MULTILEVEL ANALYSES OF CHILDHOOD MALNUTRITION AND TEMPERATURE EXTREMES IN KENYA, BURKINA FASO, NEPAL, AND PAKISTAN: EXAMINING INDIVIDUAL AND CONTEXTUAL FACTORS

Abstract

This dissertation investigates the multifaceted determinants of child malnutrition amidstescalating climate change and rapid nutrition transitions across Sub-Saharan Africa and South Asia. Focusing on Burkina Faso, Kenya, Nepal, and Pakistan, the research first explores how temperature extremes both heat and cold interact with household variables to influence child stunting. The analysis reveals that the impact of climate anomalies on child growth is heavily mediated by local environmental conditions and social resources. While access to electricity, improved water, and sanitation consistently serves as a critical buffer, the specific health risks associated with temperature fluctuations differ markedly by region. Notably, the study uncovers significant associations between cold anomalies and increased stunting risk in specific contexts, broadening the climate-health discourse beyond heat stress alone. Complementing this environmental analysis, the dissertation examines the "double burden" of malnutrition, characterized by the coexistence of child stunting and maternal overweight within the same households. The findings demonstrate that this dual burden manifests heterogeneously, driven by divergent patterns of wealth, urbanization, and maternal education. In several contexts, socioeconomic gains were linked to rising maternal obesity without fully resolving child undernutrition, complicating traditional poverty-reduction narratives. Collectively, these chapters highlight that malnutrition is shaped by a complex interplay of climatic stressors and sociodemographic shifts. The study concludes that addressing these disparities requires moving beyond one-size-fits-all interventions toward integrated, context-specific policies capable of tackling both the environmental roots of undernutrition and the emerging complexities of the nutrition transition.