Title : Socioeconomic inequalities and environmental determinants of child undernutrition in Cambodia: Evidence from the 2021–22 demographic and health survey
Abstract:
Introduction: Childhood undernutrition remains a major public health challenge in low- and middle-income countries, including Cambodia, despite improvements in economic development and health services. This study examined the prevalence and socioeconomic and environmental determinants of stunting, wasting, and underweight among children aged 0–59 months using data from the 2021–22 Cambodia Demographic and Health Survey (CDHS).
Methods: A total of 3,821 weighted children were included in the analysis. The prevalence of stunting, wasting, and underweight was 20.4%, 9.4%, and 15.9%, respectively. Stunting was most prevalent among children aged 12–23 months. Children from the poorest households consistently contributed the highest burden of undernutrition across all indicators.
Results: In multivariable analysis, children aged 12–23 months had higher odds of stunting compared with infants (AOR = 2.64; 95% CI: 1.87–3.74). Male children had higher odds of stunting (AOR = 1.33; 95% CI: 1.10–1.61), wasting (AOR = 1.35; 95% CI: 1.01–1.82), and underweight (AOR = 1.28; 95% CI: 1.02–1.59). Children from richer (AOR = 0.55; 95% CI: 0.31–0.95) and richest households (AOR = 0.33; 95% CI: 0.16–0.68) had significantly lower odds of stunting. Maternal secondary or higher education was associated with reduced odds of wasting (AOR = 0.49; 95% CI: 0.28–0.84) and underweight (AOR = 0.51; 95% CI: 0.32–0.79). Access to bottled water and digital connectivity were also protective against undernutrition. Conversely, poor household environmental conditions were associated with increased risk. Interaction analysis indicated a synergistic effect between maternal education and household wealth, with the lowest risk of undernutrition observed among children of educated mothers in wealthier households.
Conclusion: Despite progress, childhood undernutrition remains a significant public health issue in Cambodia. Strengthening complementary feeding practices, reducing socioeconomic inequalities, and improving multisectoral interventions across nutrition, education, WASH, and digital health systems are essential to accelerate progress toward SDG 2.
Keywords: Child Undernutrition; Stunting; Wasting; Underweight; Cambodia; Socioeconomic Inequality; WASH; CDHS
