Malnutrition in Malawian Children: Prevalence and Correlates with Lack of Access to Microfinance, and Sustainable Agricultural Programming — Results from SAGE4Health Project

Background

Child malnutrition in Sub-Saharan Africa is a major social and public health problem. Malnutrition is also the underlying contributing factor of child deaths. In Malawi, a country of 6.8 million children, one child in eight dies before reaching age 5 and nearly half of all children under 5 have stunted development. To examine child malnutrition trends and possible correlates with access to microfinance, and sustainable agricultural programming, we used data from a nonequivalent control group effectiveness study (SAGE4Health) of a combined agricultural sustainability and economic empowerment intervention in rural Malawi.

Methods

Anthropometric measurements were taken for all children under 5. A generalized linear mixed model (SAS GLIMMIX) was applied to examine the association between children’s malnutrition status and household access to microeconomic and nutrition services, as well as use of sustainable agriculture techniques. Epi Info was used for analyzing children’s nutritional status, using CDC 2000 reference populations. SAS was used for other analyses.

Results

Among all children (n=662), 10.1% were underweight (weight-for-age Z-score: -3<=WAZ<=-2) and 6.5% were severely underweight (WAZ<-3). Stunting (height-for-age Z-score: -3<=HAZ<=-2) and severe stunting (HAZ<=-3) were found in 30.2% and 9.5% of the sample, respectively. Marginally significant correlation was observed. Children in households who had not received micro-finance and who did not use sustainable agriculture techniques were more likely to be stunted or severely stunted (OR=1.50, p= 0.06).

Conclusion

The high prevalence of chronic malnutrition suggests that stunting is a sustained problem. Investment in long-term, community-based, sustainable food-based strategies (e.g., Village Saving and Loans) is needed.