Exclusive breastfeeding (EBF) is essential for optimal infant nutrition and health, yet its uptake remains suboptimal in Nigeria. Although the Accelerating

Malnutrition in children aged 0-5 years is a significant public health concern in many societies and is influenced by various sociodemographic factors that, when understood, may improve intervention planning and results. Background. This study aimed to identify the sociodemographic determinants of malnutrition in rural and urban areas of Abia State, Nigeria. Methods. A cross-sectional observational study involving 842 children (aged 6-59 months) and their caregivers was conducted across selected rural and urban areas in Abia State, Nigeria. Data collected through semistructured questionnaires focused on sociodemographic information as well as anthropometric measurements such as weight, height, and mid-upper arm circumference (MUAC). The dietary diversity score (DDS) was also calculated for each child via a questionnaire that recorded the consumption of various food groups over a 7-day period. Chi-square tests were adopted for categorical variables, whereas binomial logistic regression was used to identify determinants of malnutrition and weight classification. Results. Marked sociodemographic differences were found between rural and urban caregivers, with urban caregivers being more likely to have higher knowledge of nutrition (p < 0.01) and education (p < 0.01). Malnutrition, indicated by global acute malnutrition (GAM), was significantly higher in rural areas (53.5%) than in urban areas (46.5%) (χ2 = 5.353, p = 0.021). Logistic regression revealed that children of caregivers in rural areas were more likely to have an abnormal BMI-for-age (AOR: 1.407, 95% CI: 1.001–1.978, p = 0.049), whereas children of caregivers in urban areas were less likely to be malnourished (COR: 0.565, 95% CI: 0.347–0.921, p = 0.022). Conclusion. Implementation scientists should focus on enhancing caregiver education, particularly in rural areas, to promote awareness of diets, thereby reducing malnutrition.