Understanding the complexity of child malnutrition in Nigeria: a structural equation modelling approach to Household, Maternal and Child factors.

Child malnutrition remains an important public health concern in Nigeria, where approximately 34% of children under five are stunted. This study investigates the relationship between household, maternal, and child-level factors in child nutritional outcomes, focusing on height for age z-scores (HAZ). Using data from the 2018 Nigeria Demographic and Health Survey (NDHS), a structural equation model (SEM) was estimated to analyse the effects of a latent household variable, including wealth index and paternal education, alongside maternal dietary diversity (MDD-W), mother’s age, and child’s sex. The results show that the household construct is a strong predictor of HAZ, confirming the central role of socioeconomic environment in child development. Maternal dietary diversity and female sex have also positive and significant effects on HAZ, while maternal age showed a smaller influence. A multi-group SEM comparing North and South regions revealed stronger household effects in the North and important regional differences in the significance of MDD-W. The findings highlight the multidimensional nature of child malnutrition and the importance of context-specific interventions. The thesis contributes to the literature by incorporating MDD-W as a measure for maternal nutrition and using latent variables to model a household construct.