Factors Associated With Childhood Undernutrition in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Undernutrition increases the risk of morbidity and mortality, making it essential to identify and address its key determinants. This systematic review and meta-analysis examines the impact of selected child-related, household and hygiene, and sanitation factors on the nutritional status of infants and young children aged 0–59 months in Sub-Saharan Africa. We conducted a comprehensive search of online databases using defined Medical Subject Headings and keyword search terms. Nutritional status was assessed using the WHO child growth Standards Z-scores for stunting, underweight and wasting. A meta-analysis was performed to estimate pooled associations, and heterogeneity was assessed using the Cochrane Q and I2 statistic. Sensitivity analyses were conducted, and publication bias was evaluated. Out of 1, 992 articles identified, 49 studies met the inclusion criteria. Our findings indicated that diarrhoea was associated with 77% increased risk of overall undernutrition (odds ratio (OR) = 1.77; confidence interval [Cl] = 1.52, 2.06), and 92% increased risk of wasting (OR = 1.92; 95% Cl = 1.48, 2.48). Low birthweight was linked to a two-fold increased risk of stunting (OR = 2.35; 95% Cl = 1.84, 3.00), while low maternal education was associated with a higher risk of underweight (OR = 1.55; 95% Cl = 1.17, 2.04). These findings highlight the need for targeted interventions to reduce childhood undernutrition in the region.