Document Type

Article

Department

Institute for Human Development

Abstract

Background:Childundernutritionremainsoneofthemostpressingglobalpublic health challenges, particularly in low and middle-income countries (LMICs). Most studies focus broadly on children under five, potentially overlooking the unique vulnerabilities a ecting children in the first 1,000 days of life. This study investigated potential factors associated with stunting and underweight malnutritional presentation among children aged 0–3 years in Nairobi City County, Kenya.

Methods: We conducted a cross-sectional study of 2903 caregiver-child dyads living in Nairobi City County to assess stunting [Height-for-Age Z-scores (HAZ)] and underweight [Weight-for-Age Z-scores (WAZ)] using the World Health Organisation (WHO) growth standards among 0–3-year-olds. Child, caregiver, and householdcharacteristicswereincludedinthelinearmixede ects regression models of factors associated with the study outcomes.

Results: Themean(standarddeviation)HAZandWAZwere−0.90(1.5)and−0.38 (1.3), respectively. Approximately 22.0% of children in the study were stunted and 10.0% underweight (< −2 Z-score). Common factors associated with stunting and underweight in multivariable models were older age (β = −0.04 and β = −0.01, respectively, both p < 0.001), male gender (β = −0.30 and β = −0.22; Reference = Female, respectively, both p < 0.001), low birth weight (β = −1.19 and β=−0.94), respectively, both p < 0.001, and living in informal settlements (β = −0.15, p = 0.010 and β = −0.14, p = 0.008). Additionally, severe household food insecurity (β = −0.47, p = 0.004; Reference = Secure) was associated with stunting, while high wealth index (β = 0.16, p = 0.018; Ref = Low wealth index) and history of hospitalization (β = −0.17, p = 0.032) were associated with underweight.

Conclusion: The high burden of stunting and underweight in this setting signals a serious public health risk and necessitates tailored interventions targeting individual and household-level vulnerabilities.

Publication (Name of Journal)

Frontiers in nutrition

DOI

https://doi.org/10.3389/fnut.2026.1793821

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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Nutrition Commons

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