Climate variability, crop production, and child undernutrition: A mediation analysis from a drought-prone area in the rural Sidama Region, Ethiopia

Background Ethiopia is a predominantly agricultural community that relies on farming and animal husbandry for subsistence. It is vulnerable to the adverse effects of climate variability. However, the association between weather conditions and health has not been well studied. Therefore, the primary objective of this study was to assess the impact of climate variability on child acute malnutrition, mediated by crop production. Methods This study was part of a large, open, dynamic cohort study designed to examine the relationship between weather conditions, nutrition, and health. For this study, a cohort of 395 children was monitored quarterly from June 2023 to March 2024. Using a cohort study design, we established the temporal sequence in which the exposures occurred before the mediators and the outcome. A two-stage sampling method was employed to select households, and data were collected using a pre-tested, structured questionnaire. Structural equation modelling was employed to assess the direct, indirect, and total effects of a proxy for crop production on acute malnutrition. Results An increase in Normalised Difference Vegetation Index (NDVI) had a positive direct effect and an indirect impact on wasting via household food. Similarly, rainfall had a positive effect on the NDVI. Furthermore, children who initiated complementary feeding late and large families were at increased risk of wasting. However, children from wealthier families had less wasting. Conclusion Climate variability and crop production were risk factors for wasting, and this relationship is primarily mediated by household food insecurity. This finding could imply that rural communities depending on rain-fed subsistence agriculture exhibit vulnerability to the impacts of climate variability.