(P23-023-25) Associations of Land Surface Temperature and Drought With Undernutrition Among Under-Five Children In Nepal: A Multilevel and Spatial Analysis

Objectives: To examine the association of land surface temperature (LST) and drought with undernutrition and explore spatial variability and patterns in the relationship between these climatic factors and undernutrition among children under five in Nepal.

Methods: This study used secondary data from the 2022 Nepal Demographic and Health Survey (NDHS), a nationally representative cross-sectional survey. Anthropometric measurements for 2,379 children aged 0–5 years from the NDHS were linked to remotely sensed daily mean daytime LST and the Normalized Difference Vegetation Index (NDVI), which is considered a proxy indicator for drought. The odds of stunting and wasting were assessed with LST and NDVI, and child, parental, and household level factors using multilevel mixed-effect logistic regression. We used ordinary least squares and multi-scale geographically weighted regression (MGWR) to derive global and local estimates, examining spatial heterogeneity in the relationships between climatic and undernutrition variables.

Results: With every 1°C increase in LST the odds of stunting increased by 11% (aOR = 1.11; 95% CI: 1.01–1.23) in children under 2 years. A higher average NDVI was significantly associated with lower odds of stunting in children aged 2−5 years (aOR = 0.11; 95% CI: 0.01–0.99). MGWR analysis showed statistically significant spatial variations in the relationship between temperature variability and stunting rates across districts in the western hilly mountainous regions. NDVI was found to have spatially varying associations with stunting rates, especially in the eastern and central regions. The average daytime LST had a spatial varying association with wasting across districts in the Sudurpaschim, Karnali, Lumbini, and some districts of Madhesh provinces.

Conclusions: This study found that young children living in high-temperature areas were more likely to be stunted and increased vegetation levels were associated with a reduced burden of stunting. The relationship between temperature and child undernutrition varies spatially across Nepal. The spatial heterogeneity in the association of LST with stunting and wasting suggests that certain areas are more sensitive to climatic variability, highlighting the need for tailored interventions based on local climatic conditions.

Funding Sources: None