Concurrent Wasting and Stunting Among Children in Mozambique: Determinants and Predicted Burden Under Nutrition and WASH Scenarios

Background: Concurrent wasting and stunting (WaSt) identifies children with compounded anthropometric deficits, but evidence on determinants and predicted burden is limited in climate-shock prone settings like Mozambique. This study examined WaSt correlates and predicted burden under plausible improvements in diet, breastfeeding, and WASH.Methods: Quantitative cross-sectional surveys of children aged 0–59 were analysed. Logistic models estimated unadjusted and adjusted odds ratios between determinants and WaSt, and compared results with wasting and stunting. A predictive model simulated WaSt reduction given improvements in minimum dietary diversity, exclusive breastfeeding, and basic water, sanitation, and hygiene (WASH).Results: The sample included 20,148 children. WaSt prevalence averaged 2.05%. In the fully adjusted model, WaSt was more strongly associated with age 12–23 months, diarrhoea, fever, lower wealth, lower caregiver education, and absence of basic sanitation. WaSt shared determinants with both wasting and stunting but had a sharper morbidity and sanitation profile. Climate markers were not clearly associated with WaSt after adjustment. The simulated scenario including all improvements reduced predicted prevalence from 2.06% to 1.11%.Conclusions: WaSt clustered around early childhood, morbidity, sanitation, and socioeconomic disadvantage. The analysis of climate risk showed no increased prevalence in high-risk settings. Scenario modelling suggests that integrated diet, breastfeeding, and WASH improvements could lower predicted burden. Taken together, these findings provide relevant insights on WaSt and the relevance of integrated nutrition programming to address its determinants.