{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:50Z","timestamp":1772168930728,"version":"3.50.1"},"reference-count":60,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018822","name":"Western Sydney University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018822","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Algeria has made significant progress in addressing childhood undernutrition. Despite improvements, nearly 12% of Algerian children under five years of age suffered from stunting in 2022. This study aimed to evaluate the prevalence of three indicators of undernutrition (stunting, wasting, and underweight) and their associated variables in children aged 0\u201323 months in Algeria between 2013 and 2019. Methods Pooled data from Multiple Indicator Cluster Surveys (MICS) (2012-13 and 2018-19) covering 14,498 children were used. Univariate and multiple logistic regression analyses were performed to test the associations. Results Stunting decreased significantly, but wasting and being underweight showed no significant reductions from 2013 to 2019. Stunting, wasting, and underweight decreased by 2.2%, 1.3%, and 0.3%, respectively, with an overall prevalence of 10.1%, 5.4%, and 3.6%, respectively. Factors associated with undernutrition included child age and small size at birth, whereas stunting was linked to the poorest households, male children, higher maternal body mass index (BMI), and low antenatal care (ANC) visits. Wasting was associated with younger age and paternal age, fewer maternal ANC visits, underweight male sex, low maternal education, high maternal BMI, and delayed breastfeeding initiation. Conclusion Public health experts and stakeholders must adopt a comprehensive community-centered approach to achieve long-term improvements in child nutrition in Algeria. This strategy should focus on key factors including high maternal BMI, low maternal education, male children, and infrequent ANC visits. This action can help Algeria progress towards achieving the UN\u2019s goal of eradicating malnutrition.<\/ns3:p>","DOI":"10.12688\/f1000research.158413.1","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T11:30:54Z","timestamp":1732620654000},"page":"1428","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Undernutrition before two years in Algeria: Repeated cross-sectional analyses (2012-13 to 2018-19)"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0482-4352","authenticated-orcid":false,"given":"Nagwa Farag","family":"Elmighrabi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharine A. K.","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kingsley E.","family":"Agho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"ref1","article-title":"Malnutrition impact.","year":"cited 2024 Sep 2"},{"key":"ref4","article-title":"Prevalence of malnutrition among children in Algeria 2022 by condition.","year":"cited 2024 Sep 2"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"12-26","DOI":"10.1111\/mcn.12231","article-title":"Childhood stunting: a global perspective.","volume":"12","author":"M De Onis","year":"2016","journal-title":"Matern. Child Nutr."},{"key":"ref6","article-title":"Monitoring the situation of children and women: child malnutrition.","year":"cited 2024 Sep 2"},{"key":"ref7","first-page":"71-74","article-title":"Prevalence of underweight and its risk factors among under five children in a rural area of Kancheepuram District in Tamil Nadu, India.","volume":"3","author":"P Stalin","year":"2013","journal-title":"IOSR-J Dental Med. Sci."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"340-357","DOI":"10.1016\/S0140-6736(07)61692-4","article-title":"Maternal and child undernutrition: consequences for adult health and human capital.","volume":"371","author":"C Victora","year":"2008","journal-title":"Lancet."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"821-824","DOI":"10.1007\/s13312-012-0187-2","article-title":"Determinants of undernutrition in children under 2 years of age from rural Bangladesh.","volume":"49","author":"A Ahmed","year":"2012","journal-title":"Indian Pediatr."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"477-489","DOI":"10.1016\/j.scitotenv.2012.08.092","article-title":"Lost food, wasted resources: Global food supply chain losses and their impacts on freshwater, cropland, and fertiliser use.","volume":"438","author":"M Kummu","year":"2012","journal-title":"Sci. Total Environ."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"101029","DOI":"10.1016\/j.cppeds.2021.101029","article-title":"A global child health perspective on climate change, migration and human rights.","volume":"51","author":"R Uddin","year":"2021","journal-title":"Curr. Probl. Pediatr. Adolesc. Health Care."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1611-1613","DOI":"10.1093\/infdis\/jiad513","article-title":"The Costly Vicious Cycle of Infections and Malnutrition.","volume":"229","author":"P Sinha","year":"2024","journal-title":"J. Infect. Dis."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"243-260","DOI":"10.1016\/S0140-6736(07)61690-0","article-title":"Maternal and child undernutrition: global and regional exposures and health consequences.","volume":"371","author":"R Black","year":"2008","journal-title":"Lancet."},{"key":"ref16","first-page":"568-576","article-title":"Trends in the prevalence of undernutrition, nutrient and food intake and predictors of undernutrition among under five year tribal children in India.","volume":"21","author":"I Meshram","year":"2012","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"417-440","DOI":"10.1016\/S0140-6736(07)61693-6","article-title":"What works? Interventions for maternal and child undernutrition and survival.","volume":"371","author":"Z Bhutta","year":"2008","journal-title":"Lancet."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"S54-S62","DOI":"10.51745\/najfnr.4.9.S54-S62","article-title":"An update of the nutritional situation in eastern Algeria.","volume":"4","author":"M Bencharif","year":"2020","journal-title":"The North African Journal of Food and Nutrition Research."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e0283685","DOI":"10.1371\/journal.pone.0283685","article-title":"A systematic review and meta-analysis of the prevalence of childhood undernutrition in North Africa.","volume":"18","author":"N Elmighrabi","year":"2023","journal-title":"PLoS One."},{"key":"ref22","article-title":"Algeria Multiple Indicator Cluster Survey 2013. Final report.","year":"2013"},{"key":"ref23","article-title":"Algeria Multiple Indicator Cluster Survey 2019. Final report.","year":"2019"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e203386-e","DOI":"10.1001\/jamanetworkopen.2020.3386","article-title":"Factors associated with child stunting, wasting, and underweight in 35 low-and middle-income countries.","volume":"3","author":"Z Li","year":"2020","journal-title":"JAMA Netw. Open."},{"key":"ref26","article-title":"Chapter 2: Access to Clean Fuels and Technologies for Cooking. Tracking SDG 7: The Energy Progress Report.","year":"2022"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1408385","DOI":"10.1080\/16549716.2017.1408385","article-title":"Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014.","volume":"10","author":"Z Li","year":"2017","journal-title":"Glob. Health Action."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"3875","DOI":"10.3390\/nu12123875","article-title":"Factors associated with stunting among children under 5 years in five South Asian countries (2014\u20132018): Analysis of demographic health surveys.","volume":"12","author":"N Wali","year":"2020","journal-title":"Nutrients."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"233-241","DOI":"10.1016\/S0140-6736(03)13917-7","article-title":"Applying an equity lens to child health and mortality: more of the same is not enough.","volume":"362","author":"C Victora","year":"2003","journal-title":"Lancet."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e13537","DOI":"10.1111\/mcn.13537","article-title":"Patterns in child stunting by age: A cross-sectional study of 94 low-and middle-income countries.","volume":"19","author":"O Karlsson","year":"2023","journal-title":"Matern. Child Nutr."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"354-370","DOI":"10.1111\/j.1740-8709.2011.00380.x","article-title":"World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries.","volume":"8","author":"B Marriott","year":"2012","journal-title":"Matern. Child Nutr."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"452-477","DOI":"10.1016\/S0140-6736(13)60996-4","article-title":"Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?","volume":"382","author":"Z Bhutta","year":"2013","journal-title":"Lancet."},{"key":"ref37","first-page":"49-51","article-title":"Islamic and cultural practices in breastfeeding.","volume":"17","author":"S Yashmin","year":"2017","journal-title":"Australian Midwifery News."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"17-21","DOI":"10.47705\/kjdmr.215104","article-title":"Awareness of Libyan Mothers About Child Feeding Practices in Benghazi, Libya.","volume":"5","author":"F Ziuo","year":"2021","journal-title":"Khalij-Libya Journal of Dental and Medical Research."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"264-267","DOI":"10.4103\/0970-0218.37691","article-title":"Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population.","volume":"32","author":"A Mittal","year":"2007","journal-title":"Indian J. Community Med."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e13223","DOI":"10.1111\/mcn.13223","article-title":"Predictors of complementary feeding practices among children aged 6\u201323 months in five countries in the Middle East and North Africa region.","volume":"17","author":"L Shaker-Berbari","year":"2021","journal-title":"Matern. Child Nutr."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1-15","DOI":"10.1186\/s12889-019-6688-2","article-title":"Determinants of stunting, underweight and wasting among children< 5 years of age: evidence from 2012-2013 Pakistan demographic and health survey.","volume":"19","author":"S Khan","year":"2019","journal-title":"BMC Public Health."},{"key":"ref44","doi-asserted-by":"crossref","first-page":"1-10","DOI":"10.1186\/s13052-021-01110-8","article-title":"Severe stunting and its associated factors among children aged 6\u201359 months in Ethiopia; multilevel ordinal logistic regression model.","volume":"47","author":"A Muche","year":"2021","journal-title":"Ital. J. Pediatr."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"102574","DOI":"10.1016\/j.eclinm.2024.102574","article-title":"Maternal education and its influence on child growth and nutritional status during the first two years of life: a systematic review and meta-analysis.","volume":"71","author":"G Rezaeizadeh","year":"2024","journal-title":"Eclinicalmedicine."},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.1316","article-title":"The role of parents\u2019 literacy in malnutrition of children under the age of five years in a semi-urban community of Pakistan: a case-control study.","volume":"9","author":"U Khattak","year":"2017","journal-title":"Cureus."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e0149700","DOI":"10.1371\/journal.pone.0149700","article-title":"Stunted at 10 years. Linear growth trajectories and stunting from birth to pre-adolescence in a rural Bangladeshi cohort.","volume":"11","author":"P Svefors","year":"2016","journal-title":"PLoS One."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1-10","DOI":"10.1186\/1471-2431-7-17","article-title":"Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys.","volume":"7","author":"H Wamani","year":"2007","journal-title":"BMC Pediatr."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e001155","DOI":"10.1136\/bmjgh-2018-001155","article-title":"Path analyses of risk factors for linear growth faltering in four prospective cohorts of young children in Ghana, Malawi and Burkina Faso.","volume":"4","author":"E Prado","year":"2019","journal-title":"BMJ Glob. Health."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"491","DOI":"10.3390\/nu9050491","article-title":"Factors associated with stunting among children aged 0 to 59 months from the central region of Mozambique.","volume":"9","author":"L Garcia Cruz","year":"2017","journal-title":"Nutrients."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"120","DOI":"10.11604\/pamj.2013.15.120.2535","article-title":"Malnutrition in Sub\u2013Saharan Africa: burden, causes and prospects.","volume":"15","author":"L Bain","year":"2013","journal-title":"Pan Afr. Med. J."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3390\/nu9010044","article-title":"Multilevel analysis of factors associated with wasting and underweight among children under-five years in Nigeria.","volume":"9","author":"B Akombi","year":"2017","journal-title":"Nutrients."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"368-377","DOI":"10.6000\/1929-6029.2014.03.04.5","article-title":"Determinants of wasting among under-five children in Ethiopia: (a multilevel logistic regression model approach).","volume":"3","author":"G Dabale","year":"2014","journal-title":"Int. J. Stats. Med. Res."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"251-257","DOI":"10.2223\/JPED.1776","article-title":"Some risk factors associated with overweight, stunting and wasting among children under 5 years old.","volume":"84","author":"M Vitolo","year":"2008","journal-title":"J. Pediatr."},{"key":"ref55","first-page":"111-116","article-title":"Consanguinity among the risk factors for underweight in children under five: a study from rural Sindh.","volume":"21","author":"S Hasnain","year":"2009","journal-title":"J. Ayub. Med. Coll. Abbottabad."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s40795-023-00683-3","article-title":"Factors associated with wasting and stunting among children aged 06\u201359 months in South Ari District, Southern Ethiopia: a community-based cross-sectional study.","volume":"9","author":"T Toma","year":"2023","journal-title":"BMC Nutr."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"e0278097","DOI":"10.1371\/journal.pone.0278097","article-title":"Prevalence and determinants of wasting of under-5 children in Bangladesh: Quantile regression approach.","volume":"17","author":"M Hossain","year":"2022","journal-title":"PLoS One."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"72-82","DOI":"10.1017\/S136898001900140X","article-title":"Reducing childhood malnutrition in Bangladesh: the importance of addressing socio-economic inequalities.","volume":"23","author":"M Islam","year":"2020","journal-title":"Public Health Nutr."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"159-166","DOI":"10.1177\/0260106017722924","article-title":"Why are our children wasting: Determinants of wasting among under 5s in Ghana.","volume":"23","author":"E Darteh","year":"2017","journal-title":"Nutr. Health."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"427-451","DOI":"10.1016\/S0140-6736(13)60937-X","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries.","volume":"382","author":"R Black","year":"2013","journal-title":"Lancet."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1285-1305","DOI":"10.1016\/j.worlddev.2005.03.002","article-title":"Why is child malnutrition lower in urban than in rural areas? Evidence from 36 developing countries.","volume":"33","author":"L Smith","year":"2005","journal-title":"World Dev."},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.11564\/30-2-836","article-title":"Key determinants of malnutrition of children under five years of age in Rwanda: Simultaneous measurement of three anthropometric indices.","volume":"30","author":"F Habyarimana","year":"2016","journal-title":"Afr. Popul. Stud."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"e0219665","DOI":"10.1371\/journal.pone.0219665","article-title":"The epidemiology of undernutrition and its determinants in children under five years in Ghana.","volume":"14","author":"M Boah","year":"2019","journal-title":"PLoS One."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1186\/s12889-024-18836-9","article-title":"Predictors of under-weight among children younger than 24 months in Nimule Border Town, Eastern Equatoria State, South Sudan: a community-based cross sectional study.","volume":"24","author":"F Eriga","year":"2024","journal-title":"BMC Public Health."},{"key":"ref66","doi-asserted-by":"publisher","first-page":"260-265","DOI":"10.1111\/j.1442-200X.2007.02354.x","article-title":"Risk factors for protein\u2013energy malnutrition in children under 5 years: study from Luangprabang province, Laos.","volume":"49","author":"M Phengxay","year":"2007","journal-title":"Pediatr. Int."},{"key":"ref67","doi-asserted-by":"publisher","first-page":"169-181","DOI":"10.1002\/ajhb.20481","article-title":"Availability of childcare support and nutritional status of children of non-working and working mothers in urban Nepal.","volume":"18","author":"S Nakahara","year":"2006","journal-title":"Am. J. Hum. Biol."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"5129-5136","DOI":"10.1002\/fsn3.3472","article-title":"Early initiation of breastfeeding, bottle feeding, and experiencing feeding challenges are associated with malnutrition.","volume":"11","author":"H Garti","year":"2023","journal-title":"Food Sci. Nutr."},{"key":"ref69","doi-asserted-by":"publisher","first-page":"1-14","DOI":"10.1186\/s12889-017-4621-0","article-title":"Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013\u201314.","volume":"18","author":"H Kismul","year":"2018","journal-title":"BMC Public Health."},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.4314\/ajfand.v10i4.55329","article-title":"Relationship between breastfeeding practices and nutritional status of children aged 0-24 months in Nairobi, Kenya.","volume":"10","author":"E Muchina","year":"2010","journal-title":"Afr. J. Food Agric. Nutr. Dev."},{"key":"ref71","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.4172\/2161-0509.1000208","article-title":"Prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia 2016.","volume":"7","author":"S Shine","year":"2017","journal-title":"J Nutr Disorders Ther."},{"key":"ref72","doi-asserted-by":"publisher","first-page":"69-82","DOI":"10.1111\/mcn.12080","article-title":"The economic rationale for investing in stunting reduction.","volume":"9","author":"J Hoddinott","year":"2013","journal-title":"Matern. Child Nutr."},{"key":"ref73","doi-asserted-by":"publisher","first-page":"87-101","DOI":"10.1016\/j.foodpol.2016.07.004","article-title":"How important is economic growth for reducing undernourishment in developing countries?","volume":"63","author":"B Soriano","year":"2016","journal-title":"Food Policy."},{"key":"ref75","doi-asserted-by":"crossref","first-page":"1-10","DOI":"10.1186\/1475-2891-13-65","article-title":"Strong nutrition governance is a key to addressing nutrition transition in low and middle-income countries: review of countries\u2019 nutrition policies.","volume":"13","author":"B Sunguya","year":"2014","journal-title":"Nutr. 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Maulana Azad Memorial College, Cluster University of Jammu, Jammu & Kashmir, 16 Jan 2025, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/13-1428\/v1#referee-response-355576","order":0,"name":"referee-response-355576","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Nelmighrabi Elmighrabi<\/b>; \n<i>Posted: 20 Jan 2025<\/i>; Dear Om Raj Katoch,  Thank you for your valuable feedback on my manuscript, \u201c\n<b>Undernutrition before two years in Algeria: Repeated cross-sectional analyses (2012-13 to 2018-19).&quot;<\/b> I have carefully considered your comments, and here is a response&nbsp;to each of your comments, outlining the changes made and providing clarification where necessary. I hope these address your concerns and enhance the clarity and quality of the manuscript.  1. The methodology section lacks details on the calculation of undernutrition indicators\u2014stunting, wasting, and underweight. Definitions and formulas, such as stunting being a height-for-age Z-score (HAZ) below -2 SD of WHO standards, must be specified. Indicate the software or statistical tools (e.g., WHO Anthro, R, Stata, SPSS) used for analysis  \n<b>1. Author response: <\/b>\n<i>The &quot;Outcome Variables&quot; subheading describes three undernutrition indicators\u2014stunting, wasting, and underweight\u2014and their calculation methods. STATA 2017 software was utilised software for the analysis, and we specified that in the data analysis subheading that descriptive analyses were conducted using Stata \u2018Svy\u2019 commands (Stata Corp 17.0).<\/i>  2. The discussion would benefit from comparing findings with existing literature. The authors should explore contributing factors, such as improved maternal education and healthcare access, and situate these findings within regional trends. \n<b>2. Author response: <\/b>\n<i>We strongly agree with this observation. However, due to the limited literature available, to the best of our knowledge, we have addressed this by comparing our results with studies from other countries that share similar circumstances. Specifically, we have included comparisons in nearly every paragraph of the discussion section, such as &quot;The<\/i>\n<b>&nbsp;findings indicated a significant association between perceived small birth size and a higher likelihood of wasting in children. This finding is consistent with those of a previous study conducted in Nigeria.<sup>52<\/sup>&nbsp;Other studies from Ethiopia,<sup>53<\/sup>&nbsp;Brazil<sup>54<\/sup>&nbsp;and Pakistan&nbsp;<sup>55&quot;, &quot;<\/sup>The present study found that older children aged 18\u201323 months were less prone to underweight. The results of this study are consistent with the findings of Eriga et al. and Pheringxay et al., which found that children aged 13-24 months and 12-24 months have a greater chance of being underweight.&nbsp;&quot;&nbsp;<sup>65,66&nbsp;<\/sup><\/b>\n<i><sup> <\/sup> and<\/i> \n<b><sup>&quot;<\/sup>The current study observed increased odds of stunting and being underweight among mothers with limited education. Similar findings were found in Pakistan, in a sample of 3071 Pakistani children aged 0-59 months from the Pakistan Demographic and Health Surveys (DHS) 2012-2013 found a significant association between undernutrition among children under five and mothers with low education levels.&nbsp;<sup>43&nbsp;<\/sup>Similarly, a study conducted in Ethiopia aimed to evaluate stunting and its related factors in children aged 6\u201359 months.<sup>44<\/sup>&nbsp;A systematic study and meta-analysis conducted in middle-income countries also found a statistically significant inverse correlation between maternal educational level and probability of being underweight.<sup>45<\/sup>&nbsp;&quot;<\/b>  -\n<b> <\/b>\n<i>We also agree with your suggestion regarding the importance of exploring contributing factors. This aspect has been discussed in the manuscript, particularly in the discussion section, where we highlighted healthcare access and maternal education as factors that also associated with undernutrition in Algeria<\/i>\n<b>. &quot;&nbsp;Children of mothers who did not visit any ANC clinic were significantly more prone to wasting. Previous research demonstrated a significant correlation between mothers\u2019 lack of knowledge of child feeding practices and the occurrence of wasting.<sup>57<\/sup>&nbsp;This corroborates our finding of an association between ANC clinic attendance and wasting, as it is at such places that mothers gain the requisite knowledge of appropriate child-feeding practices, which may be applied to prevent wasting.&quot;&nbsp;<\/b> \n<i>and<\/i> \n<b>&quot;The current study observed increased odds of stunting and being underweight among mothers with limited education. Similar findings were found in Pakistan; a sample of 3071 Pakistani children aged 0-59 months from the Pakistan Demographic and Health Surveys (DHS) 2012-2013 found a significant association between undernutrition among children under five and mothers with low education levels.<sup>43<\/sup>&nbsp;Similarly, a study conducted in Ethiopia aimed to evaluate stunting and its related factors in children aged 6\u201359 months.&nbsp;&nbsp;<sup>44<\/sup>A systematic study and meta-analysis conducted in middle-income countries also found a statistically significant inverse correlation between maternal educational level and probability of being underweight.<sup>45&quot;.<\/sup><\/b>  3. The manuscript should explicitly acknowledge the limitations of the study. \n<i><b>3. <\/b><\/i>\n<b>Author response: <\/b>\n<i>The limitations of this study were clearly articulated in the final paragraph of the discussion.<\/i>  4. What are the policy implications of the study to the study are or to the world? \n<b>4<\/b>. \n<b>Author response: <\/b>Policy implications and recommendations have been addressed and stated in the discussion section of the manuscript, specifically before the last two paragraphs that discuss the strengths and limitations of the study.  \n<i>Please feel free to share any additional feedback.<\/i>  Best regards,  Nagwa Elmighrabi","URL":"https:\/\/f1000research.com\/articles\/13-1428\/v1#referee-comment-13178","order":1,"name":"referee-comment-13178","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.173995.r355578, Asif Khaliq, Queensland University of Technology, Queensland, 31 Oct 2025, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/13-1428\/v1#referee-response-355578","order":2,"name":"referee-response-355578","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The article is supported by Western Sydney University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}