Malnourished Child, Overweight Mother? Examining the Double Burden of Malnutrition in Sub‐Saharan Africa

The double burden of malnutrition (DBM) - the coexistence of child undernutrition and maternal overweight/obesity - within the same household is a growing public health challenge in sub-Saharan Africa (SSA). This study assessed the prevalence and determinants of DBM at the household level across 22 SSA countries using recent nationally representative Demographic and Health Survey (DHS) data from 103,497 mother-child under-five pairs. Outcomes included child stunting, maternal overweight/obesity, and DBM, defined as the concurrent occurrence of child stunting and maternal overweight/obesity in the same household. Descriptive statistics, binary logistic regression, and complementary log-log models were applied, accounting for complex survey designs. Across SSA, 28.34% of children were stunted, 29.59% of mothers were overweight/obese, and 6.09% of households experienced DBM. Child stunting was associated with maternal short stature (AOR = 3.00; 95% CI: 2.61-3.46 for those with height below 145 cm vs. the above), low maternal education (AOR = 0.44; 95% CI: 0.38-0.51 for higher vs. no education) and poverty (AOR = 0.43; 95% CI: 0.39-0.47 for richest vs. poorest). Maternal overweight/obesity was associated with higher maternal age (AOR = 4.52; 95% CI: 3.75-5.44 for 45-49 vs. 15-19 years), higher education (AOR = 1.54; 95% CI: 1.35-1.76 for higher vs. no education), wealthier households (AOR = 4.91; 95% CI: 4.37-5.51 for richest vs. poorest), and urban residence. The likelihood of DBM was higher in wealthier (AOR = 1.51; 95% CI: 1.28-1.79), urban households (AOR = 0.90; 95% CI: 0.82-0.99 for rural vs. urban), among older mothers (AOR = 1.92; 95% CI: 1.43-2.58 for 45-49 vs. 15-19 years), and children aged 2 years or more (AOR = 2.12; 95% CI: 1.91-2.37 for 2 vs. < 1 year). These findings highlight that the DBM in SSA reflects overlapping yet contrasting drivers of undernutrition and overnutrition. Urgent, integrated interventions, focusing on maternal education, early childhood nutrition, and the reduction of socioeconomic disparities, are needed to simultaneously curb child stunting and address the rising tide of maternal overweight and obesity

Developing country · Double burden · Household income · Logistic regression · Malnutrition · Overweight · Poverty · Public health · Rural area · Breastfeeding Practices and Influences · Child Nutrition and Water Access · Poverty, Education, and Child Welfare

• Demographic and health surveys

  Open Access•Daniel J Corsi, Melissa Neuman et al.•International Journal of…•2012

  Incluir item

• Revisiting maternal and child undernutrition in low-income and middle-income countries

  Open Access•Cesar G Victora, Polly Christian et al.•The Lancet•2021

  Incluir item

• Dynamics of the double burden of malnutrition and the changing nutrition reality

  Open Access•Barry M Popkin, Carlos Corvalán et al.•The Lancet•2020

  Incluir item

• Double burden of malnutrition among women and children in Zimbabwe

  Open Access•Akim Tafadzwa Lukwa, Plaxcedes Chiwire et al.•Frontiers in Public Health•2024

  Incluir item

• Socioeconomic and urban-rural inequalities in the population-level double burden of child malnutrition in the East and Southern African Region

  Open Access•Rishi Caleyachetty, Niraj S Kumar et al.•PLOS Global Public Health•2023

  Incluir item

• Magnitude, trends and drivers of the coexistence of maternal overweight/obesity and childhood undernutrition in Ethiopia

  Open Access•Rebecca Pradeilles, Ana Irache et al.•Maternal and Child Nutrition•2022

  Incluir item

• Mitigating the Impact of Intergenerational Risk Factors on Stunting

  Open Access•Kate Rich, Lambert Engelbrecht et al.•Maternal and Child Nutrition•2024

  Incluir item

• The Nutrition Transition and the Double Burden of Malnutrition in Sub-Saharan African Countries

  Open Access•Johanna H Nel, Nelia P Steyn•International Journal of…•2022

  Incluir item

• Overweight and obesity among women

  Open Access•Subas Neupane, Prakash K C et al.•BMC Public Health•2015

  Incluir item

• What Do Mothers Know About Nutrition? Impacts on Childhood Nutrition Outcomes in Sub-Saharan Africa

  Open Access•Achamyeleh Birhanu Teshale, Godness Kye Biney et al.•Maternal and Child Health Journal•2025

  Incluir item

• Galvanizing political commitment in the UN Decade of Action for Nutrition

  Open Access•Patrizia Fracassi, Kendra Siekmans et al.•Food Policy•2019

  Incluir item