Demographic and Social-Economic Determinants of Malnutrition among Children (0-23 Months Old) in Kenya


  • Teresia Mbogori Department of Nutrition and Health Science, HB 542, Ball State University, Muncie, IN 47306, USA
  • James Muriuki Department of Agricultural and Applied Economics, Texas Tech University, Lubbock TX, USA



Underweight, stunting, wasting, overweight, obesity, malnutrition, Kenya, Africa


Objective: To identify the demographic, social, and economic determinants of malnutrition in Kenya's children aged 0-23 months.

Methods: Data from the Kenya Demographic and Health Survey (KDHS), a nationally representative cross-sectional study conducted in 2014/2015, were used in this study. Data from children 0-23 months old with complete information on weight, height, age, and sex were used for analysis. Height for Age Z scores (HAZ), Weight for Height Z scores (WHZ), and BMI for age Z scores (BAZ) was determined using WHO guidelines to determine the nutritional status of the children. Chi-square statistics were used to determine the relationship between social-economic status and place of residence indicators and the nutritional status of the children. Significance was set at p <0.05.

Results: Among all participating (n=7578), 22.7% were stunted (HAZ < -2), 6.2% were wasted (WHZ < -2), and 6.1% were either overweight or obese (BAZ > 2). Wasting and stunting were significantly higher in children from rural areas, poorer wealth index, and mothers with no education. In contrast, children from urban areas, the richest wealth index category, and mothers with secondary or higher education were significantly more likely to be overweight or obese.

Conclusion: Current and future policies and programs to curb malnutrition in Kenya need to target specific needs of children based on their social-economic status, area of residence, and other demographic characteristics that were identified as determinants of child malnutrition instead of using a general approach.


De Sanctis V, Soliman A, Alaaraj N, Ahmed S, Alyafei F, Hamed N. Early and long-term consequences of nutritional stunting: from childhood to adulthood. Acta Biomed 2021; 92(1): e2021168-e.

Mwene-Batu P, Bisimwa G, Baguma M, et al. Long-term effects of severe acute malnutrition during childhood on adult cognitive, academic and behavioral development in fragile African countries: The Lwiro cohort study in the Democratic Republic of the Congo. PLoS One 2020; 15(12): e0244486.

Schwarzenberg SJ, Georgieff MK. Advocacy for improving nutrition in the first 1000 days to support childhood development and adult health. Pediatrics 2018; 141(2): e20173716.

Blake-Lamb TL, Locks LM, Perkins ME, Woo Baidal JA, Cheng ER, Taveras EM. Interventions for childhood obesity in the first 1,000 days a systematic review. Am J Prev Med 2016; 50(6): 780-9.

Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk factors for childhood obesity in the first 1,000 days: a systematic review. Am J Prev Med 2016; 50(6): 761-79.

Reinhardt K, Fanzo J. Addressing chronic malnutritionthrough multi-sectoral, sustainable approaches: a review of the causes and consequences. Front Nutr 2014; 1: 13.

Ijarotimi OS. Determinants of childhood malnutrition and consequences in developing countries. Curr Nutr Rep 2013; 2(3): 129-33.

Mbogori T, Kimmel K, Zhang M, Kandiah J, Wang Y. Nutrition transition and double burden of malnutrition in Africa: A case study of four selected countries with different social-economic development. AIMS Public Health 2020; 7(3): 425.

Chirwa EW, Ngalawa HP. Determinants of child nutrition in Malawi. S Afr J Econ 2008; 76(4): 628-40.

Kenya National Bureau of Statistics, Ministry of Health/Kenya, National AIDS Control Council/Kenya, Kenya Medical Research Institute, National Council for Population and Development/Kenya. Kenya Demographic and Health Survey 2014. Rockville, MD, USA 2015.

World Health Organization. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development: World Health Organization 2006.

Van de Poel E, Hosseinpoor AR, Speybroeck N, Van Ourti T, Vega J. Socioeconomic inequality in malnutrition in developing countries. Bull World Health Organ 2008; 86(4): 282-91.

Ekholuenetale M, Tudeme G, Onikan A, Ekholuenetale CE. Socioeconomic inequalities in hidden hunger, undernutrition, and overweight among under-five children in 35 sub-Saharan Africa countries. J Egypt Public Health Assoc 2020; 95(1): 9.

Asuman D, Ackah CG, Fenny AP, Agyire-Tettey F. Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa. J Public Health 2020; 28(5): 563-73.

Fotso J-C. Urban-rural differentials in child malnutrition: Trends and socioeconomic correlates in sub-Saharan Africa. Health & Place 2007; 13(1): 205-23.

Van de Poel E, O’Donnell O, Van Doorslaer E. Are urban children really healthier? Evidence from 47 developing countries. Soc Sci Med 2007; 65(10): 1986-2003.

Hong SA, Winichagoon P, Khang Y-H. Rural-urban differences in socioeconomic inequality trends for double burden of malnutrition in Thailand 2005–2016. Eur J Clin Nutr 2020; 74(3): 500-8.

Ameye H, De Weerdt J. Child health across the rural-urban spectrum. World Dev 2020; 130: 104950.

Smith LC, Ruel MT, Ndiaye A. Why is child malnutrition lower in urban than in rural areas? Evidence from 36 developing countries. World Dev 2005; 33(8): 1285-305.

Mishra VK, Retherford RD. Women's education can improve child nutrition in India. Natl Fam Health Surv Bull 2000(15): 1-4.

Mshida HA, Kassim N, Mpolya E, Kimanya M. Water, sanitation, and hygiene practices associated with nutritional status of under-five children in semi-pastoral communities Tanzania. Am J Trop Med Hyg 2018; 98(5): 1242-9.

Ohonba A, Ngepah N, Simo-Kengne B. Maternal education and child health outcomes in South Africa: A panel data analysis. Dev South Afr 2019; 36(1): 33-49.

Kimani-Murage EW, Fotso JC, Egondi T, et al. Trends in childhood mortality in Kenya: The urban advantage has seemingly been wiped out. Health & Place 2014; 29: 95-103.

Filmer D, Pritchett LH. Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India. Demography 2001; 38(1): 115-32.

Hong R, Mishra V. Effect of wealth inequality on chronic under-nutrition in Cambodian children. J Health Popul Nutr 2006; 24(1): 89-99.

Hong R, Banta JE, Betancourt JA. Relationship between household wealth inequality and chronic childhood under-nutrition in Bangladesh. Int J Equity Health 2006; 5(1): 15.

Tasnim T, Dasvarma G, Mwanri L. Housing conditions contribute to underweight in children: an example from rural villages in southeast Sulawesi, Indonesia. J Prev Med Public Health 2017; 50(5): 328-35.

Nepali S, Simkhada P, Davies I. Trends and inequalities in stunting in Nepal: a secondary data analysis of four Nepal demographic health surveys from 2001 to 2016. BMC Nutr 2019; 5(1): 19.

Khan S, Zaheer S, Safdar NF. Determinants of stunting, underweight and wasting among children <5years of age: evidence from 2012-2013 Pakistan demographic and health survey. BMC Public Health 2019; 19(1): 358.

Mekonnen AG, Odo DB, Nigatu D, Sav A, Abagero KK. Women's empowerment and child growth faltering in Ethiopia: evidence from the Demographic and Health Survey. BMC Women's Health 2021; 21(1): 42.

Determinants of Childhood MalnutritionInternational Journal of Child Health and Nutrition, 2021, Vol. 10, No. 3 87

United Nations, Transforming our world: the 2030 Agenda for Sustainable Development 2015 [cited 2021 June 6]; Available from: https: //

GOK, Kenya Vision 2030: A Global Competitive and Prosperous Kenya, Ministry of Planning and National Development and National Economic and Social Council (NESC, Nairobi, 2007)






General Articles