Determinants of undernutrition in children under five years in the Southern Africa sub-region: A scoping review

Abstract

Background: Undernutrition remains a fundamental public health challenge responsible for impaired growth, mortality, and morbidity in children under five years. This review aimed to assess the current evidence on child undernutrition determinants within the Southern African sub-region. Methods: The review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. The search was conducted from electronic databases: PubMed, Cochrane, Google Scholar, Scopus, Embase, HINARI, EbscoHost and CINAHL. The search focused on studies on child undernutrition determinants conducted in the Southern African subregion and published in English between January 2000 and November 2022. Results: The review showed that there is a paucity of research on maternal and child nutrition in Southern Africa. Furthermore, undernutrition is prevalent and above national averages. Stunting ranged between 18% and 48%. Child undernutrition determinants were categorized at four levels: maternal, child, household, and community-related factors. For maternal-related factors, maternal education was the most important predictor of childhood undernutrition whereas birthweight was the most significant child-related factor. Other important determinants included; maternal stature, employment, and age. Conclusion: Childhood undernutrition remains prevalent in the Southern Africa sub-region and the determinants of undernutrition appear to operate at the mother, child, household, and community levels. These four contact points are where sustainable interventions to address undernutrition should be derived to realize the maximum impact.