CHILDHOOD UNDERNUTRITION AND ITS DETERMINANTS AMONG UNDER-FIVE CHILDREN IN NIGERIA

Background and objectives: Child undernutrition continues to be a public health problem in Nigeria. Because few studies indicate the determinants of malnutrition among under-5s re-analysis of nationally representative data could help inform programme planning to meet the national target to reduce stunting and wasting by 20% and 10%, respectively by 2018. This study aimed to find determinants of stunting and wasting among 0-59 months old children in Nigeria. Methods: A secondary data analysis of the 2011 Nigeria Multiple Indicator Cluster Survey (MICS) including all 25,192 children aged 0-59 months old surveyed. The prevalence of stunting was defined as height-for-age ≤-2SD and wasting as weight-forheight ≤-2SD of the WHO Growth Reference Standards . The UNICEF conceptual framework of malnutrition was used to build the logistic regression models, following chi-square tests on the MICS measures of the immediate, underlying or basic causes of undernutrition. Results: The study confirmed that 35.8% and 10.2% of the children were stunted and wasted, respectively. Girls (12%, 15%), children who were no longer being breastfed (20%, 47%), absence of recent episodes of fever (12%, 21%), increase in maternal age (22-35%, 4-30% ) and in duration of maternal education (14- 36%, 13-18%) and households with higher wealth index (2-63%, 4-27%) were all at reduced risks of stunting and wasting. However, non-Christian children (47-48%, 18-49%) and children residing in the Northern Nigeria (55-64%, 11-39%) had increased risks of stunting and wasting. Children with no birth certificate had increased (23-28%), absence of diarrhoea episodes (15%) and household animals (19%) were associated with a reduced risk of stunting. Households with fewer toddlers (=2 under-5s) and =36 months-old were associated with a reduced risk of wasting. Conclusions: Interventions to reduce child undernutrition should target children =36 months-old. They should also include strengthening of the Maternal and Child health system and health workers, improving the educational level of women especially in the Northern Nigeria and financial empowerment of women. Every State of the Federation should also develop a costed plan of action on nutrition to tackle the problem in their states.