Background Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6 to 59 months in the two districts of Nepal. Methods We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centers (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value < 0.05 was considered as significant. Results Out of 398 children, 5.8% were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23–12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88–10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06–71.09) children (0–12 vs. 24–59 months). Conclusions The findings of this study indicated that household size, household food access, and the child’s age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.

Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child’s diet between the ages of 6 and 23 months. Identifying factors associated with MAD among children can inform policymakers to improve children’s nutritional status. Methods: We extracted data of 1930 children aged 6–23 months from the Nepal Multiple Indicator Cluster Survey 2019. Multilevel analysis was performed to identify factors associated with MAD. Results: Only 30.1% of the children received MAD. Children aged 13–18 months [aOR (Adjusted odds ratio): 2.37, 95% CI (95% Confidence Interval): 1.77, 3.17] and 19–23 months (aOR: 2.6, 95% CI: 1.95, 3.47) were more likely to receive MAD than children aged 6–12 months. Early breastfed children (aOR: 1.34, 95% CI: 1.05, 1.72), those currently breastfeeding (aOR: 4.13, 95% CI: 2.21, 7.69) and children without siblings aged under five (aOR: 1.33, 95% CI: 1.03, 1.73) were more likely to receive MAD. Younger maternal age (aOR: 0.97, 95% CI: 0.95–1.0), higher level of mother’s education (aOR: 1.04, 95% CI: 1.0–1.08) and more media exposure among mothers (aOR: 1.66, 95% CI: 1.24, 2.21) were positive predictors of MAD. Relatively disadvantaged ethnicity/caste (aOR: 0.71, 95% CI: 0.53, 0.94), rural residence (aOR: 1.45, 95% CI: 1.06, 2.00) and residing in Madhesh province (aOR: 0.61, 95% CI: 0.37, 1.0) were also significant predictors of MAD. Conclusions: Children aged 6–12 months, without appropriate breastfeeding, having under-five years siblings, with older mother or mother without media exposure or low education, from relatively disadvantaged ethnicity/caste, from urban areas and residing in Madhesh Province were less likely to receive MAD. Our findings can inform infant and young child feeding policies and practices in Nepal.

Background : The main objective of this study was to identify the risk factors of severe acute malnutrition in under-five children in the two districts of Nepal. Methods: Using a mid-upper arm circumference measure, nutritional status along with the associated factors underlying determinants of undernutrition of 404 children who visited the Outpatient Therapeutic Centres were assessed using a validated structured questionnaire. Multivariate logistic regression was used to determine the factors associated with severe acute malnutrition (SAM) and associated variables. Results: The odds of a child being in the SAM category increased significantly if the family have five or more children and if the household yearly income is below an average. The children in the Madhesi family were 3.6 times more likely to be malnourished. Toilet facility (Adjusted Odds Ratio [AOR]: 4.45; 95% Confidence Interval [CI]: 1.88-10.53) and family with no kitchen garden (AOR: 3.16; 95% CI: 1.28-7.89) were significantly associated with SAM among under five children. Children from moderate food insecure and severe food insecure households were 3.2 and 5.5 times more likely to be malnourished respectively. Compared to the mothers with no job, mother with some sort of paid job had more than six times higher odds of having severely acute malnourished children.Conclusions: These findings suggest that the nutrition interventions as well as awareness on child feeding practices are crucial to improve the nutritional status of children especially among Madhesi community, poorer households and among illiterate mothers.

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Background: Despite consistent efforts to enhance nutritional child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among mothers of 6 to 59 months children admitted to the Outpatient Therapeutic Centres (OTCs). The nutritional status of 398 children was assessed using mid-upper arm circumference (MUAC) measurement. To evaluate associated factors with SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as statistically significant. Results: Among 398 children, 5.8 percent were found to be severely malnourished including under-two years and female children. Family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71) was positively associated with SAM. Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months) were significantly associated with childhood undernutrition. Conclusions: The findings of this study indicated that household size, household food access, and child’s age were the major predictors of severe acute malnutrition. Hence, nutrition health programs should be targeted to improve the nutritional status of children by ensuring household food access by focusing poor families engaging them in kitchen gardening to promote nutritious diet to the children.