Understanding household economic influences on child stunting: A cross-sectional study in Eastern Uganda

• This study examined the relationship between household economic indicators and child stunting in a rural district of Eastern Uganda. • Stunting prevalence was 28% among children aged 24–59 months, indicating a high burden of undernutrition. • Household asset-based wealth was not significantly linked to child stunting • Children in households with two or more income earners had approximately 50% lower stunting prevalence, with more pronounced effects in severely food-insecure households. Child stunting is a significant public health concern in rural Uganda, where poverty and food insecurity are prevalent. This study aimed to examine how household economic factors influence child stunting in a rural district of Eastern Uganda and to assess whether food security moderates this relationship. A cross-sectional study was conducted involving 289 children aged 24-59 months in Namutumba District, Eastern Uganda. Data were collected on household asset-based wealth, food security, and household income diversification using a validated questionnaire, while anthropometric measurements of children were obtained using standard measurement procedures. Prevalence rate ratios (PRRs) were calculated to determine the association between household economic factors and child stunting using modified Poisson regression, and the moderating effect of food security was assessed on the additive scale using predictive margins. The prevalence of stunting was 28%. Household asset-based wealth was not significantly associated with stunting. However, household income diversification showed an inverse association with stunting. Children from households with two or more income-earning members had a significantly lower prevalence of stunting compared to those with none (adjusted PRR = 0.50; 95% Confidence Interval (CI): 0.26, 0.97). Among severely food-insecure households, the predicted probability of stunting was 23% lower (95% CI: -2.8%, -43.4%) for children living in households with multiple income earners compared with those in households with no income earners. While asset-based wealth was not associated with child stunting, household income diversification proved to be protective. These findings indicate considerations for interventions that integrate multiple income generation with food security strategies to reduce child stunting in this population.