Sibling gender dynamics and childhood stunting in Ghana

Background: Stunting remains a public health concern in sub-Saharan Africa. Despite the evolving awareness of the effect of family composition on child health outcomes, the influence of sibling gender on stunting has seldom been consistent. The current study investigated the association between sibling composition and stunting among children under five years in Ghana. Methods: This cross-sectional study utilized data from the most recent Ghana Demographic and Health Survey (GDHS 2022), focusing on 5416 mother-child dyads. Stunting prevalence was assessed through descriptive analysis, while logistic regression analysis was employed to examine the association between sibling composition and identify other risk factors associated with stunting. Results: The prevalence of stunting among children under five years of age was 18%. It was observed from the male sex-stratified model that having male siblings and having a combination of male and female siblings increased male children’s odds of being stunted. In contrast, having siblings of either gender or having a combination of male and female siblings may not pose any stunting threats to female children as observed in the female sex-stratified model. Furthermore, being a male child (OR: 1.54; 95% CI: 1.25, 1.90) and never being breastfed (OR: 2.07; 95% CI: 1.31, 3.21) increased children’s likelihood of stunting. Conclusion: This study concludes that the extra nutrients boys require for healthy growth and development may increase their competition for nutrients, especially in households with limited resource. Parents and guardians are advised to be consciously aware of the subtle and apparent competition between male children and take appropriate measures to prevent children’s deprivation of nutrition by their male siblings.