Structural Determinants of Child Undernutrition in Nigeria: A Political Economy Analysis Integrating Multilevel and Geospatial Methods

Child undernutrition in Nigeria persists despite decades of intervention, suggesting that surface-level programmatic approaches fail to address deeper structural drivers operating at state, community, and household levels. This study applied a political economy analytical lens integrated with multilevel statistical and geospatial methods to examine structural determinants of child undernutrition across Nigeria's six geopolitical zones. Using data from the 2021 Nigeria Demographic and Health Survey, complemented by geospatial datasets on food environment, agroecology, conflict exposure, and public expenditure, a multi-level hierarchical analysis was conducted for a national sample of 12,000 children under five. Child stunting, wasting, and underweight were the outcome variables. Individual, household, community, and state-level determinants were simultaneously modelled using multilevel logistic regression with random effects. Geospatial clustering was assessed using Moran's I and Kulldorff spatial scan statistics. Results revealed significant spatial clustering of undernutrition in the North West and North East zones. State-level governance quality, public health expenditure per capita, and conflict intensity emerged as powerful determinants independent of household-level factors. Household dietary diversity and maternal education remained significant predictors at the individual level but were substantially mediated by structural factors. The study presents an original analytical framework and empirical contribution to understanding the political economy of child undernutrition in Nigeria. Keywords: child undernutrition, political economy, multilevel analysis, geospatial methods, Nigeria