Factors influencing different forms of malnutrition in children under 5 in Zimbabwe: An urgent need to address inequalities in access to healthcare, food security, and sanitation

Background Nutritional problems remain a major public health concern among children under 5, leading to significant morbidity and mortality. Objectives This study aimed to determine the factors associated with being underweight, stunted, wasted and overweight in this age group in Zimbabwe using data from the 2019 Multiple Indicators Cluster Survey. Methods A cross-sectional analysis of 6102 children under 5 was conducted. Anthropometric measurements were used to identify underweight, stunting, and wasting, while overweight was defined as exceeding the WHO growth standards. Associations between nutritional status and sociodemographic, environmental, and health-related factors were assessed using multivariable logistic regression analysis Results Age was significantly associated with being underweight with children 1 year old having the highest prevalence (13%), p = 0.001 when compared to other age groups. Children living in rural areas had a significantly higher prevalence of being underweight than those living in urban areas, 10% versus 8%, OR (95%CI) 1.41 (1.12–1.77), p = 0.003. Children with a recent episode of diarrhoea had a higher prevalence of being underweight than those who did not have a diarrhoea episode, 12% versus 9%, p = 0.011. Children with no health insurance coverage had a significantly higher prevalence of being underweight than those who had health insurance coverage, 10% versus 4%, OR (95%CI) 2.96 (1.44–6.11), p = 0.003. Age was significantly associated with being stunted with children 2 years old having the highest prevalence (13%), p = 0.001, when compared to other age groups. Males were more likely to be stunted compared to females, 26% versus 20%, OR (95%CI) 1.42 (1.24–1.62), p = 0.001. Children living in rural areas had a significantly higher prevalence of being stunted than those living in urban areas, 25% versus 18%, OR (95%CI) 1.51 (1.30–1.76), p = 0.001. Significant differences in being overweight were noted for children's age, mother’s education level and having a vaccination card. Conclusion This study highlights the complex interplay of factors influencing different forms of malnutrition in children under 5 in Zimbabwe. Addressing inequalities in access to healthcare, food security, and sanitation, along with promoting early childhood development programs, appears crucial in tackling this multifaceted challenge.