Evolving patterns of child malnutrition in northern Nigeria: trends in stunting, wasting, and underweight from 2013 to 2018

INTRODUCTION: Child malnutrition remains a critical public health challenge in low- and middle-income countries, significantly contributing to morbidity and mortality among children less than age 5 years. In Northern Nigeria, persistent nutritional deficiencies, compounded by socioeconomic disparities and regional variations, demand urgent attention. This study examines trends and determinants of stunting, wasting, and underweight from 2013 to 2018. METHODS: A cross-sectional research design was used for this study. Household and anthropometric secondary data were extracted from the 2013 and 2018 Nigeria Demographic and Health Surveys, focusing on 39,720 mother-child pairs in Northern Nigeria. Anthropometric measurements were converted into Z-scores, with stunting, wasting, and underweight defined as scores less than −2 standard deviations. Chi-squared analyses were used to assess associations between malnutrition and various factors. Analyses were performed using IBM Statistical Package for the Social Sciences (v28.0), with statistical significance set at p<0.05. RESULTS: Findings reveal that stunting increased from 39.4% to 44.7% (p<0.001) over the study period, whereas wasting declined markedly from 17.0% to 8.1% (p<0.001) and underweight decreased from 30.0% to 27.5% (p<0.001). Significant disparities emerged across regions, with the North-West exhibiting the highest malnutrition rates, and rural areas showing greater vulnerability than urban settings. Rural children had higher malnutrition rates than urban children. Higher maternal education and greater household wealth were strongly associated with a reduced risk of malnutrition. CONCLUSION: This study contributes to the literature by showing that regional disparities and conflict-related instability exacerbate child malnutrition in Northern Nigeria. The findings revealed subnational variations that mirrored patterns in other crisis-affected regions, yet with distinct local drivers. The divergent trends in wasting (improved) and stunting (worsened) challenge the assumption that short-term interventions alone can address malnutrition in fragile settings. For practitioners in rural and remote health, these results emphasize the need for localized, multisectoral approaches. Such strategies must combine immediate nutritional support with long-term investments in maternal education, economic empowerment, and health systems adapted to the unique challenges of rural contexts, such as limited infrastructure and access to care.