Precipitation, temperature, and child undernutrition: evidence from the Mali demographic and health surveys 2012-2013 and 2018.

backgroundUndernutrition among children remains a severe burden in Sub-Saharan Africa. Climate change is widely recognized as a major obstacle to improving children's nutritional outcomes. Mali, a landlocked country in West Africa, has one of the highest prevalence of child undernutrition in the region and is also considered one of the most vulnerable nations to climate change globally. This study, therefore, aimed to assess the effects of precipitation and temperature on child undernutrition in Mali, with a focus on climatic differences between the southern and northern regions.

methodsWe pooled the two most recent cross-sectional datasets from the Mali Demographic and Health Surveys (DHS) 2012-2013 and DHS 2018, integrating them with climatic variables at the DHS cluster level. The study included data from 12,281 children under five years of age. Precipitation and temperature data were extracted from the Advancing Research on Nutrition and Agriculture's DHS-Geographical Information System database, which provides a comprehensive range of climatic and geographic variables at the DHS cluster level. We assessed the effects of precipitation and temperature over periods of three months, six months, one year, and two years before the survey on child undernutrition using multivariable multilevel logistic regression models.

resultsIn southern Mali, 25.0% of children under five were stunted (95% CI 23.7-26.3%), 24.9% were underweight (95% CI 23.7-26.1%), and 9.3% were wasted (95% CI 8.5-10.1%). In northern Mali, the prevalence rates were higher: 29.6% for stunting (95% CI 27.0-32.1%), 28.7% for underweight (95% CI 26.0-31.3%), and 10.5% for wasting (95% CI 8.8-12.3%). From the pooled data analysis, we found that higher average monthly rainfall over the last three months (AOR = 0.977, p = 0.012) and six months (AOR = 0.974, p = 0.003) preceding the survey was significantly associated with lower odds of wasting in northern Mali, predominantly comprising desert areas. Moreover, in addition to reducing wasting, rainfall over the one year (AOR = 0.985, p = 0.010) and two years (AOR = 0.984, p = 0.009) prior to the survey showed a significant effect in reducing the odds of underweight among children in the north.

conclusionsIncreased precipitation had a beneficial effect on children's nutritional status, particularly in the northern part of Mali, where water scarcity is a persistent challenge. Amid growing concerns about declining rainfall due to climate change, the risk of child undernutrition is expected to rise in the northern part. To address this escalating threat, it is crucial to implement effective and timely measures to mitigate the impacts of climate change and improve children's nutrition.