Background: Undernutrition is a health condition caused by lack of enough food intake, not having enough of the right combination of food nutrients or the body’s failure to utilize the food eaten. This deficiency of food intake results into any of the three health problems namely; stunting, underweight or body wasting. Though the condition affects both the young and old, the young especially the under-fives are at a higher risk. Globally, undernutrition affects more than 149 million under-fives while in Uganda about 3 in every 10 children suffer from undernutrition. The prevalence is unevenly distributed throughout the country. The effects of undernutrition go beyond physical deformities to the child’s poor mental development, poor cognitive development, frequent morbidity and can lead to death. Methods: This study aimed at establishing spatial variation of undernutrition within Uganda. Anthropometric data on children was obtained from the 2016 Uganda Demographic and Health Survey (UDHS). Data for prevalence rates and percentages of factors affecting undernutrition were combined with the Uganda district shape file to allow spatial analysis. Moran’s I, Getis-Ord (GI*) and GWR respectively, were used to establish the local, global and geographically weighted regressions across the country. ArC GIS (version 10) was used for analysis. Results: The results indicate that, undernutrition in Uganda shows varies spatially across regions. Evidence of hot spots exist in the North Eastern part of Uganda (the Karamoja region) and the Arua region, cold spot areas exist around the central part of the country while the greatest part of Western Uganda, Northern and Eastern were not significant. Conclusion: The study reveals that a variation in the distribution of undernutrition throughout the country. Significant spatial patterns associated with undernutrition as were identified through hotspot and cold spot analysis do exist in Uganda. Programmes targeting to reduce the undernutrition of under-fives in Uganda should consider the spatial distribution of undernutrition and its determinants. Prioritization in reducing undernutrition should be given to specific hotspot areas. The spatial intensity of undernutrition and its determinants indicate that focus should be tailored to meet the local needs as opposed to a holistic national approach.

The main aim of this study was to establish the differences in both the determinants of stunting and the causal mechanism through which the identified determinants influence stunting amongst male and female under-fives in Uganda. Literature shows that male children below the age of five years are at a higher risk of being stunted than their female counterparts. Specifically, studies in Uganda indicate that being a male child is positively associated with stunting while being a female is negatively associated with stunting. Data for 904 male and 829 female under-fives was extracted form UDHS-2016 survey dataset. Key variables for this study were identified and used in generating relevant models and paths. Structural equation modeling techniques was used in its generalized form (GSEM). The generalized nature necessitated specifying both the family and link functions for each response variables in the system of the model. Sex of the child (b4) was used as a grouping factor and the height for age (HAZ) scores were used to construct the status for stunting of under-fives. The estimated models and path clearly indicated that the set of underlying factors that influence male and female under-fives respectively were different and the path through which they influence stunting were different. However, some of the determinants that influenced stunting amongst male under-fives also influenced stunting amongst the female under-fives.   To reduce the stunting problem to the desirable state, it is important to consider the multifaceted and complex nature of the risk factors that influence stunting amongst the under-fives but more importantly consider the different sex specific factors and their causal mechanism or paths through which they influence stunting.