PREVALENCE OF UNDERNUTRITION AND ITS SOCIO-DEMOGRAPHIC AND SOCIO-ECONOMIC DETERMINANTS AMONG CHILDREN AGED 6 TO 23 MONTHS IN THE LAMBUSSIE DISTRICT, UPPER WEST REGION, GHANA

Background: Undernutrition in the first two years of life is a leading contributor to child mortality and irreversible growth deficits. Ghana has recorded national declines in stunting and underweight, yet the Upper West Region lags behind and district-level evidence remains scarce. This study determined the prevalence and determinants of undernutrition among children aged 6 to 23 months in the Lambussie District, Ghana. Methods: An analytical cross-sectional survey of 405 caregiver and child pairs was conducted across 27 communities selected by multistage sampling. Anthropometric z-scores were derived against the WHO Child Growth Standards. Socio-economic position and seven-day child morbidity were recorded by structured interview. Chi-square tests and multivariable logistic regression adjusting for household clustering were applied (p < 0.05). Results: The prevalence of underweight, stunting and wasting was 12.59%, 13.58% and 14.57% respectively. Caregivers were uniformly disadvantaged: 55.80% had no formal education, 80.25% were subsistence farmers and 92.10% of households occupied earthen dwellings. Caregiver education, occupation, income and recent child morbidity were not associated with any outcome. Odds of wasting were lower among children aged 12 to 23 months than among infants aged 6 to 11 months (aOR 0.53, 95% CI 0.30 to 0.93) and among children in mud-only dwellings than in block dwellings with zinc roofing (aOR 0.10, 95% CI 0.01 to 0.85), the latter estimate resting on a single case. Conclusions: Undernutrition is of medium to high public health significance, with wasting approaching the very high threshold. Child age, rather than caregiver education, occupation or income, was the robust determinant of wasting, with infants aged 6 to 11 months at greatest risk; age-targeted nutrition-specific interventions beginning at the introduction of complementary foods should take priority over income-based targeting.