Shared geographic spatial risk of childhood undernutrition in Malawi: An application of joint spatial component model

OBJECTIVES: This study aimed at assessing shared spatial risk of childhood undernutrition indicators in Malawi. STUDY DESIGN: Cross-sectional design. METHODS: The shared spatial component model was fitted to childhood undernutrition indicators, namely: stunting, wasting and underweight, using 5066 child records of the 2015/16 Malawi demographic health survey data. The spatial components were districts, and were modeled by the convolution prior, with the structured components being assigned the conditional autoregressive distribution. RESULTS: There is significant clustering of shared spatial risk of stunting and wasting (Moran I = 0.464, p-value = 0.009), and wasting and underweight (Moran I = 0.392, p-value = 0.026), and the risk maps show southern districts, followed by central districts being at greater risk of jointly having stunting and wasting, wasting and underweight, compared to the northern region districts. The shared spatial risk of stunting and underweight is randomly dispersed across the country (Moran I = - 0.044, p-value = 0.539). CONCLUSION: Interventions to reduce the shared risk of child undernutrition should focus on the southern region districts and those in the central region, and a suggestion is made to address the issue of overpopulation and effects of climate change.