Trends in the Nutritional Status of Children Under 5 in Africa (1990–2024): A Multidimensional Analysis by Country Income Level

Background Children under the age of 5 are in a critical period for growth and development. Their nutritional status is directly related to an individual's lifelong health and the quality of the population in a country or region. The nutritional status in African regions is a global disaster area and one of the core areas of global health monitoring by the World Health Organization (WHO). Objective This study aims to analyze the changing trends in the nutritional status of children under 5 years old in the African region from 1990 to 2024, based on the 2024 data from the World Health Organization's Global Health Observatory (GHO) database. Methods This study uses data from the Global Health Observatory database in 2024 to conduct a retrospective analysis, covering the nutritional status of children under 5 years old in 46 countries in the African region from 1990 to 2024, and adopts descriptive statistics for the nutritional status. Based on the 2025 income level grouping by the World Bank (WB), three countries with different income levels, namely Algeria, Senegal, and Niger, were selected. Stratification was performed according to dimensions such as gender, education level, and place of residence, and two-way analysis of variance was used to compare whether there were differences in nutritional status across different dimensions and different years. Results In African regions, indicators such as stunting, underweight, wasting, and severe wasting have decreased to varying degrees, while overweight has increased slightly. In Algeria, there are significant differences in child nutrition indicators among different ages, places of residence, genders, economic statuses, and maternal education levels. The overweight rate among children aged 0–1 is high, and the problem of undernutrition is more prominent in groups such as males and those in poverty. In Senegal, various child nutrition indicators are significantly affected by multiple factors. Indicators such as overweight among children aged 0–1 are relatively high, and undernutrition indicators are higher in rural areas, among males, in poverty-stricken groups, and in groups where mothers have low educational levels. In Niger, child nutrition indicators are significantly affected by multiple factors. Undernutrition indicators are higher in rural areas, among males, and in groups where mothers have low educational levels, while economic status has no significant impact on various indicators. Conclusion The nutritional status of children under 5 in Africa has improved significantly, but the improvement varies across different regions and income levels. The nutritional transition shows differentiation, and socioeconomic factors have different impacts on various nutritional indicators. Therefore, targeted intervention measures need to be formulated based on different dimensions in different countries.