Risk factors of child malnutrition under 5 years: Evidence from Pakistan using the Composite Index of Anthropometric Failure

Objectives: Child malnutrition is a very serious health issue globally, particularly in emerging countries. Among South Asian countries, Pakistan has been observed to have a high prevalence of child malnutrition. In spite of the implementation of many health strategies and preventive measures for vulnerable populations, this issue is still unresolved and needs further investigation. The purpose of this study was to investigate the role of various social-, maternal-, and child-level factors considered to be responsible for nutritional health disparities among children. Methods: An assessment method of malnutrition, i.e., Composite Index of Anthropometric Failure (CIAF), was used to detect the prevalence of malnutrition among children under 5 years of age in Pakistan in order to present a comprehensive view that was lacking conventional indices of malnutrition. A binary logistic regression model was fitted to assess the link between malnutrition and socioeconomic, maternal, and child attributes based on CIAF data compiled from weight-for-height, weight-for-age, and height-for-age Z-scores using data from the Pakistan Demographic Health Survey (2017-2018). Results: A total of 4224 children under 5 years of age were included in the analysis. Approximately half of the children (45.34%) comprised anthropometric failures for the overall prevalence of undernutrition based on CIAF. The results of this study revealed that the leading determinant associated with CIAF was the child's age in months, small birth size, lack of breastfeeding, lack of maternal education, poor economic status of the household, and poor-quality water sources. The factors associated with stunting comprised the child's age in months, small child birth size, underweight maternal body mass index, and uneducated mothers. Only one factor-low household economic profile-was significantly associated with waste. Sindh, Baluchistan, and Khyber Pakhtunkhwa provinces had a higher risk of having wasted children. On the other hand, children aged 25-36 months had higher, small child birth size, underweight maternal BMI, un-educated mother, uneducated father, low economic profile of household experiencing of being underweight. Conclusions: The findings of this study reinforce the significance of maternal health, parental education, and household economic profile in the prevention of malnutrition within young children of adequate birth size, as well as better overall health care up to adolescence in Pakistan. Well-nourished individuals are a valuable human resource and a requirement for a nation's progress and prosperity. In emerging nations such evidence-based policies are crucial for fostering children's optimal physical and mental development to ensure a healthier future generation. Therefore, the execution of national health policies aimed at the improvement of maternal and societal factors could result in improved nutrition levels among children below 5 years of age in Pakistan. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.