Coexisting burden of maternal and child undernutrition in Ethiopia: a systematic review and meta-analysis

Maternal and child undernutrition is one of the contemporary pervasive and pressing public health crises in developing country, like Ethiopia. It perpetuates a devastating intergenerational cycle that adversely impacts health, cognitive development, and socioeconomic well-being.

This systematic review analyzed maternal and child undernutrition in Ethiopia from 2015 to 2025. Studies were identified through PubMed, Scopus, Web of Science, and Google Scholar using predefined inclusion criteria. Methodological quality was assessed using the Newcastle-Ottawa Scale, and a random-effects meta-analysis was conducted to estimate prevalence and regional variations.

According to meta-analysis result, maternal undernutrition was 29%, which exceeding national estimates. Among children under-five, stunting stands at 35%, wasting at 14%, and underweight at 24%, with marked disparities across regions. Subgroup analysis identified Tigray, Afar, Amhara, and Somali regions had the highest under-five undernutrition. Stunting was highest in Tigray (40%) and Amhara (38%), wasting in Somali (21%) and Afar (18%), and underweight in Afar (34%) and Tigray (30%). The review categorizes the most key drivers of undernutrition, including inadequate dietary intake, recurrent infections, food insecurity, suboptimal child feeding practices, and insufficient access to healthcare services, further exacerbated by poverty, low maternal education, and inadequate water, sanitation, and hygiene (WASH) conditions.

Multiple interconnected factors contribute to the high prevalences of maternal and child undernutrition in Ethiopia. This urgently calls for comprehensive, multi-sectorial intervention of undernutrition. Addressing these challenges is imperative to achieve Ethiopia's progress toward its national health and national development goals.