Published in PLOS One on 2026-03-13, 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: Abdulkerim Hassen Moloro, Kebede Gemeda Sabo, Kusse Urmale Mare, Beriso Furo Wengoro, Eshetu Elfios Endrias, Roda Mehadi Ibrahim, Teshager Dubie, Oumer Abdulkadir Ebrahim, Begetayinoral Kussia Lahole, Ayodeji Oginni
Source: PLOS One • DOI 10.1371/journal.pone.0344358
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Despite efforts by initiatives like the World Bank’s ‘All Hands-on Deck’ and UNICEF’s programs to address stunting through multisectoral approaches, the burden of stunting remains alarmingly high in sub-Saharan Africa. This study utilized recent large-scale survey data from 35 SSA countries (2011–2024) to estimate the pooled prevalence of stunting and its determinants among children under 5 years of age. Key variables such as antenatal care visits, postnatal care, and maternal nutritional indicators, which previous studies did not account for, are incorporated into the analysis.
A secondary analysis was conducted using recent demographic and health survey data (2011–2024) from 35 sub-Saharan African (SSA) countries. A total weighted sample of 191,953 children under 5 years of age was included in the analysis. Descriptive and inferential analyses were performed using STATA 17. Forest plots were utilized to illustrate both pooled and country-specific stunting rates. Determinants of stunting were identified through a multilevel mixed-effects Poisson regression model with robust variance. The adjusted prevalence ratios and their 95% confidence intervals were used to assess the strength and statistical significance of associations.
The pooled prevalence of stunting among children under 5 years of age in 35 sub-Saharan African countries was 29.89% (95% CI: 26.63, 33.14%), with the lowest level in Gabon (13.91%) and the highest in Burundi (55.80%). Being male children (aPR = 1.24, 95% CI: 1.21–1.26), being aged 12 months or older (aPR: ≥ 1.81, p < 0.01), insufficient antenatal care (ANC) visits (aPR: ≥ 1.17, p < 0.01), lack of postnatal visits(aPR = 1.03, 95% CI: 1.07, 1.05), children perceived as small or average at birth (aPR: ≥ 1.16, p < 0.01), mother without a higher education (aPR: ≥ 1.94, p < 0.01), living in a poor or average wealth household (aPR: ≥ 1.23, p < 0.01) were significant predictors of stunting. Conversely, maternal overweight (aPR = 0.81, 95% CI: 0.77–0.84) and obese mothers (aPR = 0.88, 95% CI: 0.85–0.90) were associated lower prevalence of stunting.
Study revealed significant country-level variations and rates exceeding 30% in 15 countries, signaling a major public health concern. The key individual, household and contextual factors associated with stunting in this study suggest the need for immediate actions expanding antenatal and postnatal care, promoting facility-based deliveries, enhancing maternal education, and media outreach. Long term strategies must tackle poverty, food systems, and equitable nutrition access, supported by governance and stability. A multisectoral approach integrating health, education, agriculture, WASH, and social protection ensures substantiable child growth, complemented by longitudinal research for policy coherence.
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 financing & policy 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 Abdulkerim Hassen Moloro, Kebede Gemeda Sabo, Kusse Urmale Mare, Beriso Furo Wengoro, Eshetu Elfios Endrias, Roda Mehadi Ibrahim, Teshager Dubie, Oumer Abdulkadir Ebrahim, Begetayinoral Kussia Lahole, Ayodeji Oginni. 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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- Evidence brief: Unveiling the full picture of malnutrition in Sub-Saharan Africa: The extended composite index of anthropometric failure among children under-5 in the SDG era
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