Prevalence of Malnutrition and Associated Factors Among School Children in Hawella Tula Rural District, Hawassa, Sidama Regional State, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Malnutrition, including stunting, wasting, and underweight, remains a major public health problem among school-age children in low-resource settings. In Hawella Tula, a sub-city of Hawassa, evidence on the magnitude and determinants of malnutrition is limited and not sufficiently context-specific. This gap constrains the development of targeted and effective interventions. OBJECTIVE: This study aimed to assess the prevalence of malnutrition and its associated factors among primary school children in Hawella Tula, Sidama, Ethiopia. METHODS: A school-based cross-sectional study was conducted involving 394 primary schoolchildren from June to December 2023. Data were collected using an interviewer-administered questionnaire and anthropometric measurements. Weight and height were measured using a calibrated digital scale and a Seca stadiometer. Nutritional status was assessed using height-for-age Z-scores (HAZ) and BMI-for-age Z-scores (BAZ). Bivariate and multivariable logistic regression analyzes were performed to identify factors associated with malnutrition. RESULTS: The prevalence of stunting and underweight was 29.4% (95% CI: 25.1-34.1) and 33.5% (95% CI: 29.0-38.3), respectively. Factors significantly associated with stunting included age > 12 years (AOR = 2.39, 95% CI: 1.43-3.98), family size > 5 (AOR = 2.94, 95% CI: 1.73-4.99), maternal lack of formal education (AOR = 2.88, 95% CI: 1.30-6.38), low household wealth (AOR = 2.28, 95% CI: 1.02-5.12), paternal polygamy (AOR = 2.24, 95% CI: 1.16-4.32), severe food insecurity (AOR = 3.02, 95% CI: 1.46-6.24), poor dietary diversity, and soil-transmitted helminth infection (AOR = 1.97, 95% CI: 1.19-3.25). CONCLUSION: Malnutrition affects nearly one-third of schoolchildren in the study area, indicating a substantial public health concern. Targeted interventions focusing on improving dietary diversity, household food security, parental education, and parasitic infection control are urgently needed.