{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:45:50Z","timestamp":1786988750699,"version":"build-2736575974"},"reference-count":42,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005721","name":"Universit\u00e4t Bielefeld","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/501100005721","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,9]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study examined high-risk fertility behaviour and its association with under-five undernutrition in sub-Saharan Africa (SSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of data from 32 sub-Saharan African countries\u2019 Demographic and Health Surveys. A weighted sample of 110 522\u2009mother-child pairs was included in final analysis. Multilevel binary logistic regression was used to examine the association between high-risk fertility behaviour and undernutrition. The results were presented using adjusted odds ratio (aOR) with their respective 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Thirty-two countries in SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measure<\/jats:title>\n                    <jats:p>Stunting, wasting, and underweight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled prevalence of stunting was 31.3%, ranging from 15.0% in Gabon to 51.7% in Burundi. Wasting was highest among children from Burkina Faso (19.1%) and lowest among those from South Africa (1.6%). The overall prevalence of wasting was 8.1%. The prevalence of underweight was 17.0%, with the highest among children in Niger (37.1%) and lowest in South Africa (4.8%). Mothers who gave birth at the age less than 18 years and those with short birth interval were more likely to have their children being stunted, wasted, and underweight. The odds of stunting and wasting were high among children born to women with high parity. However, maternal age at birth more than 34 was associated with lower odds of childhood underweight as against those with age at birth less than 34.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Countries in SSA are encouraged to address the issue of maternal age at birth less than 18, high parity, and shorter birth intervals in order to meet the Global Nutrition targets, which aim to achieve a 40% reduction in the number of stunted children under the age of 5 and to reduce and maintain childhood wasting to less than 5% by 2025.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066543","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T12:15:15Z","timestamp":1687868115000},"page":"e066543","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["High-risk fertility behaviour and undernutrition among children under-five in sub-Saharan Africa: a cross-sectional study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9734-9054","authenticated-orcid":false,"given":"Abdul-Aziz","family":"Seidu","sequence":"first","affiliation":[{"name":"Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana"},{"name":"College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3530-6133","authenticated-orcid":false,"given":"John Elvis","family":"Hagan Jnr","sequence":"additional","affiliation":[{"name":"Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana"},{"name":"Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Budu","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3498-2909","authenticated-orcid":false,"given":"Richard Gyan","family":"Aboagye","sequence":"additional","affiliation":[{"name":"Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4080-7522","authenticated-orcid":false,"given":"Joshua","family":"Okyere","sequence":"additional","affiliation":[{"name":"Department of Population and Health, University of Cape Coast, Cape Coast, Ghana"},{"name":"Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Sakyi","sequence":"additional","affiliation":[{"name":"Department of Population and Health, University of Cape Coast, Cape Coast, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1300-6327","authenticated-orcid":false,"given":"Collins","family":"Adu","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"},{"name":"Center for Social Research in Health, University of New South Wales, Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-895X","authenticated-orcid":false,"given":"Bright Opoku","family":"Ahinkorah","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"2025120520092215000_13.6.e066543.1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0140-6736(07)61690-0","article-title":"Maternal and child Undernutrition study group. maternal and child Undernutrition: global and regional exposures and health consequences","volume":"371","author":"Black","year":"2008","journal-title":"The Lancet"},{"key":"2025120520092215000_13.6.e066543.2","doi-asserted-by":"crossref","unstructured":"Ward A , Guillot A , Nepomnyashchiy LE , et al . 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