Determinants of malnutrition among children of adolescents and young mothers in rural Uganda: a community-based cross-sectional study

Abstract Background Children aged 6–59 months are vulnerable to malnutrition, which impairs growth, development, and immunity. Adolescent and young mothers face unique challenges including poverty, limited education, and social marginalization that may increase malnutrition risk in their children. However, evidence from post-conflict, climate-vulnerable regions of northern Uganda remains limited. This study aimed to determine the prevalence and associated factors of malnutrition among children aged 6–59 months born to adolescent and young mothers in Otuke District, northern Uganda. Methods A community-based cross-sectional study was conducted from August to October 2024 in Otuke District. Using multistage cluster sampling, 500 mother-child pairs were enrolled. Anthropometric measurements (weight, height/length, mid-upper arm circumference) were taken using standard protocols. Malnutrition was defined as stunting (height-for-age Z-score < -2), wasting (weight-for-height Z-score < -2), or underweight (weight-for-age Z-score < -2) according to WHO growth standards. Data were collected using structured questionnaires and analyzed using STATA version 17. Logistic regression was used to identify factors associated with malnutrition, with results presented as adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results The overall prevalence of malnutrition was 37.6% (188/500). Wasting affected 13.2% (66/500), underweight 28.6% (143/500), and stunting 4.2% (21/500). Boys had higher rates of wasting (17.7% vs. 8.5%) and underweight (34.3% vs. 22.8%) compared to girls. In multivariate analysis, maternal education was protective: primary education (AOR = 0.14, 95% CI: 0.04–0.52, p = 0.003) and secondary education (AOR = 0.03, 95% CI: 0.00-0.14, p < 0.001) compared to no education. Living in semi-permanent housing increased malnutrition risk compared to mud-and-grass thatched homes (AOR = 3.34, 95% CI: 1.50–7.44, p = 0.003). Absence of harmful cultural practices was protective (AOR = 0.52, 95% CI: 0.31–0.87, p = 0.014). Conclusions Malnutrition prevalence among children of adolescent and young mothers in Otuke District is high, particularly wasting and underweight among boys. Maternal education, housing conditions, and harmful cultural practices are key determinants. Interventions should target these underlying factors through community-based nutrition education, improved housing, and culturally sensitive behavior change programs.