Prevalence and Factors Associated With Malnutrition Among Under-Five Children in Iran: A Cross-Sectional Study Publisher

Summary: Which children face malnutrition in Mashhad? A local study found notable under-five malnutrition in vulnerable areas and links with socioeconomic conditions and feeding. #ChildNutrition #PublicHealth

Rivaz R ; Jafarzadeh Esfehani A ; Zeraati T ; Nematy M ; Sobhani S R
Source: Advances in Public Health Published:2026

Abstract

Background: Although global progress has reduced stunting and wasting, progress remains uneven across countries and is insufficient in many settings, including parts of Iran, to achieve Sustainable Development Goal 2.2 by 2030. Data on malnutrition prevalence and determinants among under-five children in Iran, particularly in large urban settings, are limited. The aim of this study was to determine the prevalence and factors associated with malnutrition among under-five children in Mashhad, Iran. Methods: This cross-sectional study was a secondary analysis of baseline screening data from a community-based nutritional intervention study conducted in Mashhad, Iran. The sample included 219 children aged 12–60 months from economically at-risk households attending primary healthcare centers. Anthropometric measurements were converted to Z-scores based on the World Health Organization (WHO) 2006 Child Growth Standards. Parental questionnaires collected sociodemographic, birth, feeding, and economic data. Results: Overall prevalence of underweight, stunting, and wasting were 22.8%, 16%, and 24.7%, respectively. Only the crude prevalence of stunting decreased significantly across age groups, from 29.4% in children aged 12–24 months to 9.5% in those aged 36–60 months (p = 0.007). In contrast, after adjustment for potential confounders, children aged 36–60 months had higher odds of stunting than those aged 12–24 months (OR = 5.68, 95% CI: 1.56–20.65, p = 0.008). Paternal unemployment was a risk factor for underweight (OR = 4.40, 95% CI: 1.18–16.29, p = 0.02). Maternal employment was protective against stunting (OR = 0.09, 95% CI: 0.13–0.65, p = 0.02). Delayed complementary feeding initiation was protective against wasting (OR = 0.19, 95% CI: 0.04–0.87, p = 0.03). Conclusion: Malnutrition was prevalent among under-five children in economically vulnerable areas of Mashhad. Socioeconomic factors, parental occupation, and timely complementary feeding should be considered in designing targeted interventions to eliminate childhood malnutrition. Copyright © 2026 Raha Rivaz et al. Advances in Public Health published by John Wiley & Sons Ltd.