Global, regional and national estimates of coexisting forms of malnutrition among the neonates, infants and young children - A secondary data analysis of Demographic & Health Surveys (DHS) from 2006 to 2024.

Objectives: To estimate Global, Regional, and National prevalence of Malnutrition, specifically Coexisting forms of malnutrition (CFM) and its various types: Coexistence of underweight with stunting (CUS), Coexistence of underweight with wasting (CUW), Coexistence of underweight with wasting & stunting (CUWS), Coexistence of stunting with overweight/obesity (CSO) among children under five years in low- and middle-income countries (LMICs). Methods: This cross-sectional observational study utilized latest nationally representative Demographic and Health Surveys (DHS) datasets of 62 LMICs corresponding to six global regions from 2006 to 2024. Data of 541,707 children aged 0 to 59 months with complete anthropometry were analysed descriptively (prevalence estimates) and inferentially (multivariate logistic regression). Results: The global malnutrition prevalence among children was 43.9%, of which CFM was observed among 20.9% children. Among various CFM types, CUS was highly prevalent (11.8%), followed by CUW (4.2%), CUWS (3.2%), and CSO (2.1%). South & Southeast Asian had highest CFM prevalence of 29.6%, while Central Asia and Latin America & Caribbean reported the lowest CFM prevalence of 8.1% and 6.2%, respectively. Among all the LMIC included, Timor-Leste exhibited the highest CFM at 41.8%. In general, children aged between 12 to 35 months had 2-3 times higher odds of various forms of CFM. However, female sex, maternal education, improvement in socioeconomic status, medium to large family size showed significantly lower odds with various forms of CFM. Conclusions: This study advances the understanding of CFM's prevalence, determinants, and regional variations, filling a critical gap in global nutrition research. The findings serve as a reminder to reinvest in efforts to protect children from malnutrition during their early years of life. Governments and other global health sector must invest in a well-established system of nutrition surveillance for addressing CFM, informing targeted interventions to improve child health outcomes in LMICs.