Amare Abera ^1* Anissa Mohammed ² Amare Muche ² Yeshimebet Ali ²

• ¹ Jimma University, Jimma, Ethiopia
• ² College of Medicine and Health Science, Wollo University, Dessie, Amhara, Ethiopia

Background: Despite progress in developing countries in reducing underweight, the recent development of overweight and obesity has affirmed that the double burden of malnutrition will remain a crucial problem in the foreseeable future. Some countries with past reductions in underweight have shown a recent increment in the problem. Despite the presence of initiatives in sub-Saharan African (SSA) countries to reduce malnutrition, they are backed by little evidence. This study aimed to identify risk groups for malnutrition among women of reproductive age in SSA countries and prioritize intervention areas.Methods: A total of 247,911 reproductive-age women from recent demographic and health surveys of 33 SSA countries were used for analysis. Our outcome was nutritional status measured using body mass index (BMI). We computed the pooled prevalence of different forms of malnutrition using the random effects inverse variance method. We evaluated the factors associated with different forms of malnutrition using multilevel multinomial regression. We reported the adjusted odds ratio and 95% confidence interval (CI).Results: The pooled prevalence of underweight, overweight, and obesity was 11% (95% CI: 9%-12%), 18% (16%-20%), and 10% (8%-12%), respectively, among women in SSA. Woman's age, highest educational level, wealth index, current breastfeeding status, contraceptive use, parity, media exposure, marital status, place of residence, and SSA region were factors significantly associated with malnutrition generally. Education, wealth, age, contraceptive use, parity, and being in union are risk factors for overweight and obesity, whereas they are protective for underweight. Women's engagement in work was protective of all three forms of malnutrition.Conclusion: An increase in women's age, an increase in their wealth index, not breastfeeding during the time of the survey, contraceptive use, multiparity, being in a union, residing in urban regions, and southern and central Africa increased the odds of a higher BMI and decreased the odds of being underweight. In designing interventions for overweight and obesity, emphasis should be given to the wealthy, reproductiveage women in later age, urban residents, and multiparous. Whereas the poorest and youngest is priority intervention segments for underweight.