Virginia Via Research Day Book 2026

Medical Student Research Public Health

14 COUNTRY CONTEXT AS A PREDICTOR OF CHILD NUTRITIONAL OUTCOMES IN WEST AFRICA DURING COVID-19

Ames-Zuniga, P. E., Fleming, N.K., Lenker, L.K., Esia-Donkoh, K., Doku, D., Bradberry, C., Blackburn-Lynch, W., Nicholson, J., Hicks, A.M., Kadio, B. Corresponding author: llenker@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

Fragile State Index (FSI), Climate Risk Index (CRI), and Human Development Index (HDI). Nutritional outcomes were measured using prevalence of wasting (low weight-for-height) and stunting (low height for-age) among children under five. Pre-COVID (2012–2018) and post-COVID (2022–2025) data were obtained from Demographic and Health Surveys, UNICEF, and World Bank sources. Percent changes in malnutrition indicators were calculated and correlated with Pre-COVID contextual indices. Results: Post-COVID wasting increased across multiple contexts, including Ghana, Nigeria, Senegal, Liberia, and Niger, regardless of relative stability or development status. Stunting prevalence improved in most countries; however, Nigeria and Niger demonstrated worsening trends. Correlations between malnutrition outcomes and FSI, CRI, and HDI were

inconsistent, suggesting that macro-level country context alone did not adequately explain observed nutritional changes in the studied countries. Conclusion: Country context, as measured by macro-level indicators, did not confer protection against worsening child wasting during the COVID-19 period in West Africa. These findings highlight the need for future research incorporating micro- and meso-level factors within a socio-ecological framework to better understand the child nutrition during global crises.

Background: Child malnutrition remains a major contributor to preventable morbidity and mortality in West and Central Africa, where systemic shocks such as the COVID-19 pandemic may exacerbate existing vulnerabilities. Country context, including social stability, climate vulnerability, and level of development, may influence a nations ability to buffer adverse child health outcomes during crises. Objective: This study examined whether country context functioned as a protective buffer against changes in child nutritional outcomes during the COVID-19 pandemic in West Africa. Methods: An analysis was conducted across nine West African countries selected based on geography, stability, and development status. Country context was assessed using three macro-level proxies: the

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28 Edward Via College of Osteopathic Medicine (VCOM)