Socioeconomic and environmental determinants of child malnutrition in Burkina Faso

Abstract

Child malnutrition remains a critical public health challenge in sub-Saharan Africa, particularly in Burkina Faso, where persistent socioeconomic and environmental disparities worsen its prevalence. Despite numerous interventions, malnutrition rates remain stubbornly high, especially in rural communities. This study aims to identify the key determinants of child malnutrition by examining household socioeconomic conditions and environmental factors using data from the Nouna Health and Demographic Surveillance System (HDSS). A cross-sectional analytical design was applied, drawing on data collected from 2,463 households in 2022. Logistic regression models, including both simple and mixed-effects specifications, were tested to assess the influence of factors such as main income source, water supply, toilet type, electricity access, and presence of a protected garden on the nutritional status of children under five. The final retained model was the simple logistic regression, selected for its parsimony and interpretability. The analysis identified key risk factors including rural residence, dependence on agriculture, absence of a protected garden, and use of torches for lighting. Interestingly, some non-conventional sanitation practices and use of alternative water sources were associated with lower odds of malnutrition. The model was statistically significant ($p<0.001$) with an AIC of 3075.028 and a pseudo$-R^2$ of 0.065. These findings highlight the potential of improving water infrastructure, strengthening agricultural resilience, promoting household gardens, and expanding educational opportunities as pathways to reduce child malnutrition. Future research should integrate longitudinal and spatial analyses to better capture dynamic and contextual drivers of nutritional outcomes.