Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Trends and Determinants of Child Growth Indicators in Malawi and Implications for the Sustainable Development Goals

1 Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt;
2 College of Medicine, School of Public Health, University of Malawi, Blantyre 30096, Malawi

Sustainable development goals (SGD) 2 links malnutrition, morbidity and child mortality to stunting, wasting and overweight among children under-5 years of age. Sub-Saharan Africa still registers high nutritionally insecure people. In particular, Malawi has made modest progress in improving nutritional outcomes; and still experiences a number of structural challenges leading to negative nutritional outcomes. We describe trends of under nutrition and how the effect of selected determinants of child nutrition affect Malawian children under-5 from 1992 to 2015-16; and examine the changing patterns of the effect of selected socio-demographic characteristics on stunting and underweight using data from demographic and health surveys (DHS). The analysis included 31,630 children under-5 years from 1992, 2000, 2004, 2010, and 2015-16 DHS. Our outcome measures are stunting (height/length-for-age) and underweight (weight-for-age) less than -2 SD (Z-score). We perform logistic regression to assess the relationship between selected socio-demographic characteristics with the stunting and underweight variables. Underweight decreased by 14.0% from 24.7% (1992) to 10.7% (2015-16). Stunting decreased by 23.0% from 55.6% (1992) to 32.6% (2015-16). Underweight was more prevalent among children from central and southern regions; among male children; and children above 6 months of age or more. Later surveys were associated with reduced likelihood of underweight than the earliest surveys. Similar trends were observed between socioeconomic factors and stunting. The observed underweight and stunting prevalence is 2.2% and 1.9% lower than expected, respectively. Despite modest declines in underweight and stunting among young children in Malawi, underweight and stunting remain significant public health challenges particularly in southern and central Malawi which constitute about 85% of the total population. Interventions to address the critical malnutrition challenges in Malawi are inevitable within the context of SDG 2 on health.
  Article Metrics


1. Chopra M, Darton-Hill I (2006) Responding to the crisis in sub-Saharan Africa: the role of nutrition. Public Health Nutr 9: 544-550.

2. Kakietek JJ, Dayton JM, Walter D, et al. (2017) An investment framework for nutrition : reaching the global targets for stunting, anaemia, breastfeeding, and wasting, The World Bank. retrieved: http://documents.worldbank.org/curated/en/793271492686239274/

An-investment-framework-for-nutrition-reaching-the-global-targets-for-stunting-anemia-breastfeeding-and-wasting [Accessed: 3 August 2017]

3. Dercon S, Portner C (2014) Live aid revisited: long-term impacts of the 1984 ethiopian famine on children. J Eur Econ Assoc 12: 927-948.    

4. Kinney MV, Kerber KJ, Black RE, et al. (2010) Sub-Saharan Africa's mothers, newborns, and children: where and why do they die? PLoS Med 7: e1000294.    

5. Beattie RM, Brown NJ, Cass H (2015) Millennium Development Goals progress report. Arch Dis Child 100 Suppl 1: S1.

6. Mussa R (2014) A matching decomposition of the rural-urban difference in Malnutrition in Malawi. Health Econ Rev 4:11.    

7. World Bank (2017) Malawi Overview. Retrieved: http://www.worldbank.org/en/country/

malawi/overview [Accessed: 3 August 2017]

8. Maleta K, Virtanen S, Espo M, et al. (2003) Childhood malnutrition and its predictors in rural Malawi. Paediatr Perinat Epidemiol 17: 384-390.    

9. Chikhungu L, Madise N, Padmass S (2014) How important are community characteristics in influencing children's nutritional status? Evidence from Malawi population-based household and community surveys. Health Place 30: 187–195.

10. WHO (2011a) WHO Anthro for personal computers software for assessing growth and development of the world's children. Retrieved: http://www.who.int/childgrowth/software/anthro_pc_manual_v322.pdf [Accessed: 3 August 2017]

11. Government of Malawi (2009) National Nutrition Policy and Strategic Plan 2007-2011. retrieved: https://extranet.who.int/nutrition/gina/sites/default/files/MWI%202009%20National%20Nutrition%20Policy%20Strategic%20Plan%202009.pdf [Accessed: 15 June 2017]

12. Masibo P, Makoka D (2012) Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008-2009. Public Health Nutr 15: 1715-1727.    

13. VanderJagt D, Waymire L, Obadofin MO, et al. (2009) A cross-sectional study of the growth characteristics of Nigerian infants from birth to 2 years of age. J Trop Pediatr 55: 356-362.

14. Alderman H, Behrman JR (2006) Reducing the incidence of low birth weight in low-income countries has substantial economic benefits. World Bank Res Obs 21: 25-48.    

15. Black RE, Victoria CG, Walker SP, et al. (2013) Maternal and child under-nutrition and overweight in low-income and middle-income countries. The Lancet 382: 427-451.    

16. Doctor HV (2013) Layers of socioeconomic vulnerability in Malawi in the context of the millennium development goals. ISRN Economics.

17. Waldron I (1983) The Role of Genetic and Biological Factors in Sex Differences in Mortality. In: Lopez A, Lado T. eds. Sex differences in mortality: trends, determinants and consequences, Canberra: Australia National University, Department of Demography: 141-164

18. Lutter CK, Daelmans BM, de Onis M, et al. (2011) Undernutrition, poor feeding practices, and low coverage of key nutrition interventions. Pediartics 128: e1418-1427.

19. Biondi D, Kipp W, Jhangri GS, et al. (2011) Risk factors and trends in childhood stunting in a district in Western Uganda. J Trop Pediatr 57: 24-33.    

20. Altare C, Delbiso TD, Mutwiri GM, et al. (2016) Factors associated with stunting among pre-school children in Southern highlands of Tanzania. J Trop Pediatr 62: 390-408.    

21. Shekar M, Kakietek J, D'Alimonte MR, et al. (2017) Reaching the global target to reduce stunting: an investment framework. Health Policy Plan 32: 657-668.    

22. Haider BA, Bhutta ZA (2015) Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev 4:CD004905.

23. WHO. (2011b) Guideline: Vitamin A Supplementation in Infants and Children 6–59 Months of Age. Retrieved: https://www.ncbi.nlm.nih.gov/books/NBK185172/ [Accessed: 3 August 2017]

24. Imdad A, Bhutta Z (2011) Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: A meta analysis of studies for input to the lives saved tool. BMC Public Health 11: S22.    

25. Lassi Z, Zahid G, Das J, et al. (2013) Impact of education and complementary feeding on growth and morbidity of children less than 2 years of age in developing countries: A systematic review. BMC Public Health 13: S13.    

Copyright Info: © 2017, Henry V. Doctor, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved