Analysis of Factors Affecting Child Nutrition in Nepal Using the Nepal Demographic and Health Survey 2022.

Background Child malnutrition remains a major public health problem globally, including in Nepal. Previous studies reported that low maternal body mass index, maternal education, wealth status, anemia, low birth weight, etc., are significant predictors of childhood under-nutrition. However, child feeding practices/complementary feeding, in multivariable models specific to each anthropometric outcome, have not been explored. This study, using updated information from the Nepal Demographic and Health Survey (NDHS) 2022, will address child factors such as feeding practices, especially focusing on complementary feeding of younger children, along with other birth factors, parental factors, and socioeconomic factors.  Methods This study used nationally representative data from the NDHS 2022, where a total of 629 children aged 6-23 months were selected for analysis. Three anthropometric indicators (stunting, wasting, and underweight) were used to monitor the nutritional status of children. Independent variables were child characteristics, infant and young child feeding practices, parental factors, household wealth, and region. Binomial logistic regression analysis was carried out after adjusting for covariates. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were reported, and p-values <0.05 were considered statistically significant. Results Children with increasing age (12-23 months) had significantly higher odds of stunting. Children from households with better economic status showed lower odds of stunting. Children perceived as very small birth size had significantly higher odds of stunting (OR = 6.06; 95% CI: 2.05-17.91; p = 0.001) and being underweight (OR = 6.28; 95% CI: 2.06-19.17; p = 0.001). Maternal factors showed a strong association with all three outcomes. Children whose fathers underwent secondary and higher education had significantly greater odds of wasting compared with those whose fathers had no education (OR = 3.56; 95% CI: 1.08-11.82; p = 0.038), (OR = 11.40; 95% CI: 2.14-60.58; p = 0.004), respectively. Feeding frequency and minimum dietary diversity score were not significantly associated with any of the three anthropometric outcomes.  Conclusion The findings of this study showed that the increasing age of children was significantly associated with stunting. Maternal education, maternal age, and maternal BMI were important protective determinants of child under-nutrition. From the findings of this study, complementary feeding practices, along with maternal and household factors, may prevent child under-nutrition.