The Triple Burden of Malnutrition in Urban Informal Settlements: Undernutrition, Overweight and Anemia Among Women of Reproductive Age in Ouagadougou

Women of reproductive age (WRA) living in informal settlements are exposed to socioeconomic, food, and health constraints that can contribute to various forms of malnutrition. Undernutrition, overweight, and anemia can thus coexist within the same population. However, data describing this nutritional vulnerability remain limited. This study aimed to describe the nutritional status of WRA living in informal settlements in Ouagadougou, highlighting undernutrition, overweight, and anemia. This was a descriptive cross-sectional study conducted in informal settlements of Ouagadougou between November and December 2023. It included 417 WRA aged 15 to 49 years, selected using a two-stage stratified sampling method. The characteristics of the WRA were collected using a standardized questionnaire. Mid-upper arm circumference (MUAC) was assessed in WRA and body mass index (BMI) in non-pregnant women. Anemia was assessed using hemoglobin levels measured with a HemoCue® device. Statistical analyses considered stratification, weighting, and clustering. The prevalence of undernutrition, as measured by MUAC, was 21.3%. Among non-pregnant women, 8.7% were underweight, with 2.1% experiencing severe underweight, while 27.9% were overweight. Anemia affected 68.3% of pregnant women and 50% of non-pregnant women. MUAC value varied significantly according to age (p = 0.013), household head status (p = 0.011), education level (p = 0.029), and meal frequency (p = 0.018). Nutritional vulnerability was particularly pronounced among younger women, female heads of household, women with little or no formal education, and those consuming no more than two meals a day. No significant associations were observed with physiological status, income-generating activities, or anorexia. These findings underscore the need for multisectoral interventions that combine improved access to adequate nutrition, nutrition education, enhanced food security, and improved access to healthcare.