Overnutrition and associated factors among women of reproductive age in Sub-Saharan Africa: A hierarchical analysis of 2019-2023 standard demographic and health survey data

Objectives: Overnutrition, a leading cause of global mortality, has seen a significant rise in low- and middleincome countries, including sub-Saharan Africa. Despite emerging evidence linking overnutrition to noncommunicable diseases, limited action has been taken to address this issue. While undernutrition studies have received more attention, research on overnutrition and women's health remains scarce in sub-Saharan Africa. Our study aims to assess the prevalence and associated factors of overnutrition among reproductive women in this region Methods: We conducted a secondary analysis of 2019-2023 Demographic and Health Survey datasets in subSaharan Africa. Our study included a weighted sample of 65,161 women aged 15-49 y. Using a multilevel mixed-effects logistic regression model, we identified factors associated with overnutrition. The adjusted odds ratio, along with a 95% confidence interval and a significance level of p < 0.05, determined the statistical significance of the explanatory variables. Results: The pooled prevalence of overnutrition among women of reproductive age in sub-Saharan Africa was 34.79% (95% CI: 34.42-35.16). Specifically, the prevalence of overweight and obesity was 21.81% and 12.99%, respectively. Women's educational status, age, media use, household wealth, urbanization, community poverty, and country income level were significantly associated with higher odds of overnutrition. Conclusions: The prevalence of overnutrition among women of reproductive age in sub-Saharan Africa is relatively high. Key factors associated with this issue include women's educational status, age, media utilization, household wealth, place of residence, community poverty level, and national income status. These multilevel determinants highlight the need for a comprehensive, evidence-based approach to address overnutrition in this population. Effective strategies should target individual behaviors while considering broader social, economic, and environmental contexts. Integrating overnutrition prevention into maternal and reproductive health services, as well as strengthening social protection measures, are recommended steps to tackle this growing challenge in sub-Saharan Africa . (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)