Abstract:
BACKGROUND: The double burden of malnutrition (DBM) is a public health issue
characterised by the coexistence of undernutrition and overnutrition within
the same population, household, or individual. Undernutrition, manifesting as
stunting, wasting, or being underweight, results from insufficient nutrient intake
while overnutrition, manifesting as overweight or obesity, results from excessive
caloric intake, poor diet quality, and sedentary lifestyles. This dual burden poses
significant challenges for health systems due to lost productivity and increased
healthcare expenditure.
METHODS: This study utilised data from the Demographic and Health Surveys
(DHS) conducted in Zimbabwe for 2010–2011 and 2015, which provided
information on women’s and children’s health and nutritional status, household
characteristics, and socio-economic status. Pooled logistic regression was
used to analyse the association between various sociodemographic factors and
DBM among women and children. The Oaxaca-Blinder decomposition method
explored differences in DBM between 2010–2011 and 2015.
RESULTS: The average age of mothers was approximately 31 years, and children’s
ages averaged around 32 months. From 2010 to 2015, there was a notable
socio-economic improvement, with a decrease in the percentage of mothers in
the poorest quartile from 20 to 16% and an increase in the richest quartile from
22 to 23%. The study found a slight decrease in overall household DBM among
women from 34% in 2010 to 32% in 2015, while DBM among children increased
from 12 to 14%. Pooled logistic regression analysis indicated that children in rural
areas had statistically significantly higher odds of experiencing DBM than their
urban counterparts. The Oaxaca-Blinder decomposition showed that changes
in residence status significantly impacted the increase in DBM among children.
At the same time, the coefficient effect accounted for most of the unexplained
differences in DBM among women.
CONCLUSION: The growing DBM among women and children in Zimbabwe is
significantly influenced by changes in residence status. The findings highlight the need for targeted public health interventions to address urban–rural disparities
and emphasise the importance of considering socio-economic, environmental,
and behavioural factors. Context-specific public health strategies, aligned with
WHO’s Double Duty Actions, are essential to improve the nutritional health of
Zimbabwe’s population.
