The Prevalence and Determinants of Undernutrition Among Infants and Children Aged 6 Months to 5 Years in Sub-Saharan African Countries: A Systematic Scoping Review

Objective: To explore the prevalence and determinants of undernutrition among infants and children aged 6 months to 5 years in sub-Saharan African countries. Background: Despite substantial progress over the past 20 years, undernutrition has remained an alarming global challenge. Sub-Saharan Africa is the only region where the prevalence of stunting in children younger than 5 years has significantly increased. This study seeks to update the evidence on the prevalence and determinants of childhood undernutrition in this vulnerable region. Methods: This systematic scoping review was conducted following the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Five electronic databases were searched on December 14, 2022, with no date or language restrictions. Primary studies presenting evidence on the prevalence and determinants of childhood undernutrition among infants and children aged 6 months to 5 years were included. Data on the prevalence of stunting, wasting, and underweight, and on determinants of undernutrition were extracted, described, and compared with national survey data. Results: A total of 59 publications from 11 countries were included, with most studies conducted in Ethiopia (n = 38) and Tanzania (n = 7). Stunting prevalence ranged from 8% to 64%, wasting prevalence ranged from 1% to 58%, and the prevalence of underweight ranged from 2% to 63%. The most frequently reported determinants of undernutrition were the child's age (>24 months), male sex, maternal illiteracy, diarrhea or illness in the past 2 weeks, low household socioeconomic status, or living in a larger household (n > 4 members). Overall, 56% of the included studies reported higher stunting prevalence, 60% reported higher wasting prevalence, and 57% reported a higher prevalence of underweight than reported by relevant national surveys. Conclusion: The prevalence of childhood undernutrition reported by primary studies is often higher than that reported by national surveys. Several immediate and underlying determinants influence childhood undernutrition. Future research should incorporate the findings from primary research to develop holistic, multistrategy approaches to address childhood undernutrition in sub-Saharan African countries.