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Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis
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BACKGROUND: Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0-23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria. METHODS: The sample included 24,529 children aged 0-59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz < -2SD) and severe stunting (HFAz < -3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria. RESULTS: The prevalence of stunting and severe stunting were 29% [95% Confidence interval (Cl): 27.4, 30.8] and 16.4% [95%Cl: 15.1, 17.8], respectively for children aged 0-23 months, and 36.7% [95%Cl: 35.1, 38.3] and 21% [95%Cl: 19.7, 22.4], respectively for children aged 0-59 months. Multivariate analysis revealed that the most consistent significant risk factors for stunting and severe stunting among children aged 0-23 months and 0-59 months are: sex of child (male), mother's perceived birth size (small and average), household wealth index (poor and poorest households), duration of breastfeeding (more than 12 months), geopolitical zone (North East, North West, North Central) and children who were reported to having had diarrhoea in the 2 weeks prior to the survey [Adjusted odds ratio (AOR) for stunted children 0-23 months = 1.22 (95%Cl: 0.99, 1.49)];[AOR for stunted children 0-59 months = 1.31 (95%Cl: 1.16, 1.49)], [AOR for severely stunted children 0-23 months = 1.31 (95%Cl: 1.03, 1.67)]; [AOR for severely stunted children 0-59 months = 1.58 (95%Cl: 1.38, 1.82)]. CONCLUSIONS: In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women's nutrition, child feeding practices and household sanitation.
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“Concretely, studies showed that maternal, or household access to clean water significantly reduced the risk of under-five mortality (Ahmed et al., 2016;Acheampong et al., 2017Acheampong et al., , 2018)), child stunting (Akombi et al., 2017;Vos et al., 2017;Marinda et al., 2018), schistosomiasis (Atalabi et al., 2016;Donohue et al., 2017), and hookworm infections (Baker et al., 2018).”
From A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health (2020) · cites this paper as Akombi et al., 2017
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Kalsum, U., Annisa, N., Abdullah, A. D., & Latif, A. R. (2022) · Ahmar Metastasis Health Journal · doi:10.53770/amhj.v2i3.152 · Cited by 3
Suwarni, L., Selviana, S., Vidyastuti, V., Abdullah, A., & Adi, P. (2023) · GHMJ (Global Health Management Journal) · doi:10.35898/ghmj-62965 · Cited by 3
Maulina, E. E. T., Alma, L. R., & Nurrochmah, S. (2021) · KnE Life Sciences · doi:10.18502/kls.v0i0.8872 · Cited by 3
Magnitude of Stunting and Its Determinants Among Under‐Five Children in Awi Zone, Northwest Ethiopia
Birhan, N. A., Getahun, K. T., Wolde, Z. M., Birhan, T. Y., & Astatkie, T. (2026) · Journal of Nutrition and Metabolism · doi:10.1155/jnme/5984957 · Cited by 2
Matovu, N., Kizito, N., & Aljohani, M. (2026) · Nutrition · doi:10.1016/j.nut.2026.113187 · Cited by 2
The Effects of Early Childhood Malnutrition on Neurodevelopment
Burch, E. (2022) · Nutritional neurosciences · doi:10.1007/978-981-16-9205-5_11 · Cited by 4
Ramadhani, N. I. (2023) · World Journal of Advanced Research and Reviews · doi:10.30574/wjarr.2023.18.3.1000 · Cited by 2
Obi, N. J., & Harris, J. K. (2023) · Journal of Maternal and Child Health · doi:10.26911/thejmch.2023.08.03.05 · Cited by 2
Mbae-Mugambi, U. K., Onyango, A. C., & Okeyo, D. O. (2023) · BMC Nutrition · doi:10.1186/s40795-023-00772-3 · Cited by 2
Featured Product "Mung Bean Agar" in Carangrejo Village to Reduce the Risk of Stunting
Wibowo, S. E., Nuraini, H., Syukroni, A., & Sarilah (2023) · Jurnal Inovasi dan Pengembangan Hasil Pengabdian Masyarakat · doi:10.61650/jip-dimas.v1i1.23 · Cited by 2
Maternal Complications during Pregnancy and Risk Factors for Stunting
Maulina, R., Qomaruddin, M. B., Prasetyo, B., & Indawati, R. (2024) · Iranian Journal of Nursing and Midwifery Research · doi:10.4103/ijnmr.ijnmr_358_22 · Cited by 2
Sahiledengle, B., Agho, K., Tekalegn, Y., Gomora, D., Atlaw, D., Zenbaba, D., Desta, F., Teferu, Z., Beressa, G., Mesfin, T., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0323332 · Cited by 2
Self-citationPutri, S. K., & Dari, D. W. (2023) · Jurnal Abdimas Kesehatan (JAK) · doi:10.36565/jak.v5i1.419 · Cited by 2
Lwiza, S. S. (2020) · Journal of Education, Humanities and Sciences (JEHS) · Cited by 2
Metadata
- Authors
- Akombi, B. J., Agho, K. E., Hall, J. J., Merom, D., Astell-Burt, T., & Renzaho, A. M. N.
- Affiliations
- Western Sydney University (AU)
- University of Newcastle Australia (AU)
- Venue
- BMC Pediatrics
- Published
- 2017-01-13
- Volume
- 17
- Issue
- 1
- Pages
- 15-15
- ISSN
- 1471-2431 (ISSN-L)
- PMC
- PMC5237247
- OpenAlex
- W2575304420
- Cited by
- 322
- References
- 37
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 51 · 2023: 73 · 2022: 56 · 2021: 44 · 2020: 37 · 2019: 21 · 2018: 7 · 2017: 6
- FWCI
- 16.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Pediatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion, cc-by)
- Research Online (University of Wollongong) (submittedVersion)
- Figshare (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Western Sydney University
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- child stunting, severe stunting, children under five, risk factors for stunting, breastfeeding duration, diarrhea, household wealth, sex of child, Nigeria, height-for-age z-score, first 1000 days, under-five malnutrition, geopolitical zones, multilevel analysis
- MeSH terms
- Child, Preschool, Cross-Sectional Studies, Female, Growth Disorders, Health Surveys, Humans, Infant, Infant, Newborn, Male, Nigeria, Risk Factors, Severity of Illness Index, Prevalence, Multivariate Analysis, Logistic Models
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