Determinants of wasting, stunting, and undernutrition among children under five years: Cross-sectional study in southern Punjab, Pakistan

Background Malnutrition is a serious concern globally and may lead to early death if it remains untreated. Prevalence of malnutrition is high in South Asian countries. Therefore, this study aims to evaluate the determinants of wasting, stunting, and undernutrition in under-five children of southern Punjab, Pakistan.

Methods We conducted a cross-sectional study among 185 children. Anthropometric measures were done by nutritional experts and pediatricians. Data were analyzed with SPSS version 25.0. A p-value <0.05 was considered statistically significant.

Results Significant determinants of wasting (weight-for-height) were family monthly earnings (β=-0.14; 95% CI: -0.89 to -0.04; p=0.03) and complementary feeding practices (β=-0.21; 95% CI: -1.14 to 0.19; p<0.001). For stunting (length/height-for-age), the significant determinants were tuberculosis (TB) contact history (β=-0.15; 95% CI: -0.97 to -0.03; p=0.03) and non-use of exclusive breastfeeding practices (β=-0.19; 95% CI: -1.40 to 0.16; p=0.01). For undernutrition, significant determinants were monthly income (β=0.28; 95% CI: 0.11 to 0.62; p=0.02) and exclusive breastfeeding practices (β=0.22; 95% CI: 0.17 to 0.39; p=0.02).

Conclusion Social determinants such as family earnings, family food security, practices of exclusive breastfeeding and proper complementary feeding, number of under-five siblings, and history of TB contact have a strong association with malnutrition and undernutrition. Concerted and comprehensive strategies are needed for the improvement of associated factors to combat malnutrition as well as undernutrition among children.