Abstract
Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study was to systematically review studies to determine the factors associated with stunting, wasting and underweight in SSA and contribute to the existing body of evidence needed for the formulation of effective interventions. Methods: This systematic review was conducted using the 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Five computerized bibliographic databases were searched: Scopus, PubMed, PsycINFO, CINAHL and Embase. The included studies were rated using eight quality-appraisal criteria derived from the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist: sample size, sampling methodology, response rate, outcome measures, statistical analyses, control for confounding, study limitation, and ethical consideration. Results: Of a total of 2810 articles retrieved from the five databases, 49 studies met our inclusion criteria. The most consistent factors associated with childhood stunting, wasting and underweight in SSA were: low mother’s education, increasing child’s age, sex of child (male), wealth index/SES (poor household), prolonged duration of breastfeeding (>12 months), low birth weight, mother’s age (<20 years), source of drinking water (unimproved), low mother’s BMI (<18.5), birth size (small), diarrhoeal episode, low father’s education and place of residence (rural). Conclusions: The factors that predispose a child to undernutrition are multisectoral. To yield a sustainable improvement in child nutrition in SSA, a holistic multi-strategy community-based approach is needed that targets the factors associated with undernutrition, thereby setting the region on the path to achieving the WHO global nutrition target by 2025.
Highlights
Child undernutrition is a major public health problem
Three anthropometric indicators were retained for this systematic review: stunting, wasting and underweight
Underweight (Weight-for-age) is a composite index of height-for-age and weight-for-height. It takes into account both acute malnutrition and chronic malnutrition, but it does not distinguish between the two
Summary
Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). 1000 days post-conception is detrimental to the cognitive and physical health of the child as this is the crucial period for proper brain development and linear growth [3]. Undernutrition has both short- and long-term consequences for the health of children, and adversely affects the economic productivity of nations [4]. It is associated with lower educational performance, cognitive deficits. Public Health 2017, 14, 863; doi:10.3390/ijerph14080863 www.mdpi.com/journal/ijerph
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