High-risk fertility behaviour and undernutrition among children under-five in sub-Saharan Africa: a cross-sectional study

ObjectiveThe study examined high-risk fertility behaviour and its association with under-five undernutrition in sub-Saharan Africa (SSA). DesignWe conducted a cross-sectional analysis of data from 32 sub-Saharan African countries' Demographic and Health Surveys. A weighted sample of 110 522 mother-child pairs was included in final analysis. Multilevel binary logistic regression was used to examine the association between high-risk fertility behaviour and undernutrition. The results were presented using adjusted odds ratio (aOR) with their respective 95% confidence intervals (CIs). SettingThirty-two countries in SSA. Outcome measureStunting, wasting, and underweight. ResultsThe pooled prevalence of stunting was 31.3%, ranging from 15.0% in Gabon to 51.7% in Burundi. Wasting was highest among children from Burkina Faso (19.1%) and lowest among those from South Africa (1.6%). The overall prevalence of wasting was 8.1%. The prevalence of underweight was 17.0%, with the highest among children in Niger (37.1%) and lowest in South Africa (4.8%). Mothers who gave birth at the age less than 18 years and those with short birth interval were more likely to have their children being stunted, wasted, and underweight. The odds of stunting and wasting were high among children born to women with high parity. However, maternal age at birth more than 34 was associated with lower odds of childhood underweight as against those with age at birth less than 34. ConclusionCountries in SSA are encouraged to address the issue of maternal age at birth less than 18, high parity, and shorter birth intervals in order to meet the Global Nutrition targets, which aim to achieve a 40% reduction in the number of stunted children under the age of 5 and to reduce and maintain childhood wasting to less than 5% by 2025.

Automated summary

This study examined the association between high-risk fertility behavior and under-five undernutrition in sub-Saharan Africa. The findings showed that early marriage, high parity, and short birth intervals were significantly associated with stunting, wasting, and underweight among children. In order to achieve the Global Nutrition targets, sub-Saharan African countries should address the issues of maternal age at birth less than 18, high parity, and shorter birth intervals.