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Nutrients
Volume 18
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10.3390/nu18020200
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Article

Undernutrition and Feeding Difficulties Among Children with Disabilities in Uganda: A Cross-Sectional Study

by
Zeina Makhoul
1,*,
Moses Fisha Muhumuza
2,
Bella Kyarisiima
2,
Grace Amongin
2,
Maria Nakibirango
2,
Carolyn Moore
1,
Daniella Akellot
3,
Lutgard Musiime
1,
Doreen Alupo
1,
Lorna Mary Namususwa
1,
Pamela Magero
1,
Kate Miller
1 and
Douglas Taren
1,4
1
SPOON, Portland, OR 97210, USA
2
CoRSU Rehabilitation Hospital, Kisubi P.O. Box 46, Uganda
3
Deval Consultancy Services Ltd., Wakiso P.O. Box 256, Uganda
4
Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO 80045, USA
*
Author to whom correspondence should be addressed.
Nutrients 2026, 18(2), 200; https://doi.org/10.3390/nu18020200
Submission received: 25 November 2025 / Revised: 26 December 2025 / Accepted: 6 January 2026 / Published: 8 January 2026
(This article belongs to the Special Issue Nutrition in Vulnerable Population Groups)
Review Reports Versions Notes

Abstract

Background/Objectives: Inclusive nutrition services and data on children with disabilities living in low- and middle-income countries remain limited. We estimated the prevalence of undernutrition and described feeding practices and difficulties among children with disabilities ages birth to 10 years at a rehabilitation hospital in Uganda and identified barriers and opportunities for inclusive nutrition. Methods: This cross-sectional study enrolled 428 children. Data included demographics, weight, height, mid–upper arm circumference (MUAC), hemoglobin levels, risk for feeding difficulties, caregiver-reported feeding practices, and functional difficulties complemented by 32 caregiver and stakeholder interviews. Undernutrition was defined using WHO z-scores, MUAC, and anemia cutoffs. Associations were examined using Pearson’s chi-squared tests and adjusted odds ratios from logistic regression. Results: Over half of participants were boys (56.1%) and 65.9% were <24 months old. Common conditions included cleft lip/palate (55.4%) and cerebral palsy (38.6%). Undernutrition was prevalent: 45.2% were underweight, 38.3% stunted, 16.1% wasted (by MUAC), and 39.5% anemic. Being at risk for feeding difficulties (67.2% of children) increased the odds of underweight [AOR = 2.28 (1.23–4.24)], stunting [2.46 (1.26–4.79)], and wasting [2.43 (1.10–5.35)] after adjusting for covariates. Bottle-feeding increased the odds of stunting [3.09 (1.24–7.70)] in infants with cleft lip/palate <12 months old. Poor access to services, food insecurity, and feeding challenges were key barriers to optimal nutrition. Most caregivers reported using practices that support responsive feeding. Conclusions: Reported barriers to services and high levels of undernutrition, strongly linked to feeding difficulties, underscore the need for targeted feeding interventions and better access to inclusive nutrition services in Uganda.
Keywords: disability; undernutrition; Uganda; cleft lip and palate; feeding difficulties; inclusion; nutrition; underweight; stunting; wasting disability; undernutrition; Uganda; cleft lip and palate; feeding difficulties; inclusion; nutrition; underweight; stunting; wasting

Share and Cite

MDPI and ACS Style

Makhoul, Z.; Muhumuza, M.F.; Kyarisiima, B.; Amongin, G.; Nakibirango, M.; Moore, C.; Akellot, D.; Musiime, L.; Alupo, D.; Namususwa, L.M.; et al. Undernutrition and Feeding Difficulties Among Children with Disabilities in Uganda: A Cross-Sectional Study. Nutrients 2026, 18, 200. https://doi.org/10.3390/nu18020200

AMA Style

Makhoul Z, Muhumuza MF, Kyarisiima B, Amongin G, Nakibirango M, Moore C, Akellot D, Musiime L, Alupo D, Namususwa LM, et al. Undernutrition and Feeding Difficulties Among Children with Disabilities in Uganda: A Cross-Sectional Study. Nutrients. 2026; 18(2):200. https://doi.org/10.3390/nu18020200

Chicago/Turabian Style

Makhoul, Zeina, Moses Fisha Muhumuza, Bella Kyarisiima, Grace Amongin, Maria Nakibirango, Carolyn Moore, Daniella Akellot, Lutgard Musiime, Doreen Alupo, Lorna Mary Namususwa, and et al. 2026. "Undernutrition and Feeding Difficulties Among Children with Disabilities in Uganda: A Cross-Sectional Study" Nutrients 18, no. 2: 200. https://doi.org/10.3390/nu18020200

APA Style

Makhoul, Z., Muhumuza, M. F., Kyarisiima, B., Amongin, G., Nakibirango, M., Moore, C., Akellot, D., Musiime, L., Alupo, D., Namususwa, L. M., Magero, P., Miller, K., & Taren, D. (2026). Undernutrition and Feeding Difficulties Among Children with Disabilities in Uganda: A Cross-Sectional Study. Nutrients, 18(2), 200. https://doi.org/10.3390/nu18020200

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