Childhood undernourishment was a central public health difficulty [1]. It touches children's mental and physical progress, raises the outlook of infections, and meaningfully contributes to the child’s illness and death [2, 3]. A good diet sets children on the trail to persist and succeed. Well-nourished children raise, mature, acquire, play, contribute and participate while undernutrition mugs children of their complete potential, with concerns for teenagers, nations, and thus the world [4]. Measures of under-five children’s undernourishment are familiarized to touch on development progress and socioeconomic inequalities in several low and middle-income countries. Scarce food within the primary thousand days of duration may a consequence of reduced physical development, which integrates a long-term influence on power thus resulting in reduced educational performance and economic productivity in maturity [5].
The three commonly known measures of under-five children’s undernourishment indicators are stunting, wasting, and underweight [6]. Being stunting and wasting indicate chronic and acute malnutrition respectively, underweight may be a pooled indicator, and comprises both acute (wasting) and chronic (stunting) malnutrition [6]. So, different dimensions of undernourishment may take place concurrently in under-five children [6].
A baby who is simply very short for his or her age (low height for age) is known as stunting. Children tormented by stunting can suffer severely irreparable physical and cognitive injuries that go together with their stunted growth. The devastating consequences of stunting can last a lifespan and even touch the long run group [7]. A baby who is simply very thin for his or her height (low weight for height) is called wasting. It is the outcome of current fast weight loss or the failure to achieve weight. A wasted child has an increased risk of death, but management is feasible. Likewise, underweight states to a baby who is simply very small for his or her age (low weight for age) which is the weight for age less than negative 2 standard deviation(SD) of the WHO Child Growth Standards median [7, 8].
Height for age, weight for height, and weight for age standard scores were calculated based on the 2006 WHO childhood growth criteria endorsed for worldwide sets [4]. Children are considered stunted after they have a height for age standard score below minus two compared with the WHO Child Growth criteria median of same age and gender. Wasting is defined by weight for height standard score (WHZ) below negative two and suggests acute undernutrition or rapid weight loss. Underweight is defined by weight for age standard score (WAZ) below negative two [9].
Globally malnutrition in children is exceptionally prevalent and remains a giant challenge [10]. Keeping with the worldwide organization Children’s Fund (UNICEF) report in 2020, 22% of youngsters under the age of 5 years are stunted, 12.6% are underweight and 6.7% are wasted [4]. Two districts in the world such as Asia and Africa bear the two in all the best burdens of undernutrition. Stunting affected around 149.2 million children age under-five in 2020. of those 53% of stunted under-five children lived in Asia and 30.7% lived in Africa [4]. During this year, wasting contributed to threatening the lives of an estimated 45.4 million under-five children. Of these, over two-thirds of all wasted under-five children are found in Asia and over one quarter was found in Africa [4]. However, a more detailed have a look at the distribution of undernutrition within the African region shows that Eastern Africa (32.6%) encompasses a better prevalence of stunting compared to Western Africa (30.9%), Central Africa (36.8%), Northern Africa (21.4%) and Southern Africa (23.3%) [4]. While Western Africa (6.9%) incorporates a better rate of wasting than the remainder of African regions, Southern Africa (3.2%), Central Africa (6.2%, Northern Africa (6.6%), and Eastern Africa (5.2%) [4]. These estimates reveal regional disparities within the distribution of undernutrition.
Numerous studies have assessed determinants of childhood undernutrition [11–13] and haven't focused on the association between undernourishment indicators. The rest studies have focused on the relationship of babyhood undernourishment indicators with their factors [1, 14], and have ignored the association of stunting, underweight, and wasting themselves while the other studies consider only single country [9], therefore the current study intended to investigate the association of under-five children stunting, underweight, and wasting using a log-linear model for the three-way table to evaluate the pairwise and three-dimensional association of indicators for Sub-Saharan region. The significance of showing the three-dimensional relationship is that it helps to judge whether childhood undernourishment indicators are distinct (main effects) or even taken integrated effect. The concurrent (interaction) effect would be reflected to represent possible relationship of the magnitude [1].