Socio-economic and demographic determinants of undernutrition among 6-59 months old children living in Malawian stunting hotspots: a cross-sectional community study

BackgroundMalnutrition is a global burden, with 171 million under-five children stunted and 45% of child deaths linked to it. Despite high undernutrition such as stunting in Mchinji, Mangochi, and Mzimba, no study has focused on all three hot spots. This study examined socio-economic and demographic determinants of undernutrition among children aged 6-59 months, offering insights to guide targeted interventions in these areas.MethodsThis cross-sectional study of 1,275 caregiver-child pairs from Mzimba, Mchinji, and Mangochi used multi-stage sampling. Data were analyzed with Stata 17.0, employing descriptive statistics and binary logistic regression to explore associations and identify determinants of malnutrition in children aged 6-59 months based on WHO Z-scores.ResultsThe study identified socio-demographic factors influencing wasting, underweight, and stunting among children aged 6-59 months. Wasting was linked to occupation, marital status, household size, religious affiliation, and vaccination, with protective factors including farming (AOR = 0.023), business (AOR = 0.001), being single (AOR = 0.034), and full vaccination (AOR = 0.146), while Muslim affiliation increased odds (AOR = 71.284). Underweight was associated with occupation and household type, with higher risks in business (AOR = 9.408) and single-parent households (AOR = 20.929) but protection in smaller households (AOR = 0.596). Stunting was related to unemployment (AOR = 2.339) and full vaccination (AOR = 1.472). Education and income showed no significant association with stunting.ConclusionSocio-demographic factors significantly influenced wasting, underweight, and stunting in children, highlighting the need for targeted interventions on livelihoods, vaccination, and household conditions to reduce undernutrition and inform policy and program development.