{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:42:49Z","timestamp":1792885369737,"version":"4.5.0"},"reference-count":55,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Identifying modifiable risk factors associated with childhood stunting in sub-Saharan Africa (SSA) is imperative for the development of evidence-based interventions and to achieve the Sustainable Development Goals.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate key modifiable risk factors associated with childhood stunting in SSA.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study examined the most recent (2014-2021) Demographic and Health Surveys data for children younger than 5 years from 25 SSA countries.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Modifiable risk factors included history of diarrhea within 2 weeks, consumption of dairy products, maternal body mass index, maternal educational level, antenatal care visits, place of birth, wealth index, type of toilet, and type of cooking fuel.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Stunting and severe stunting, measured using the height-for-age z<\/jats:italic> score, were the main outcomes. Children who scored below \u22122.0 SDs or \u22123.0 SDs were classified as having stunted or severely stunted growth, respectively. Relative risks and 95% CIs were computed using generalized linear latent and mixed models and log-binomial link functions. Population-attributable fractions (PAFs) were calculated using adjusted relative risks and prevalence estimates for key modifiable risk factors.<\/jats:p><\/jats:sec>Results<\/jats:title>This study included 145\u202f900 children from 25 SSA countries. The mean (SD) age of the children was 29.4 (17.3) months, and 50.6% were male. The highest PAFs of severe childhood stunting were observed for mothers lacking a formal education (PAF, 21.9%; 95% CI, 19.0%-24.8%), children lacking consumption of dairy products (PAF, 20.8%; 95% CI, 16.8%-24.9%), unclean cooking fuel (PAF, 9.5%; 95% CI, 2.6%-16.3%), home birth (PAF, 8.3%; 95% CI, 6.3%-10.0%), and low-income household (PAF, 5.8%; 95% CI, 3.4%-8.0%). These 5 modifiable risk factors were associated with 51.6% (95% CI, 40.5%-60.9%) of the severe childhood stunting in SSA.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cross-sectional study identified 5 modifiable risk factors that were associated with 51.6% of severe childhood stunting in SSA. These factors should be a priority for policy makers when considering future child health interventions to address chronic malnutrition in SSA.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.38321","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T15:05:09Z","timestamp":1697641509000},"page":"e2338321","source":"Crossref","is-referenced-by-count":25,"title":["Population-Modifiable Risk Factors Associated With Childhood Stunting in Sub-Saharan Africa"],"prefix":"10.1001","volume":"6","author":[{"given":"Kedir Y.","family":"Ahmed","sequence":"first","affiliation":[{"name":"Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abel F.","family":"Dadi","sequence":"additional","affiliation":[{"name":"Charles Darwin University, Menzies School of Health Research, Northern Territory, Australia"},{"name":"Addis Continental Institute of 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