Prevalence and determinants of malnutrition among under-five children in Talata Mafara, Zamfara State, Nigeria: A cross-sectional study

Abstract

Malnutrition remains a major public health issue in Nigeria, particularly in the northern regions where socio-economic and healthcare barriers persist. This study assessed the burden and determinants of malnutrition among under-five children in Talata Mafara Local Government Area, Zamfara State. A community-based cross-sectional study was conducted between March and June 2024 among 200 caregiver – child pairs, selected through multistage sampling. Data were collected using structured questionnaires on socio-demographic characteristics, feeding practices, and healthcare access. Anthropometric indices were measured following WHO standards. Data were analyzed using SPSS version 25, with chi-square tests and multivariable logistic regression applied at a 95% confidence level. Overall, 40% (95% CI: 33.1 – 46.9) of children were underweight, 45% (95% CI: 38.0 – 52.0) stunted, and 30% (95% CI: 23.6 – 36.4) wasted. Malnutrition was significantly associated with caregiver education (p=0.001), household size (p=0.015), socio-economic status (p<0.001), feeding practices (p=0.002), and healthcare access (p=0.045). In adjusted analysis, children from low-income households (OR=3.4, 95% CI: 1.9 – 6.0), large households (OR=2.8, 95% CI: 1.4 – 5.3), with inadequate feeding (OR=3.1, 95% CI: 1.6 – 5.9), and poor healthcare access (OR=2.1, 95% CI: 1.0 – 4.3) were at higher risk. Malnutrition among under-five children in Talata Mafara is driven by poverty, low maternal education, and weak healthcare access. Targeted interventions should strengthen maternal nutrition education, promote household economic empowerment, expand community-based nutrition programs, and improve primary healthcare services. Further research is recommended to explore cultural practices influencing child feeding.