The impact of poverty on child malnutrition and health in Lebanon: the need for multisectoral interventions.

Background/objectives: Poverty and child malnutrition are deeply interconnected. Socioeconomic disparities limit access to adequate nutrition, healthcare, and education, and can lead to long-term developmental and economic consequences. This study examines the relationship between poverty and nutritional status, micronutrient deficiencies, and recent illnesses in children in Lebanon.

Methods: Data was collected as part of a national stratified cross-sectional household-based survey conducted in 2023. A total of 1,594 children aged 0-59 months were included in the analysis. Principal component analysis was used to create a household-level poverty index using indicators related to household-level ownership of durable goods, dwelling characteristics, food security status, and relevant livelihood coping strategies. Bivariate analyses were used to estimate the associations between poverty status and nutritional status indicators (i.e., stunting, underweight, wasting, anemia, iron deficiency, and vitamin A deficiency), multiple nutritional deficiencies, and recent illnesses indicators (i.e., diarrhea, fever, and lower-respiratory infection). Multivariable logistic regressions were used to estimate the association between poverty and nutrition and illness indicators and were further evaluated using Concentration Index Curves (CIC).

Results: Multivariate analyses revealed significantly higher odds of stunting (OR: 5.27, 95% CI: 2.60, 10.66), underweight (OR: 5.46, 95% CI: 1.52, 19.56), vitamin A deficiency (OR: 2.65, 95% CI: 1.1, 6.33), diarrhea (OR: 1.99, 95% CI: 1.2, 3.3), fever (OR: 2.39, 95% CI: 1.52, 3.77) and lower respiratory infection (LRI, OR: 4.85, CI: 1.36, 17.26) for children from the poorest households compared to those from the wealthiest households. CIC showed that children from poor households were disproportionally affected by anemia, iron deficiency and wasting. Further, children with lower socioeconomic status were disproportionally affected by multiple deficiencies: 57.1% of children who suffered from 2 deficiencies were located in the lowest two poverty quintiles and 57.6% of those with three or more deficiencies were from the poorest households.

Conclusion: Our findings underscore the profound impact of poverty on child malnutrition and infections. To effectively and sustainably address these challenges, a holistic, multisectoral approach is needed, combining targeted nutritional programs, social protection programs, WASH initiatives and educational interventions to break the cycle of poverty and malnutrition.