Assessment of Nutritional Status and Associated Factors Among Public Primary School Students in Akaki Kality Sub-City, Addis Ababa, Ethiopia

Abstract Background Adequate nutrition is crucial for children's physical and cognitive development. Despite this, undernutrition remains a major public health concern globally, including in Ethiopia. Studies show a significant prevalence of undernutrition among primary school children in Addis Ababa, requiring further research and intervention. Objective To assess the nutritional status and associated factors among students in public primary schools in Akaki Kality sub-city, Addis Ababa, Ethiopia, in 2024. Methods A school-based cross-sectional study with a quantitative approach was conducted. A multi-stage simple random sampling and systematic sampling method were used to recruit 573 school children. Data collection took place from May 14 to June 21, 2024, using a structured, pretested questionnaire and anthropometric measurements. The data were entered using Epi Data manager software version v4.7.0.0(trunk), and WHO Anthro plus software was employed to determine the nutritional status of the children. Bivariate and multivariable logistic regression analyses were performed using IBM SPSS version 26 statistical software. The odds ratio with a 95% CI was calculated to measure the strength of associations, with statistical significance set at p-value < 0.05 Results Based on the WHO growth reference for school-aged children, the prevalence of stunting (HAZ score <-2 SD) and wasting (BMI Z score <-2 SD) in the study area were 9.6% (95% CI: 7.1, 12.1) and 12.9% (95% CI: 10.1, 15.7), respectively. Key predictors of stunting included age (with younger students having lower odds), handwashing before meals (a protective factor), low dietary diversity, and food insecurity. Predictors of wasting included the child's sex and dietary diversity score. Low dietary diversity was a significant predictor of both stunting and wasting, with AOR: 4.399 (95% CI: 1.878, 10.306, p-value = 0.001) for stunting and AOR = 35.62 (95% CI: 14.06, 90.241) for wasting. Conclusion and Recommendations: Wasting was more prevalent than stunting, indicating acute malnutrition as a critical issue. Older children (10–14 years) were more affected by stunting, suggesting the cumulative impact of poor nutrition. Addressing undernutrition in public schools requires nutrition education, improved school meal diversity, hygiene promotion, and coordinated efforts among stakeholders.