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Abstract
Background: malnutrition in throughout early childhood remains the important health problem in Iraq and it’s a disorder which arises when a child consumes insufficient or excessive amount of one or more of the nutrients, significantly leading to health problems.
Aim :To estimate the prevalence of malnutrition and its contributed socio-demographic, economic, and health-related factors among children under six years attending a major hospital outpatient department in Sulaymaniyah, Iraq.
Methods: A cross-sectional study was conducted in hospital setting between March 2025 to July 2025. A systematic random sample of 420 child-caregiver pairs was selected. Information were collected using structured questionnaire and anthropometric measurements. The nutritional status was categorised based on WHO Growth Standards. Bivariate and multivariate logistic regression analyses was carried out to estimate factors associated with malnutrition .
Results: Any malnutrition (stunting, wasting, or underweight) was 30.7%. Stunting was most commonly observed (14.8%), then underweight (11.7%) and wasting (7.9%). On bivariate analysis, low family income (p=0.024) was significantly associated with malnutrition (χ²=9.48). Multivariate analysis confirmed low income as the strongest predictor. Children from families earning <300,000 IQD/month (aOR=2.22, 95% CI: 1.05–4.73) and 500,000–800,000 IQD/month (aOR=2.46, 95% CI: 1.15–5.28) had significantly higher odds of malnutrition versus the highest income group.Health and dietary factors were not significant independent predictors.
Conclusion: Malnutrition is a potential public health problem in this population, with stunting being the primary concern. Socioeconomic status, not health or dietary practices, is the fundamental determinant. Effective interventions must therefore extend beyond nutritional education to include robust economic support and poverty alleviation programs to address the root causes.
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Copyright (c) 2026 Shwan Hamaseed, Heersh Saeed

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
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References
World Health Organization. Malnutrition. 2021. URL: No DOI; fact sheet available at https://www.who.int/news-room/fact-sheets/detail/malnutrition/
Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427-51. DOI: https://doi.org/10.1016/S0140-6736(13)60937-X
Victora CG, Adair L, Fall C, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340-57. DOI: https://doi.org/10.1016/S0140-6736(07)61692-4
Garfield R. The impact of economic sanctions on health and well-being. Relief and Rehabilitation Network. 1999;31. URL: No DOI; report available at https://odi.org/en/publications/the-impact-of-economic-sanctions-on-health-and-well-being/
UNICEF & Central Statistical Organization Iraq. Iraq Multiple Indicator Cluster Survey 2018. Baghdad: UNICEF; 2018. URL: No DOI; report overview at https://mics.unicef.org/news/iraq-2018-mics-datasets-survey-findings-report-and-snapshots-released
Ahmed; Hawramei. Risk factors of malnutrition among preschool children in Sulaimani. 2022. doi.org/10.33899/mjn.2022.175560
Saddam; Bahir. Assessment of malnutrition among children in Karbala. 2021. DOI: 10.36295/ASRO.2021.24536
Fateh et al. Nutritional status of children in Kalar city. 2022. DOI: 10.1186/s12889-022-14071-2
Abdulzahra; Ahmed; Kadhem. Prevalence of malnutrition in Babylon Governorate. 2022. DOI: 10.53730/ijhs.v6nS2.8394
Diyya et al. Nutritional status among children in Sulaymaniyah. 2024. doi.org/10.48047/AFJBS.6.15.2024.10887-10902
UNICEF. The UNICEF Conceptual Framework on the Causes of Malnutrition. New York: UNICEF; 2015. : No DOI; framework available via UNICEF resources.
