Vol. 2, Issue 1, Part A (2025)

Background: Child malnutrition remains a critical public health issue in rural settings, where access to nutrition services and health advocacy is often limited. Paediatric nurses are uniquely positioned to bridge this gap through direct clinical care and community-level advocacy, yet their roles in addressing malnutrition are not fully optimized.
Objective: This study aimed to examine the impact of paediatric nurse advocacy on child malnutrition outcomes in rural communities, identify barriers and facilitators to effective advocacy, and evaluate its association with key nutritional indicators.
Methods: A community-based cross-sectional study was conducted among 150 paediatric nurses and 150 caregiver-child dyads in selected rural districts. Data were collected using structured questionnaires, focus group discussions, and anthropometric assessments following WHO growth standards. Advocacy levels were categorized into high, moderate, and low using a composite score. Statistical analysis employed descriptive measures, chi-square tests, t-tests, and multivariable logistic regression to explore associations between advocacy exposure and nutritional outcomes.
Results: Children attended by nurses with high advocacy engagement exhibited lower prevalence of wasting (14.7% vs. 30.5%), underweight (22.1% vs. 41.5%), and slightly lower stunting rates (25.0% vs. 39.0%) compared to those served by low or moderately engaged nurses. High advocacy remained independently associated with reduced odds of underweight after adjusting for socio-economic factors (aOR 0.47, 95% CI 0.25-0.88, p=0.019). A positive association was also observed between outreach frequency and mean MUAC, suggesting that advocacy combined with consistent service delivery enhances outcomes.
Conclusion: Paediatric nurse advocacy plays a vital role in improving child nutritional status in rural settings. Strengthening advocacy through structured training, increased outreach activities, intersectoral collaboration, and enhanced health system support can significantly reduce malnutrition burdens. Empowering nurses as community health advocates represents a sustainable and impactful strategy to improve child health outcomes in underserved regions.