Published in PLOS One on 2026-04-06, 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: Lencho Kajela Solbana, Firezer Belay Keno, Atoma Negera, Baru Legesse Kejela, Markos Desalegn, Emiru Merdassa
Source: PLOS One • DOI 10.1371/journal.pone.0342073
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Stunting is height for age below minus 2 standard deviations of the World Health Organization standard. It affected more than one-third of children in Lesotho. Few studies applied multilevel model to identify individual, household, and community-level determinants. This study aimed to assess the prevalence and multilevel determinants of stunting among children aged 0–59 months in Lesotho using data from the 2023/24 Demographic and Health Survey.
We included a weighted 1,488 children aged 0–59 months across 400 enumeration areas. The weighted prevalence of stunting was determined. Individual and community level determinants of stunting were identified at a 0.05 level of significance. Models were compared using Akaike Information Criterion (AIC), Intraclass Correlation Coefficient (ICC), and Proportional Change in Variance (PCV).
Prevalence of stunting was 35.59% (95% CI: 33.20–38.06). Its determinants were male (AOR = 1.41; 95% CI: 1.09–1.82), age 12–23 months (AOR = 2.44; 95% CI: 1.48–4.14) and 24–59 months (AOR = 1.98; 95% CI: 1.20–3.24), 4–7 birth order (AOR = 1.43; 95% CI: 1.01–2.03), and poor (AOR = 2.58; 95% CI: 1.85–3.59) and middle wealth index (AOR = 2.03; 95% CI: 1.37–3.03). Qacha’s Nek, Thaba-Tseka, Mohale’s Hoek, and Quthing have a higher prevalence of stunting.
35.59% of children 0–59 months in Lesotho are stunted. Its determinants were male, age 12–23 and 24–59 months, poor and middle wealth, and higher birth order. Ministry of Health, Non-governmental organizations, and community health workers should therefore strengthen age-specific, equity-driven nutrition programs.
Introduction
Stunting, is defined as a height-for-age Z-score below minus 2 standard deviations [1,2]. It reflects the cumulative impacts of poor maternal nutrition, suboptimal infant feeding practices, recurrent illness, and inadequate environmental conditions [2,3]. In addition, it can happen due to poor environmental conditions and long-term restriction of a child's growth potential [4].
The Sustainable Development Goals (SDGs) aim to end all forms of malnutrition, including stunting, by 2030 [5]. The World Health Organization (WHO) targets a 40% reduction in stunting by 2025 [6]. Despite these international commitments, the 2023/24 Lesotho Demographic and Health Survey reveals that stunting prevalence has increased from 33% in 2014 to more than 35% in 2023/24 [7]. This places the country within the “high public health significance” range of 30–39% for stunting [4].
Stunting restricts children's adult height while increasing illness vulnerability, delaying mental growth, impairing academic performance, and even leading to early death [1,4] In 2022, 148.1 million children under five were stunted worldwide, 43% of them live in Africa [1]. Lesotho is among countries in Africa suffering from childhood stunting [7].
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 research & evidence 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 Lencho Kajela Solbana, Firezer Belay Keno, Atoma Negera, Baru Legesse Kejela, Markos Desalegn, Emiru Merdassa. 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: Determinants of skilled birth attendant delivery among reproductive age women in Lesotho: A multilevel analysis of demographic and health survey data
