Prevalence, Factors Associated With Malnutrition Among Children Under Five Years in Al-Shabbah Children’s Hospital-Juba, South Sudan

Abstract

Malnutrition is a serious medical condition, which results from relative, absolute, or excess deficiency of one or more essential nutrients in the human body (Mengistu et al., 2013). It is a direct cause of mortality, and a major disabler preventing children who survive to reach their full developmental potential. Hence, the purpose of this study was to investigate the prevalence of malnutrition and associated factors among children under the age of five years in Al-Shabbah Children´s Hospital Juba, South Sudan. Specifically, the study sought to determine the association between maternal factors, child related factors, and service factors related with malnutrition among children under the age of five years. The cross-sectional design and logistic regression was the main methods of data analysis. The findings indicated that 72.9% of children under five years were affected by Malnutrition including 54.3% classified as severely or moderately acutely malnourished (SAM & MAM). Specific nutritional indicators showed that underweight (WAZ) affected 59.9%, wasting (WHZ) affected 60.6%, and stunting (HAZ) affected 24.2% of children, reflecting both acute and chronic undernutrition. Maternal factors were strongly associated with malnutrition of children under the age of five years in Al-Shabbah Children´s Hospital. Children of mothers with no formal education (43.9%) had over three times higher odds of malnutrition compared to those whose mothers had tertiary education (AOR = 3.52, 95% CI: 1.68–7.35, p = 0.001). Lack of postnatal care attendance (49.8% of mothers) also increased the risk (AOR = 2.15, 95% CI: 1.10–4.20, p = 0.024). Among child-related factors, children aged 7–18 months (47.6% of the sample) were most vulnerable, highlighting the critical period of transition from exclusive breastfeeding to complementary feeding (AOR = 0.42, 95% CI: 0.21–0.85, p = 0.015). Male sex and low birth weight were associated with higher malnutrition descriptively but were not significant after adjustment. Health facility factors influenced malnutrition outcomes, with adequate availability and accessibility of services improving child nutrition (AOR = 1.56, 95% CI: 0.97–2.50, p = 0.003). Other facility-related factors, including place of care, distance, and health worker attitude, were not independently significant but remain important for program planning. It is concluded that, At Al-Shabbah Children’s Hospital, 72.9% of children under five are malnourished (54.3% SAM & MAM), with underweight affecting 59.9%, wasting 60.6%, and stunting 24.2%, highlighting a critical need for targeted nutrition interventions. Overall, these findings underscore that integrated interventions are needed, targeting maternal education, postnatal care utilization, age-specific child nutrition interventions, and strengthened, accessible health services, to reduce the high prevalence of malnutrition in children under five.