Interaction of Wealth, Residence and Region on Multiple Anthropometric Failure among Under-Five Children in Nigeria

Abstract

Aim: This study examined the prevalence of multiple anthropometric failures among Nigerian children under five years of age using the Composite Index of Anthropometric Failure (CIAF) and examined the interactions between wealth, residence and regional strata. Study Design: A retrospective cross-sectional study. Methodology: This study used dataset from the kids recode file of 2018 Nigeria Demographic and Health Survey (NDHS) with a weighted sample of 11323 under-five children. Data from the 2018 NDHS were analysed to compute CIAF indices and assess the            prevalence of anthropometric failures across 12 intersecting subgroups, defined by three domains of inequality: wealth (rich/middle/poor), place of residence (urban/rural), and region (north/south). Cross tabulation and logistic regression were carried out to assess the odds of the CIAF among interacting groups. A choropleth map was created using ARCGIS software to describe the regional clustering of CIAF in Nigeria. All analyses were carried out using IBM Statistical Package for Social Sciences (SPSS) (version 20) and statistical significance set at 0.05. Results: Overall, 40.8% of children showed composite anthropometric failure, with 20.7% experiencing at least one failure and 3.1% suffering from all three forms of undernutrition concurrently. Cross-matching these domains revealed the highest CIAF prevalence (60.3%) among children from rural-poor households in northern Nigeria, while the lowest prevalence (31.3%) was recorded among urban-rich households. The findings indicate significantly lower odds of CIAF among children from wealthier households in southern Nigeria, highlighting the importance of socio-economic and regional disparities. Conclusion: This study underscores the need for targeted nutritional interventions for the most vulnerable subgroups, emphasizing the limitations of single-dimensional inequality analyses in policy formulation and program implementation. Instead, it advocates for detailed intra-district and state-level analyses of socio-economic disparities, particularly among marginalized groups, to design equitable and context-specific strategies to address child nutritional disparities effectively.