Socioeconomic inequalities in children's nutritional status in Democratic Republic of Congo in 2017-2018: an analysis of data from a nationally representative survey.

OBJECTIVE The Democratic Republic of the Congo (DRC) has one of the highest levels of child undernutrition globally, however, little information exists on the underlying socioeconomic inequalities resulting in undernutrition. This study aims to examine the differences in the nutritional statuses of children across different wealth quintiles and explores the association between malnutrition in children and related factors. DESIGN We utilised the 2018 Multiple Indicator Cluster Survey data. We estimated the prevalence of malnutrition across all 26 provinces. The study used the World Health Organizations' (WHO) 2006 child growth standards to measure stunting, underweight, and wasting. We employed a mixed-effect linear model to analyse the association between nutritional status and healthcare accessibility, domestic sanitation, and sociodemographic factors. SETTING 26 provinces in the DRC. PARTICIPANTS 21,477 children under 5 and 21,828 women of childbearing age in the DRC. RESULTS The national prevalence of underweight, stunting and wasting was found to be 23.33%, 42.05% and 5.66%, respectively. Household wealth and mother's education level were significantly positively associated with the nutritional statuses of children. Among households in the lowest wealth quintile, residence in urban areas was a protective factor against undernutrition. CONCLUSION The findings of this study indicate considerable socioeconomic inequalities in the nutritional statuses of children under 5 in the DRC, highlighting the need for nutrition promotion as part of maternal and child healthcare. Interventions and policies should include improving nutrition education for less-educated mothers, in particular, in the central provinces of the DRC.