Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 1;14(8):863.
doi: 10.3390/ijerph14080863.

Stunting, Wasting and Underweight in Sub-Saharan Africa: A Systematic Review

Blessing J Akombi  1 , Kingsley E Agho  2 , John J Hall  3 , Nidhi Wali  4 , Andre M N Renzaho  5 , Dafna Merom  6
Affiliations

Stunting, Wasting and Underweight in Sub-Saharan Africa: A Systematic Review

Blessing J Akombi et al. Int J Environ Res Public Health. .

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.

Keywords: malnutrition; public health; stunting; sub-Saharan Africa; systematic review; undernutrition; underweight; wasting.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for study selection based on PRISMA 2015 guidelines.
See this image and copyright information in PMC

References

    1. United Nations International Children’s Fund. World Health Organization. The World Bank . 2011 Joint Child Malnutrition Estimates-Levels and Trends. World Health Organization; Geneva, Switzerland: 2014.
    1. United Nations International Children’s Fund . State of the World’s Children Statistical Report. United Nations International Children’s Fund; New York, NY, USA: 2015.
    1. Onis M., Dewey K.G., Borghi E., Onyango A.W., Blössner M., Daelmans B., Piwoz E., Branca F. The World Health Organization’s global target for reducing childhood stunting by 2025: Rationale and proposed actions. Matern. Child Nutr. 2013;9:6–26. doi: 10.1111/mcn.12075. - DOI - PMC - PubMed
    1. Franke R.H., Barrett G.V. The economic implications of malnutrition: Comment. Econ. Dev. Cult. Chang. 1975;23:341–350. doi: 10.1086/450793. - DOI
    1. Stewart C.P., Lannotti L., Dewey K.G., Michaelsen K.F., Onyango A.W. Contextualising complementary feeding in a broader framework for stunting prevention. Matern. Child Nutr. 2013;9:27–45. doi: 10.1111/mcn.12088. - DOI - PMC - PubMed

Publication types