Evolving patterns of child malnutrition in northern Nigeria: trends in stunting, wasting, and underweight from 2013 to 2018

Background: Child malnutrition remains a critical public health challenge in low- and middle-income countries, significantly contributing to morbidity and mortality among children under five. In Northern Nigeria, persistent nutritional deficiencies, compounded by socioeconomic disparities and regional variations, demand urgent attention. This study examines trends and determinants of stunting, wasting, and underweight from 2013 to 2018.

Method: A cross-sectional research design was used for this study. Household and anthropometric secondary data were extracted from the 2013 and 2018 Nigeria Demographic and Health Surveys (NDHS), focusing on 39,720 mother-child pairs in Northern Nigeria. Anthropometric measurements were converted into Z-scores, with stunting, wasting, and underweight defined as scores below −2 standard deviations. Chi-square analyses were used to assess associations between malnutrition and various factors. Analyses were performed using IBM SPSS Statistics (v28.0), with statistical significance set at p<0.05.

Results: Findings reveal that stunting increased from 39.4% to 44.7% (p<0.001) over the study period, whereas wasting declined markedly from 17.0% to 8.1% (p<0.001) and underweight decreased from 30.0% to 27.5% (p<0.001). Significant disparities emerged across regions, with the North-West exhibiting the highest malnutrition rates, and rural areas showing greater vulnerability than urban settings. Rural children had higher malnutrition rates than urban. Higher maternal education and greater household wealth were strongly associated with a reduced risk of malnutrition.

Conclusion: This study contributes to the literature by demonstrating that regional disparities and conflict-related instability exacerbate child malnutrition in Northern Nigeria. The findings revealed subnational variations that mirrored patterns in other crisis-affected regions, yet with distinct local drivers. The divergent trends in wasting (improved) and stunting (worsened) challenge the assumption that short-term interventions alone can address malnutrition in fragile settings. For practitioners in rural and remote health, these results emphasize the need for localized, multi-sectoral approaches. Such strategies must combine immediate nutritional support with long-term investments in maternal education, economic empowerment, and health systems adapted to the unique challenges of rural contexts, such as limited infrastructure and access to care.

Keywords: child malnutrition, Northern Nigeria, stunting, underweight, wasting.