Nutritional status and its associated factors among children aged 6-23 months in rural and urban communities of Kaski district of Nepal: A comparative study

Background: Child malnutrition is a significant factor contributing to infant and under-five mortality in developing countries including Nepal, making it a serious public health concern. Child nutritional status varies between urban and rural areas due to differences in educational status, socio-economic conditions, and healthcare services. Objectives: This study aimed to assess the differences in the nutritional status of children in rural and urban areas of Kaski district and identify the factors associated with nutritional status in both rural and urban areas. Methods: A community-based comparative cross-sectional study was conducted in the Kaski district. A random sample of 195 children from both urban and rural communities was included in the study. Information was collected through interviews with mothers using a structured questionnaire along with anthropometric measurements of the weight of children. Data was entered into EpiData version 3.1 and analysed using IBM SPSS version 20. Results: A total of 390 children aged 6- 23 months were included in this study for analysis. The prevalence of stunting, wasting, and underweight was 33.3%, 8.2%, and 13.8% in rural areas, and 23.1%, 4.6%, and 5.1% in urban areas, respectively. More than four-fifths of the children (84%) in urban areas and three-fourths of the children (73.3%) in rural areas were fed meals more than three times per day. Families with food insecurity were 2.77 times more likely to have underweight children (95%CI: 1.01-7.35) in comparison to families that are food secure. Children aged 12-23 months were more likely to be stunted than younger children in rural areas. Conclusion: This study found significant associations between age, sex, food insecurity, minimum dietary diversity, and food frequency, and the nutritional status of children in both rural and urban area. In rural areas, male children had a higher likelihood of being stunted compared to female children. Additionally, households experiencing food insecurity were more prone to having stunted and underweight children. To improve these conditions, enhanced nutrition education and targeted interventions, including proper counselling, are necessary to address poor dietary diversity and inadequate food frequency across both rural and urban areas.