PREVALENCE AND FACTORS ASSOCIATED WITH MALNUTRITION AMONG CHILDREN UNDER FIVE YEARS IN KISII COUNTY: A SYSTEMATIC REVIEW

Background: Malnutrition among children under five remains a major public health concern because poor nutrition in early life affects survival, growth, immunity, cognitive development, and later well-being. Although Kenya's national nutrition indicators have improved, significant disparities still exist between counties and communities. Kisii County has distinct agricultural, dietary, and socioeconomic characteristics, making local evidence important. OBJECTIVE: To systematically review evidence on the prevalence of malnutrition and the factors associated with it among children under five years in Kisii County, Kenya. 
Methods: Literature was searched using combinations of terms related to children under five, malnutrition, stunting, wasting, underweight, nutritional status, and Kisii County. Relevant biomedical databases, academic search sources, institutional repositories, and government reports were considered. Studies were eligible when they provided Kisii-specific information on nutritional status or associated factors. Because the studies differed in age groups, settings, and measurement methods, findings were synthesized narratively rather than statistically pooled 
Results: For qualitative synthesis, eight locally pertinent reports and research were kept. In a Kisii County study of children aged 6–23 months, 17.8% were stunted, 11.7% underweight, and 10.5% wasted; only 17.5% obtained the minimum recommended diet. Other local data related nutritional status with dietary diversity, breastfeeding and complementary feeding, caregiver variables, immunization, child age, household food insecurity and community nutrition services. In conclusion, there are several contributing factors to malnutrition in Kisii County. Appropriate newborn and young child feeding, dietary variety, growth monitoring, community health worker support, home food security measures, and early detection and treatment of acute malnutrition should all be part of prevention. There is a need for more recent representative county-level research.