Seasonal variation of child under nutrition in Malawi: is seasonal food availability an important factor? Findings from a national level cross-sectional study

Background: Child under nutrition is an underlying factor in millions of under-five child deaths and poor cognitive development worldwide. Whilst many studies have examined the levels and factors associated with child under nutrition in different settings, very little has been written on the variation of child under nutrition across seasons. This study explored seasonal food availability and child morbidity as influences of child nutritional status in Malawi. Methods: The study used the 2004 Malawi Integrated Household Survey data. Graphical analysis of the variation of child under nutrition, child morbidity and food availability across the 12 months of the year was undertaken to display seasonal patterns over the year. Multivariate analysis was used to explore the importance of season after controlling for well-established factors that are known to influence a child's nutritional status. Results: A surprising finding is that children were less likely to be stunted and less likely to be underweight in the lean cropping season (September to February) compared to the post-harvest season (March to August). The odds ratio for stunting were 0.80 (0.72, 0.90) and the odds ratio for underweight were 0.77 (0.66, 0.90). The season when child under nutrition levels were high coincided with the period of high child morbidity in line with previous studies. Children that were ill in the two weeks prior to survey were more likely to be underweight compared to children that were not ill 1.18 (1.01, 1.38). Conclusion: In Malawi child nutritional status varies across seasons and follows a seasonal pattern of childhood illness but not that of household food availability.