Abstract
Objective: To identify the demographic, social, and economic determinants of malnutrition in Kenya's children aged 0-23 months.
 Methods: Data from the Kenya Demographic and Health Survey (KDHS), a nationally representative cross-sectional study conducted in 2014/2015, were used in this study. Data from children 0-23 months old with complete information on weight, height, age, and sex were used for analysis. Height for Age Z scores (HAZ), Weight for Height Z scores (WHZ), and BMI for age Z scores (BAZ) was determined using WHO guidelines to determine the nutritional status of the children. Chi-square statistics were used to determine the relationship between social-economic status and place of residence indicators and the nutritional status of the children. Significance was set at p <0.05.
 Results: Among all participating (n=7578), 22.7% were stunted (HAZ < -2), 6.2% were wasted (WHZ < -2), and 6.1% were either overweight or obese (BAZ > 2). Wasting and stunting were significantly higher in children from rural areas, poorer wealth index, and mothers with no education. In contrast, children from urban areas, the richest wealth index category, and mothers with secondary or higher education were significantly more likely to be overweight or obese.
 Conclusion: Current and future policies and programs to curb malnutrition in Kenya need to target specific needs of children based on their social-economic status, area of residence, and other demographic characteristics that were identified as determinants of child malnutrition instead of using a general approach.
Highlights
Childhood malnutrition is linked to several developmental and health-related challenges
Kenya Demographic and Health Survey (KDHS) is a nationally representative crosssectional survey conducted every 5 years to determine the health and demographic characteristics of the population [10]. This survey utilized a cluster multistage sampling method where the primary sampling units were clusters drawn from the NASSEP V (Fifth National Sample Survey and Evaluation Program) master sampling frame. This sampling frame contained 5360 clusters drawn by stratified probability sampling methodology from 96,251 enumeration areas (EAs) in the 2009 Kenya Population and Housing Census. 1612 clusters were selected in the first stage, with 995 and 617 being rural and urban, respectively
It was found that children (023 months old) from rural residences and households with lower social-economic status were more likely to be undernourished than their counterparts from urban residences and higher social, economic status households
Summary
Childhood malnutrition is linked to several developmental and health-related challenges. Stunting in early childhood is associated with poor physical and mental development, increased susceptibility to infections, increased morbidity and mortality, and increased risk of overweight and obesity in adulthood [1]. Malnutrition during the first 1000 days of life - the period from conception to 2 years - is very critical as this period is considered the most important for neurological development [3]. Several studies in developed countries have shown that poor nutrition in the first 1000 days is associated with obesity and its comorbidities in later life [4, 5]. The determinants of childhood malnutrition are multifaceted and are influenced by individual, household, and community factors. The United Nations Child Education Fund (UNICEF) proposed a framework in 1990 that grouped the determinants of childhood malnutrition into 3 levels, a) immediate causes, b)
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