Prevalence of stunting and its determinants among children under five in 35 Sub-Saharan African countries (2011–2024): Insights from recent demographic health survey data using a generalized linear mixed-effects model with robust poisson regression

Abdulkerim Hassen Moloro, Kebede Gemeda Sabo, Kusse Urmale Mare, Beriso Furo Wengoro, Eshetu Elfios Endrias, Roda Mehadi Ibrahim, Teshager Dubie, Oumer Abdulkadir Ebrahim and Begetayinoral Kussia Lahole

PLOS ONE, 2026, vol. 21, issue 3, 1-29

Abstract: Background: 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. Methods: 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. Result: 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

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0344358

DOI: 10.1371/journal.pone.0344358

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