Background Double burden of malnutrition is a global problem posing a serious public health challenge especially in low- and middle-income countries including Ethiopia, where a high prevalence of under-nutrition continues to exist and overweight is increasing at an alarming rate. Although both under-nutrition and over-nutrition are investigated extensively in Ethiopia, evidence about the double burden of malnutrition especially at the individual level is very limited. Objective To assess the prevalence of the co-existence of overweight/obesity and stunting and associated factors among under-five children in Addis Ababa, Ethiopia at an individual level. Methods Institution-based cross-sectional study was conducted from May to June 2021 among 422 mothers to child pairs in Addis Ababa. Twenty-nine (30%) of the health centers in Addis Ababa were selected to take part in the study using a simple random sampling technique. The total sample size was allocated proportionally to each of the selected health centers based on their performances within 6 months prior to the study. A systematic random sampling method was used to select the study participants. An interviewer-administered structured questionnaire was used to collect data. Descriptive statistics and a hierarchical logistic regression model were used to characterize the study population and to identify factors that are associated with the outcome variable respectively. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value less than 0.05. Results The prevalence of the co-existence of overweight/obesity and stunting was 5.1% with 95% CI (2.9–7.1%). The hierarchical logistic regression analysis revealed that child age (6–23 months) [(AOR = 2.86, 95% CI: (1.02–8.04)], maternal education status (non-educated) [(AOR = 4.98, 95% CI: (1.33–18.66)], maternal age during birth (≥ 28 years) [(AOR = 0.22, 95% CI: (0.06–0.79)] and childbirth order (3+) [(AOR = 6.38, 95% CI: (1.03–39.7)] were significantly associated with the co-existence of overweight /obesity and stunting. Conclusion and recommendations: The study revealed that the prevalence of the co-existence of overweight/obesity and stunting is low in Ethiopia. However, local and national nutrition policies and programs should be tailored and implemented to simultaneously address both under-nutrition and over-nutrition.

Background: Double burden of malnutrition is a global problem posing a serious public health challenge especially in low- and middle-income countries including Ethiopia, where high prevalence of under-nutrition continues to exist and overweight is increasing at an alarming rate. Although both under-nutrition and over-nutrition are investigated extensively in Ethiopia, evidences about double burden of malnutrition especially at individual level are very limited.Objective: To assess the prevalence of the co-existence of overweight/obesity and stunting and associated factors among under-five children in Addis Ababa, Ethiopia.Methods: Institution based cross-sectional study was conducted from May to June, 2021 among 422 mothers to child pairs in Addis Ababa. Twenty nine (30%) of the health centers in Addis Ababa were selected to take part in the study using simple random sampling technique. The total sample size was allocated proportionally to each of the selected health centers based on their performances within six months prior to the study. Systematic random sampling method was used to select the study participants. An interviewer-administered structured questionnaire was used to collect data. Descriptive statistics and hierarchical logistic regression model were used to characterize the study population and to identify factors that are associated with the outcome variable respectively. Odds ratio along with 95% CI were estimated to measure the strength of the association. Level of statistical significance was declared at p value less than 0.05.Results: The prevalence of the co-existence of overweight/obesity and stunting was 5.1% with 95% CI (2.9% - 7.1%). The hierarchical logistic regression analysis revealed that child age (6 -23 months) [(AOR = 2.86, 95% CI: (1.02 - 8.04)], maternal education status (non-educated) [(AOR = 4.98, 95% CI: (1.33 - 18.66)], maternal age during birth (≥ 28 years) [(AOR = 0.22, 95% CI: (0.06 - 0.79)] and child birth order (3+) [(AOR = 6.38, 95% CI: (1.03 - 39.7)] were significantly associated with the co-existence of overweight /obesity and stunting.Conclusion and recommendations: The study revealed that the prevalence of the co-existence of overweight/obesity and stunting is low in Ethiopia. However, local and national nutrition policies and programs should be tailored and implemented to simultaneously address both under-nutrition and over-nutrition.