Predictors of undernutrition among under-five children in geographically isolated and disadvantaged areas in the Philippines

Introduction: Geographically isolated and disadvantaged areas (GIDA) are generally characterised by high morbidity and mortality of children. Undernutrition makes under-five children more vulnerable to disease and death. This study aimed to assess nutritional status and determine factors affecting undernourished children under five in GIDA. Methods: The study utilised data from children aged 0-59 months obtained from the 2018-2021 Expanded National Nutrition Survey (ENNS). GIDA were identified and 5,600 children were included in the analysis. Descriptive and multiple logistic regression analyses were employed to investigate associations between nutritional status of children [including stunting, underweight (UW), and wasting] and various factors including child-related, household-related, and biochemical markers. Results: Prevalence of UW, stunting, and wasting among children in GIDA were 39.7%, 24.1%, and 6.2%, respectively. Anaemia was of mild public health significance. Multiple logistic analysis revealed significant associations between stunting and vitamin A deficiency (VAD), food insecurity, and unimproved sources of drinking water; underweight and older age, anaemia, VAD, urban residence, and poor wealth; wasting and younger age, being female, and poor wealth. Conclusion: Existence of all forms of undernutrition in GIDA intensifies risk of mortality and morbidity among children. This study recommends that government sectors prioritise implementation of nutrition and food supplementation programmes in GIDA where the healthcare system continues to be at a disadvantage. The persistent constraints in GIDA should be addressed to improve food accessibility.