Factors and Barriers Influencing Nutritional Outcomes: A Caregiver-Reported Analysis of Malnutrition in Children Under Five

Abstract

Background: Child malnutrition, including undernutrition and overweight, remains a major global public health challenge, especially in low- and middle-income countries (LMICs), contributing to high under-five mortality and long-term cognitive, physical, and economic consequences. Understanding barriers and intervention readiness at the local level is critical to inform targeted programs. Objectives: To identify key caregiver barriers to adequate nutrition and to determine willingness to participate in nutrition education programs. Methods: A cross-sectional study of 96 caregivers of children under 5 years old was conducted at Ijitimai District Hospital. Data were collected using structured questionnaires on sociodemographic characteristics, feeding practices, barriers to child feeding, and nutritional status. Descriptive statistics summarized participant characteristics; chi-square and likelihood-ratio tests examined associations between variables. Results: Malnutrition prevalence was 16.7%, with underweight (9.4%) and wasting (5.2%) being the most common; stunting was 2.1%. Most caregivers (83.3%) were unaware of their child’s nutritional status. Malnutrition was significantly associated with the type of complementary foods (χ² = 34.46, p < 0.001), LR = 29.67 (p < 0.001), and previous malnutrition diagnosis (χ² = 42.91, p < 0.001), LR = 29.67 (p < 0.001). Primary barriers included lack of knowledge (41.7%) and financial constraints (24.0%). Most caregivers (95.8%) were willing to participate in nutrition training. Conclusion: While overall prevalence was lower than national estimates, underweight and wasting persist. Dietary quality and prior nutritional vulnerability are key determinants. Caregiver knowledge alone does not predict nutritional outcomes. Recommendations: Implement community-based nutrition education emphasizing dietary diversity, coupled with structural support (food security and social protection) and routine growth monitoring to prevent recurrence.