Prevalence and Factors Associated with the Triple Burden of Malnutrition among Mother-Child Pairs in Sub-Saharan Africa

Abstract

Despite concerns about the coexistence of overnutrition, undernutrition and micronutrient deficiencies, which is compositely referred to as the triple burden of malnutrition (TBM), little is known about the phenomenon in sub-Saharan Africa (SSA). We, therefore, aimed to examine the prevalence and investigate the factors associated with TBM in SSA. This study uses cross-sectional survey data collected through the Demographic and Health Surveys (DHS) Program from 2010 to 2019. Data from 32 countries in SSA were used for the analysis. The prevalence of TBM were presented in tables and maps using percentages. The predictors of TBM were examined by fitting a negative log-log regression to the data. The results were then presented using adjusted odds ratios (aORs) at 95% Confidence Intervals (CIs). Out of the 169,394 children, 734 (1%) suffered from TBM. The highest proportion of children with TBM in the four geographic regions in SSA was found in western Africa (0.75%) and the lowest in central Africa (0.21%). Children aged 1 [aOR = 1.283; 95% CI = 1.215–1.355] and those aged 2 [aOR = 1.133; 95% CI = 1.067–1.204] were more likely to experience TBM compared to those aged 0. TBM was less likely to occur among female children compared to males [aOR = 0.859; 95% CI = 0.824–0.896]. Children whose perceived size at birth was average [aOR = 1.133; 95% CI = 1.076–1.193] and smaller than average [aOR = 1.278; 95% CI = 1.204–1.356] were more likely to suffer from TBM compared to those who were larger than average at birth. Children born to mothers with primary [aOR = 0.922; 95% CI = 0.865–0.984] and secondary [aOR = 0.829; 95% CI = 0.777–0.885] education were less likely to suffer from TBM compared to those born to mothers with no formal education. Children born to mothers who attended antenatal care (ANC) had lower odds of experiencing TBM compared to those born to mothers who did not attend ANC [aOR = 0.969; 95% CI = 0.887–0.998]. Children born to mothers who use clean household cooking fuel were less likely to experience TBM compared to children born to mothers who use unclean household cooking fuel [aOR = 0.724; 95% CI = 0.612–0.857]. Essentially, higher maternal education, ANC attendance and use of clean cooking fuel were protective factors against TBM, whereas higher child age, low size at birth and being a male child increased the risk of TBM. Given the regional variations in the prevalence and risk of TBM, region-specific interventions must be initiated to ensure the likelihood of those interventions being successful at reducing the risk of TBM. Countries in Western Africa in particular would have to strengthen their current policies and programmes on malnutrition to enhance their attainment of the SDGs.

Association between maternal stature and household-level double burden of malnutrition: findings from a comprehensive analysis of Ethiopian Demographic and Health Survey

“…Although research is limited, sub-Saharan Africa has also been experiencing high levels of DBM in recent years [7,[18][19][20]. Earlier estimates on DBM in sub-Saharan Africa reported below 10% prevalence at the household level [21].…”

Exploring the risk factors of child malnutrition in Sub-Sahara Africa: A scoping review

“…For example, in the DRC, stunting was lower in Kinshasa, Orientale and Equateur provinces as compared to the Northeastern part of the nation that were affected by conflict and the provinces that heavily relied on local mineral mining (Kandala et al, 2011). Children living in rural areas were found to be more stunted than their counterpart in urban areas (Ahinkorah et al, 2021; Kandala et al, 2011).…”

“…Maternal education is one of the factors that determine child malnutrition (Ahinkorah et al, 2021; Endris et al, 2017; Mzumara et al, 2018). In the study of malnutrition among children under the age of five in the Democratic Republic of Congo (DRC), it was determined that children with more educated mothers were less likely to suffer from malnutrition than children with less educated mothers (Kandala et al, 2011).…”

“…Additionally, children whose mothers attended antenatal sessions were at a lesser risk of malnutrition as compared to those whose mothers did not attend (Adeyemi et al, 2019; Ahinkorah et al, 2021). Thus, it is supposed that education has the potential to improve nutritional practices (Endris et al, 2017; Kandala et al, 2011).…”

“…In Congo, it was observed that groups of people who lacked food security and those that denied their children certain foods due to cultural beliefs recorded high cases of malnutrition (Kandala et al, 2011). It was also observed that lack of safe drinking water was a risk factor for malnutrition (Ahinkorah et al, 2021; Kandala et al, 2011; Mzumara et al, 2018). For example, in the DRC malnutrition was prevalent where more than two thirds of the population had no access to drinking water (Kandala et al, 2011).…”