Correlates of Infant Growth in Abuja Communities

Roughly an estimated number of 149 million children below five years of age across the world suffer from stunting, while more than 45 million suffer from wasting, thus shedding light on an ongoing global emergency of child growth and development (Mertens et al., 2023). Stunting and wasting, which contribute considerably to growth faltering, correlate effectively with an increase in child morbidity and mortality during the early stages of life, along with adverse effects on lifetime cognition and economic impacts (Mertens et al., 2023; Schneider, 2023). In the region of Sub-Saharan Africa, despite its ongoing use of global resources, the scenario of stunting amongst children aged six months to five years still stands among the highest, measured from 8% to a staggering 64%, while the data of wasting reaches an equally alarming measure of up to 58% (Riwa et al., 2025, Scoping Review, 2025). The most populous African state of Nigeria, which continues to stand firm among the world’s leading countries registering infant malnourishment and infant death tolls, sheds light on geographical inequities (Oweibia et al., 2025; Adeyinka et al., 2020). The world’s epidemiologic picture of child growth gaps continues. Despite the global efforts and innovation, even today, children in middle and low-income countries have stunted, wasted, and underweight outcomes (de Onis et al., 2020). WHO is striving to achieve a given promise of cutting the number of stunted children by a margin of 40 percent by the year 2025. Nevertheless, not every country is moving in the right direction and the rate of progress has not been as high as was expected, especially in Sub-Saharan Africa (de Onis et al., 2020). Prenatal factors including maternal nutrient consumption, body measurements, or early first post-child growth gaps continue as an important driving force of ongoing stunting outcomes and increased risk of death in the first two years of life, including findings from longitudinal research (Mertens et al., 2023). Against this background, it becomes apparent that the first 1,000 days, from conception through age 24 months, is of pivotal importance in preventing permanent outcomes of growth gaps. Along with the mentioned longitudinal analyses, narrative literature studies underline equally the role of breastfeeding as an efficient infection protector, while stimulating healthy pattern development. A few years ago, a systematic literature review revealed significant correlations concerning increased periods of breastfeeding and reduced incidences of infection of the pulmonary or gastrointestinal tracts, increased weight gain, or reduced occurrences of obesity or death (Patnode et al., 2025). Moreover, current nutritional experts more often recommend the use of WHO Child Growth Standards in all populations. The use of specific measures (HAZ, WAZ, e.g.) allows comparisons across populations, including urban African countries like Abuja. Theoretical analyses of global changes in growth patterns among children show how various growth patterns respond differently to particular socioeconomic changes. Research by Schneider (2023) analyzes more than 150 years of progress in improving heights among children from LIMCs, demonstrating how reductions in stunting among children can be attributed to advances in nutritional, sanitation, maternal, and healthcare conditions. The application of this historical perspective enables an understanding of the current impact of infant growth within urban Nigeria. Stunting and wasting in Sub-Saharan Africa show some of the highest figures in the world. Riwa et al. (2025) identified stunting of up to 64% in a review of 59 publications from 11 countries. They found that stunting was most often attributed to illiteracy among mothers, socioeconomic status, food insecurity in households, and frequent bouts of ailments among children, including diarrheal diseases. The factors identified by the authors indicate the convergence of various risks that hamper infant growth in SSA. Related to this issue, the concept of women’s empowerment has been identified as an important framework through which outcomes of neonates can be analyzed. Using a narrative review focusing on Nigeria, Idowu et al. (2024) reveal how mother’s education, employment, or empowerment can act as strong predictors of neonate survival or perhaps growth. Empowerment outcomes like literacy levels or the ability to make decisions can ensure adequate healthcare use, proper infant-feeding practices, or hygienic home practices. The effect of infectious diseases is also significant in that cohort studies among various countries in SSA show that a high prevalence of malaria can increase the risk of low birth weight, which then portends growth faltering among the babies (Heng et al., 2020). Even though this particular research did not focus on babies after the neonatal period, its findings still relate to the effect of urban malaria control on growth outcomes in a densely populated city such as Abuja. Data from Nigeria’s national reports show that there continue to be issues concerning infant growth and MCH. The Multiple Indicator Cluster Survey conducted in Nigeria in 2016/2017 reveals stark inequities in child survival rates, with maternal education, wealth, order of birth, and the level of perinatal care as key underlying factors (Adeyinka et al., 2020). While it does not relate directly to stunting or growth rate, association patterns correlate well with growth factors, given the negative impacts of suboptimal conditions on infant growth. More recently, the NDHS 2018 and 2023-24 comparison (Oweibia et al., 2025) highlights modest improvements in exclusive breastfeeding (29% to 34%) and skilled birth attendance (57% to 68%), alongside persistent disparities across northern and rural regions. While national progress is evident, the gaps in coverage are likely more pronounced in urban poor settings like Abuja’s informal settlements warranting targeted study of local growth patterns and determinants. Other types of predictive models on a national level offer information on the macro-economic perspective. For instance, research by Adegoke et al. (2022) correlates consumption expenditure, maternal health expenditure, and national expenditure on health with progress reported on infant and maternal SDG goals. The research indicates that enhanced socioeconomic factors or better funding of healthcare could offer tangible progress on infant growth. A specific scoping review on immunization in Nigeria was done (Mohammed et al., 2024), which states there is low immunization coverage in slums of urban areas owing to a lack of service trust, residency in slums, and logistical constraints. As pathogens (diarrhea/pneumonia) greatly inhibit physical infant growth, this immunization gap is an important contextual issue within Abuja. An extended scoping review of infant mortality risk factors in Nigeria (Nwanze et al., 2023) serves once more as an indicator of commonalities in growth factors. While mortality and growth can be considered complementary or mutually exclusive outcomes, the architecture of risk is surprisingly common. Although there is abundant information available concerning national data, there remain considerable gaps in knowledge concerning infant growth correlates in African urban settings, including those of Abuja. To begin with, there is a lack of micro-level research concerning infant anthropometric characteristics, nutritional habits, and environmental factors. Most of the current literature utilizes national data (MICS, NDHS), which lack micro-level resolution focusing on intra-urban variation. Second, there could be issues with methodologies. For instance, national data sets from surveys, though hugely beneficial, tend to be cross-sectional. Also, they may lack information about such basic variables as food security at the household level, the nutritional diversity of mothers, or neighborhood or community parenting (Adeyinka et al., 2020; Oweibia et al., 2025). Third, the majority of studies present the results about the mortality or immunization coverage (Nwanze et al., 2023; Mohammed et al., 2024). Despite the utility of predictive factors of infant death, they are more likely to characterize severe outcomes, and fail to reflect subclinical stunting or faltering processes in survivors. There exist limited sources of longitudinal or multi-method data on weight-for-age, growth velocity or complementary infant-feeding patterns in Nigeria. Fourth, the issues of rapid urbanization, informal settlement housing conditions, water/sanitation issues, environmental pollution, and inequities in access to healthcare, which relate specifically to the Abuja context, have not been represented well in current growth literature. While national trends convey inequities, inequities of the micro-urban environment of Abuja’s peri-urban or slum settings are not explored sufficiently. Finally, despite the availability of theoretical findings (e.g., the role of women’s empowerment, prenatal factors, economic development) in the literature (Idowu et al., 2024; Mertens et al., 2023; Schneider, 2023), this specific application of the concepts within urban Nigeria infant growth models has not been explored. There does not appear to be research that combines the theoretical framework of UNICEF’s understanding of undernutrition concepts with data from Abuja communities. The standard of housing, population density, sanitation facilities, or access to adequate health facilities could pose a high-risk environment among others that contribute to stunted infant growth. However, it is difficult to develop interventions in the field of public health absent specific information. The research will fill key gaps in the literature by offering data on community-level anthropometric outcomes (weight-for-age and height-for-age z-scores), environmental/socioeconomic information, and information on maternal health practices and infant-feeding patterns in various neighborhoods of Abuja. Using a mixed-methods design, this research will help identify not only associations, but also help understand the perceptions of both caregivers and providers on factors that influence growth. The policymaking relevance of this research is significant. While the focus of Nigeria’s National Nutrition Policy and revamping of its Primary Health Care strategies pertains to growth surveillance, maternal education, and community nutritional services, there is a lack of customization in implementing strategies within the local settings of Abuja. Findings of this research can help design Abuja-focused interventions. Moreover, the use of WHO Child Growth Standards (Finaret & Taylor-Forde, 2025) ensures that it is possible to compare outcomes on an international level. Theoretically, this research also makes a contribution by proposing the application of concepts such as the UNICEF Conceptual Framework of undernutrition (linking immediate, underlying, and basic causes), as well as incorporating Maternal Empowerment (Idowu et al., 2024), Prenatal Determinants (Mertens et al., 2023), into a complex framework which has been calibrated on an urban-Nigerian level. In sum, this research was both academically sound and on track regarding national targets in efforts to end stunting, infant, and overall child health SDG Target 3. The research helped provide additional evidence by not only giving location-specific, data-driven analyses of what influences infant growth, which would later contribute towards more effective strategies in improving infant and overall child outcomes.

The primary aim of this study is to investigate the correlates of infant growth rates in selected communities within the Abuja Federal Capital Territory (FCT), Nigeria.

1. 1What are the key determinants of infant growth rates measured by weight, length/height, and head circumference in selected communities within the Abuja Federal Capital Territory?
2. 2How do infant feeding practices, including breastfeeding and complementary feeding, influence the growth rates of infants aged 6-12 months?
3. 3What is the impact of maternal health and nutritional status on the growth of infants aged 0-12 months?
4. 4How does maternal household income associated with infant growth patterns?

1. H1There is no significant association between maternal income and infant growth