Key Determinants of Nutritional Status Among Children Under Five in Uganda: Insights from the 2016 Demographic and Health Survey

Background: Despite concerted efforts by the Ugandan government to combat child malnutrition, it remains a persistent and significant public health challenge. The persistence of child malnutrition in Uganda is attributed to deep-rooted factors which have not been adequately examined. Using data from the 2016 Uganda Demographic and Health Survey (UDHS), this study analyzes the determinants of nutritional status among children under five, focusing on stunting, wasting, and underweight as key indicators. Methods: This study focused on 4324 children under five. The UDHS dataset used in this study was the Kids Recode file. Stunting, wasting and underweight were the dependent variables whose z-scores, where categorized based on WHO growth standards. The independent variables extracted included characteristics of the child, mother and household. Descriptive analysis was performed to generate summarized statistics, while inferential statistics by way of bivariate analysis were performed to assess the association between the outcome and the independent variables using the chi-square test, and multivariable logistic regression modelling to determine the magnitude of the associations after controlling for other covariates. All analyses considered the survey sampling design and sampling weights, and were conducted in Stata version 18. Results : Children whose mothers attained a university level education had 330% higher odds of being stunted. Children whose mothers were Anglican had 160% higher odds of being underweight. Children who were given fortified baby food had higher odds (15.6 times) of being stunted. The odds of children being underweight increased by 350% if they resided in North Buganda. Children whose households had refrigerators, had higher odds (4.0 times) of being underweight. The odds of children being wasted reduced between 40% and 60% if they were fed with eggs, potatoes, cassava, or other tubers. Conclusions : The results highlight areas of intervention that can reduce child malnutrition in Uganda and these include: promoting family-friendly policies, such as maternity leave and breastfeeding support in workplaces; caregivers should be educated on how to properly use fortified baby foods as part of a balanced diet; nutrition programs should promote the inclusion of eggs, tubers, as part of a balanced diet.