Authors: Fayo Haji , Noran Magdy Shalma

Abstract

Background: Malnutrition is a major public health concern in sub-Saharan Africa, yet recent data on its prevalence and determinants among women in Malawi are lacking. Identification of the risk factors of malnutrition is essential for developing targeted interventions to reduce its burden.

Objective: To identify determinants of underweight, overweight, and obesity among Malawian women.

Methodology: We performed a cross-sectional study of women aged 15-49 using data from the 2024 Malawi Demographic and Health Survey. We performed the analysis with SPSS version 24. Multinomial logistic regression was conducted to identify determinants of BMI categories, using normal weight as the reference group. The results were reported using adjusted odds ratios (AORs) and their corresponding 95% confidence intervals (CIs).

Results: We found that 64.1% of women had a normal weight. Meanwhile, 16.7% were overweight, 13.2% were obese, and 5.8% were underweight. On performing the regression, we found that older age (45-49 years) and higher wealth quintiles were associated with higher odds of being overweight and obese (P<0.001), while non-internet use in the previous month was associated with lower odds of being overweight (AOR: 0.618; 95% CI: 0.493–0.775) or obese (AOR: 0.604; 95% CI: 0.477–0.764); compared to daily users (P< 0.001). Urban residence was significantly associated with obesity (AOR: 1.757; 95% CI: 1.409–2.193), while not currently working increased the odds of being underweight (AOR: 1.392; 95% CI: 1.153–1.681) and overweight (AOR: 1.183; 95% CI: 1.029–1.360) (P<0.001). Education, religion, and ethnicity showed non-significant associations.

Conclusion: This study revealed a dual burden of undernutrition and obesity among Malawian women, with around one-third of women being overweight or obese. Obesity was associated with living in urban areas, being wealthier, and being older. Meanwhile, being underweight was associated with lower wealth and unemployment. These findings highlight the need for interventions to reduce the burden of malnutrition in Malawi.

Keywords: Obesity, overweight, underweight, Malawi, Malnutrition, women’s health, DHS, sub-Saharan Africa.