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Higher Maternal Education is Associated with Reduced Childhood Stunting in Zambia: Findings from the 2018 DHS

Nyirenda, N.; Muturi, H.; Muyuni, C.

2025-06-11 pediatrics
10.1101/2025.06.10.25329376 medRxiv
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BackgroundChildhood stunting remains a significant public health challenge in Zambia, contributing to poor cognitive development, increased morbidity, and long-term economic disadvantages. Maternal education is a known determinant of child nutrition outcomes, yet recent national-level data on this association are limited. MethodsWe analyzed data from the 2018 Zambia Demographic and Health Survey (DHS), focusing on children under five years of age. Stunting was defined as a height-for-age z-score below -2 standard deviations. Maternal education was grouped into four levels: no education, primary, secondary, and higher. Survey-weighted descriptive statistics and logistic regression models were used to assess the association between maternal education and child stunting, adjusting for sociodemographic and geographic covariates. ResultsAmong 8,746 children with complete data, the overall prevalence of stunting was 34.3%. In adjusted models, children of mothers with higher education had significantly lower odds of being stunted compared to those whose mothers had no education (adjusted OR: 0.42, 95% CI: 0.27-0.66; p < 0.001). Primary and secondary education were not significantly associated with stunting after adjustment. Male sex, increasing child age, and lower household wealth were also significantly associated with higher odds of stunting. ConclusionsHigher maternal education is independently associated with reduced risk of childhood stunting in Zambia. These findings underscore the importance of promoting womens education beyond basic literacy as a long-term strategy to improve child health and nutrition outcomes.

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