Multidimensional Determinants of Childhood Wasting among Children Under Five in West Africa

Abstract Childhood wasting remains a major public health challenge in West Africa, yet evidence on the combined influence of climate, environmental, water-resource, socioeconomic, and health system factors remains limited. The determinants of childhood wasting among children under five years in the sixteen West African countries were studied using a Beta Generalized Linear Mixed Model (BGLMM) and Random Forest (RF) with Shapley Additive Explanations (SHAP). Data were obtained from the World Bank panel data (2000–2023). The Beta GLMM showed that agricultural water withdrawal, N₂O emissions, basic sanitation, health expenditure, access to basic drinking water, and forest area remained significantly associated with childhood wasting in West Africa. The Random Forest model ranked agricultural water withdrawal, urban population, average precipitation, PM2.5 exposure, access to basic drinking water, and water productivity as the most informative predictors of childhood wasting. Of these, agricultural water withdrawal and access to basic drinking water were consistently identified by both the BGLMM and RF model, signifying that they remain priority areas for policies aimed at reducing childhood wasting in West Africa. Promotion of efficient use of water in agriculture by expanding drip irrigation, rainwater harvesting, and other water-saving irrigation technologies should be prioritized by governments in West Africa to reduce excessive agricultural water withdrawal and sustain food production throughout drought stages. Also, access to safe drinking water through the construction and maintenance of boreholes and community water supply systems. Improving water availability meant for farming and household use can increase food production, reduce childhood infections, and help lower the prevalence of childhood in West Africa.