Joint Modelling Application to Identify Key Determinants of Malnutrition and Anemia in Five West African Countries

Objectives: In Sub-Saharan Africa, anemia significantly contributes to infant mortality and morbidity, particularly among children affected by malnutrition. Given the intertwined nature of these conditions, separate modeling approaches are insufficient for capturing their combined effects. Joint modeling is essential to concurrently analyze anemia and malnutrition, enabling more accurate parameter estimation and a comprehensive understanding of shared risk factors. This study investigates determinants of both conditions across select West African countries, including Gabon, Gambia, Liberia, Mauritania, and Nigeria, with the aim of guiding policy measures to reduce prevalence. A novel aspect of this research is the joint modeling framework developed to analyze anemia and malnutrition together, an approach that remains limited in existing literature. By incorporating data from multiple countries, this study provides a unique and regionally contextualized perspective, addressing critical gaps in policy-relevant research. Design: A multivariate joint model was used to identify significant predictors of anemia and malnutrition in children under five years of age. Data Source: This secondary data analysis utilized demographic and health survey (DHS) data collected in selected West African countries. The DHS applied a complex, multistage sampling design incorporating stratification and cluster sampling, ensuring that the resulting weighted samples accurately represented various population subgroups. Results: The model results identified several statistically significant determinants (p < 0.05) of malnutrition and anemia. These factors included the mother’s age, the highest level of maternal education, source of drinking water, type of toilet facility, household electricity access, type of cooking fuel used, household wealth index, whether the child was given fortified food, the child’s age and gender and whether the child had a fever in the past two weeks. Conclusions: This study highlights the essential role of primary healthcare interventions, community outreach, and policy initiatives in mitigating malnutrition and anemia in West African nations. Key measures include routine anemia screening for high-risk mothers, implementing standardized treatment protocols, and addressing environmental risk factors. Partnerships with local governments and nonprofit organizations are vital for providing vulnerable groups with access to fortified foods, nutritional support, and essential healthcare services. Additionally, mobile health tools and educational webinars can address literacy barriers and enhance antenatal care. A comprehensive approach incorporating education, healthcare, and technology is crucial for improving health outcomes and reducing the prevalence of these conditions.