Multidimensional analysis of nutritional status among children under 5 years in Africa, 1990-2024

The first five years of life are critical for growth and development, with nutritional status directly impacting lifelong health and population quality. Africa, characterized by a fragile nutritional foundation, remains a priority region for global health surveillance by the World Health Organization (WHO). This study aimed to analyze five key nutritional indicators among children under five in Africa from 1990 to 2024, utilizing data from the WHO Global Health Observatory (GHO) 2024 dataset. This study employed the 2024 dataset from GHO, which contains data on the nutritional status of children under 5 years of age across 46 African countries spanning 1990 to 2024. In accordance with the 2025 income classification criteria of the World Bank (WB), three representative countries were selected: Algeria (high-income), Senegal (middle-income), and Niger (low-income). Stratified analyses were conducted across the three countries according to gender, educational attainment, and residential residence. Statistical approaches including paired design and randomized block design were applied to examine inter-group differences in childhood nutritional status within each country. From 1990 to 2024, the rates of stunting, underweight, wasting and severe wasting declined to varying degrees among children under 5 years in Africa, while the prevalence of overweight increased slightly. In Algeria, the prevalence of wasting and overweight was higher among children aged 0-1 years. Higher stunting rates were observed in rural areas and among boys. The underweight rate was higher in the low-income group, whereas the overweight rate was higher in the high-income group. Children of mothers with no formal education exhibited higher rates of stunting and underweight. In Senegal, stunting and underweight were more prevalent among children aged 2-5 years, while wasting and severe wasting were higher in the 0-1 years age group. Higher malnutrition prevalence was found in rural residents, boys, the low-income population, and children of mothers with primary education. By contrast, overweight was more common among children aged 2-5 years, urban residents, the high-income population, and children of mothers with secondary or higher education. In Niger, the stunting rate was higher in the 2-5 years age group, and the rates of wasting, severe wasting and overweight were elevated among children aged 0-1 years. Rural residents and boys had a higher burden of malnutrition. Children of mothers with primary education showed higher prevalence of stunting and wasting. The nutritional status of children under 5 years of age in Africa has improved overall, though the progress varies across countries at different income levels. Socioeconomic factors exert heterogeneous effects on different nutritional indicators within the same country. Targeted intervention measures should therefore be formulated tailored to the national context of each country.