Published in PLOS One on 2026-08-20, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Ayodeji Babatunde Oginni, Ashish Khobragade
Source: PLOS One • DOI 10.1371/journal.pone.0355408
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
This study assessed the trend in the level of under-five stunting across the different dimensions of the intersection of household wealth status (rich, average, or poor), type of place of residence (rural or urban), and gender of household heads (male or female) to identify households that were persistently most at risk of under-five stunting in Nigeria. A secondary data analysis was conducted on nationally representative children’s data from four consecutive national surveys (Nigeria Demographic and Health Survey) conducted in 2003, 2008, 2013, and 2018 in Nigeria. The study outcome variable was under-five stunting status (stunted and “not stunted”). The primary independent variable was household type derived from the intersection of the gender of the household head, household wealth status, and type of place of residence. Meta-analyses with forest plots were used to determine log odds ratios of stunting in different household types using Rich Female-Headed Urban (RFHU) Households as the reference category. Multivariate analysis was also conducted using a Generalized Linear Model for each year’s dataset. The meta-analyses show that the odds of a child becoming stunted were significantly 4.26 times higher in PMHR, 3.25 times higher in PFHR, 2.92 times higher in PMHU, 2.59 times higher in AMHR, and 2.48 times higher in AMHU households compared to RFHU households. The multivariate models also show that from 2003, 2008, 2013–2018, PMHR (AOR: 5.12; 3.31; 4.22; & 3.72; p < 0.05), PMHU (AOR: 3.25; 2.75; 2.60; & 2.84; p < 0.05), PFHR (AOR: 3.58; 2.86; 3.47; & 3.07; p < 0.05), AMHU (AOR: 3.96; 2.47; 2.25; & 1.97; p < 0.05), and AMHR (AOR: 4.47; 2.31; 2.37; & 2.08; p < 0.05), consistently had significantly higher odds of predisposing under-five children to stunting than RFHU households. These findings offer fresh insights to guide policymakers in developing new policies and help program managers design and implement more tailored nutrition-sensitive interventions and programs for the households most at risk of under-five stunting in Nigeria.
Introduction
Early childhood stunting (low height-for-age) is a nutritional outcome of chronic undernutrition in children under five and a measure of linear growth retardation and cumulative growth deficits, which reflect failure to receive adequate nutrition over a long period. Its most direct causes include inadequate nutrition (not eating enough or eating foods that lack growth-promoting nutrients) and recurrent infections or chronic diseases that cause poor nutrient intake and absorption [1].
Early childhood stunting has early and long-term consequences from childhood to adulthood [2]. It increases the risk of developmental disorders (such as delayed language and gross motoric development), and poorer neuropsychological outcomes in children [3–5]. It is also associated with poor psychological functions in late adolescence. Stunted children are more likely to have anxiety, depressive symptoms, lower self-esteem, and poorer emotional and behavioral outcomes in late adolescence [6]. There is also a link between childhood stunting and economic outcomes, as a study reveals that increased stature is associated with increased wages for men and women [7]. Other consequences of stunting include increased morbidity (increased risk of infections and non-communicable diseases, increased susceptibility to fat accumulation mostly in the central region of the body, lower fat oxidation, lower energy expenditure, insulin resistance, and a higher risk of developing diabetes, hypertension, dyslipidemia, unfavorable maternal reproductive outcomes in adulthood), mortality, lowered working capacity, etc [2]. The physical and neurocognitive damage that accompanies stunted growth is potentially irreparable and thus constitutes the major obstacle to human development [2]. The economic consequence of stunting is equally huge, as it has been estimated that, on average, the GDP per Capita is 7% lower in Sub-Saharan Africa as a result of some of today’s workers being stunted in childhood [8]. The world has made progress to reduce child stunting, with a decrease in the prevalence from 26.4% in 2012 to 23.2% in 2024 [9]. However, in Africa, although the prevalence seemed to decrease from 34.0% in 2012 to 30.3% in 2024, the number of children who are stunted increased from 61.7 million to 64.8 million. In Nigeria, the prevalence of stunting remains very high despite the development and implementation of the National Strategic Plan of Action for Nutrition (2014–2025), including effective coordination of stakeholders and increased government commitment to funding for the procurement of ready-to-use therapeutic food, and the establishment of community-based management of acute malnutrition sites across the country, and other interventions [1,10,11]. According to the Nigeria Demographic and Health Survey Reports [1,12–15], the prevalence of under-five stunting in the country has dwindled from 46% in 1999 to 37% in 2018 (Fig. 1). Between 2012 and 2024, the prevalence of stunting reduced from 36.9% to 33.8%, but the number of affected children slightly reduced from 11.5 million to 11.4 million [9].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Ayodeji Babatunde Oginni, Ashish Khobragade. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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