Levels, Patterns and Determinants of Chronic Child Malnutrition in Cameroon, Seen through the Lens of Child Age

Abstract

Objectives: Often called the attic of Central Africa, Cameroon yet counts 32.3% of children victim of chronic malnutrition (stunting), and a child mortality rate as high as 122 ‰. While the Northern regions (Sahel) are regularly pointed at as accountable for such figures, what is the reality? Methods: A sample of 4,961 children aged 0 to 5 were taken from DHS Cameroon 2011. Descriptive statistics and logistic regressions of stunting were run on a large spectrum of factors (at child, mother and household level): first on the national sample, then on sub-samples corresponding to sub-regions and different age ranges. Results: Stunting appears and worsens essentially between 6 and 24 months. Diet diversification fails to scale up during that period, with only 1 child out of 4 getting (WHO) minimum diet diversity, and even falls back after 24 months, with 1 child out of 5. Even though stunting prevalence is higher in the Northern regions (39.0%) than elsewhere (23.0%), the main determinants of stunting are similar and not nutrition-related: poor water and sanitation (OR=2.9***), small birth size (OR=2.6***), and lack of access to health services, e.g. BCG vaccination (OR=1.7***). The impact coming from small birth size decreases with child age while the one coming from poor water and sanitation or unused health services increase with child age. Conclusions: Not only should the lack of diet diversity be properly addressed, but fighting chronic malnutrition in Cameroon should be holistically approached, including widespread improvements in water and sanitation as well as accessibility to health services.