Socioeconomic Factors Associated with Double Burden of Malnutrition in Mother-Child Pairs in Burkina Faso

Abstract

Burkina Faso has historically been characterized by high rates of child stunting and recent DHS data showed a steady increase in overweight/obesity among adult women, particularly in urban areas. This dual shift creates a setting where the double burden of malnutrition (DBM) in mother-child pairs is likely to emerge. This study aimed to determine the prevalence of mother-child double burden of malnutrition (DBM) and the socio-economic associated factors in Burkina Faso. This cross-sectional study used nationally representative data from the Burkina Faso Demographic and Health Survey (BFDHS-V). The DBM in mother-child pairs was defined as maternal overweight combined with child stunting, wasting, or underweight. Among 5,232 pairs, multivariable logistic regression was used to identify socioeconomic factors associated with DBM. The prevalence of DBM in mother-child pairs was 3.2%, 1.7% and 2.1% for OM/SC, OM/WC and OM/UC respectively. In adjusted analyses, the richest wealth quintile was associated with higher odds of OM/WC (aOR = 2.68, p = 0.041). Rural residence was protective against OM/WC (aOR = 0.43, p = 0.012). Older maternal age was associated with higher odds of both outcomes: OM/WC (aOR = 2.54 for 35 - 49 years; p = 0.005) and OM/SC (aOR = 3.08 for 25 - 34 years; p = 0.001). Compared to infants (<6 months), children aged 24 - 59 months had lower odds of OM/WC (aOR = 0.31, p = 0.002) but higher odds of OM/SC (aOR = 2.64, p = 0.017). The double burden of malnutrition in Burkina Faso is less common than would be expected, with type-specific socioeconomic and demographic determinants. Wealth increases risk for stunting-related DBM, while rural residence protects against wasting-related DBM. Older maternal age is a risk factor for both, and child age shows opposite effects. Interventions should be tailored to the specific DBM subtype.