Factors associated with child stunting, underweight, and wasting in eight Latin American and Caribbean countries and regions: a regional analysis using Multiple Indicator Cluster Surveys

Background: Although child undernutrition in Latin America and the Caribbean is lower than the global average, the region still faces substantial challenges in achieving Sustainable Development Goal 2.2. We aimed to identify factors associated with child undernutrition to inform efforts in this region to improve child nutrition and reduce health inequities. Methods: We analysed 34,862 children aged 0-59 months using Multiple Indicator Cluster Surveys from eight Latin American and Caribbean countries. We fitted multivariable logistic regression models accounting for complex survey design to assess associations between selected factors and three indicators of undernutrition. Results: Prevalence of stunting, underweight, and wasting was 11.0, 4.4, and 2.8%, respectively. Compared with children aged 0-11 months, stunting was more common at 12-23 months (odds ratio (OR) = 1.55; 95% confidence interval (CI) = 1.30, 1.84). Stunting was less common among children whose mothers had higher education (OR = 0.62; 95% CI = 0.51, 0.75) and those from the richest households (OR = 0.59; 95% CI = 0.47, 0.76). Underweight was less common among children ever breastfed (OR = 0.50; 95% CI = 0.34, 0.74, in 0-23 months subgroup) and those whose mothers had higher education (OR = 0.48; 95% CI = 0.35, 0.67). Compared with the youngest group, wasting was less common in older children, e.g. 12-23 months (OR = 0.64; 95% CI = 0.47, 0.86). In subgroup analyses, maternal health insurance was associated with lower odds of wasting in seven-country analyses excluding Cuba (OR = 0.74; 95% CI = 0.56, 0.97). Conclusions: Child undernutrition in Latin America and the Caribbean reflects persistent socioeconomic inequities. These findings support policies that invest in girls' education, target nutrition interventions to the first 1000 days of life, integrate nutrition services into maternal and child health programmes, and address the emerging challenges of the nutrition transition.