhood undernutrition is influenced by multiple immediate and underlying factors.
- Future strategies must be holistic and multi-pronged, integrating primary research findings.
Objective:
To explore the prevalence and determinants of undernutrition among infants and children aged 6 months to 5 years in sub-Saharan African countries.
Background:
Despite substantial progress over the past 20 years, undernutrition has remained an alarming global challenge. Sub-Saharan Africa is the only region where the prevalence of stunting in children younger than 5 years has significantly increased. This study seeks to update the evidence on the prevalence and determinants of childhood undernutrition in this vulnerable region.
Methods:
This systematic scoping review was conducted following the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Five electronic databases were searched on December 14, 2022, with no date or language restrictions. Primary studies presenting evidence on the prevalence and determinants of childhood undernutrition among infants and children aged 6 months to 5 years were included. Data on the prevalence of stunting, wasting, and underweight, and on determinants of undernutrition were extracted, described, and compared with national survey data.
Results:
A total of 59 publications from 11 countries were included, with most studies conducted in Ethiopia (n = 38) and Tanzania (n = 7). Stunting prevalence ranged from 8% to 64%, wasting prevalence ranged from 1% to 58%, and the prevalence of underweight ranged from 2% to 63%. The most frequently reported determinants of undernutrition were the child's age (>24 months), male sex, maternal illiteracy, diarrhea or illness in the past 2 weeks, low household socioeconomic status, or living in a larger household (n > 4 members). Overall, 56% of the included studies reported higher stunting prevalence, 60% reported higher wasting prevalence, and 57% reported a higher prevalence of underweight than reported by relevant national surveys.
Conclusion:
The prevalence of childhood undernutrition reported by primary studies is often higher than that reported by national surveys. Several immediate and underlying determinants influence childhood undernutrition. Future research should incorporate the findings from primary research to develop holistic, multistrategy approaches to address childhood undernutrition in sub-Saharan African countries.
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