The right nutrition during the first 2 years of life can positively impact a child’s ability to develop, grow, and learn. Malnutrition remains a public health problem in Mali and little is known about the factors affecting the nutritional status of children. This study aims to assess the magnitude and the predictors of undernutrition in children aged 6–24 months in the poor rural regions of Mali. A community-based cross-sectional study was conducted in the villages in the Sikasso and Mopti regions in Mali from January to March 2016, comprising of 959 boys and 856 girls aged 6–24 months. A structured interviewer administered a questionnaire that was used to collect data from the mothers living in 1764 households. Anthropometric measurements were performed using standardized methods in order to identify the factors associated with children suffering from undernutrition (stunting and wasting). Bivariate and multivariate logistic regression analyses were conducted. The results of our study indicated that 23.9 and 28.4% children were underweight and stunted; the prevalence of wasting was 13.9% using the W/H measurement and 16.5% with the MUAC. Overall, the presence of diarrhea in the past 2 weeks (p < 0.001), higher child age (p < 0.001), male sex (p < 0.001), households with the lowest household amenity score (p < 0.002), and households with a low dietary diversity score (p < 001) were significantly associated with chronic malnutrition. The factors significantly associated with acute malnutrition were male sex (p < 0.01), preterm birth (p < 0.03), lower child age (0.001), a high number of siblings (p < 0.03), and living in a household with more months of inadequate food provisioning (p < 0.03). Child undernutrition is a critical public health problem in the agricultural regions of Mali. Future efforts should be directed at addressing the food insecurity and at improving the yearlong household availability and accessibility of nutritious food, as well as taking diseases prevention into account.

West Africa’s agri-food systems face a triple burden of malnutrition, climate vulnerability, and structural inefficiencies that compromise nutrition and public health. Despite increased attention to food security, agricultural strategies often prioritize yield over dietary quality. This paper explores the critical role of food processing in advancing Nutrition-Sensitive Agriculture (NSA) and Nutrition-Smart Agriculture (NSmartAg) across West Africa. Drawing on a systems lens, it positions food processing not as a peripheral activity, but as a catalytic mechanism that connects nutrient-dense production with improved consumption outcomes. Food processing can reduce post-harvest losses, preserve micronutrients, extend food availability, and foster inclusive value chains particularly for women and youth. Yet, persistent challenges remain, including institutional fragmentation, infrastructure gaps, and limited financial and technical capacity. This paper proposes a conceptual framework linking food processing to NSA and NSmartAg objectives and outlines operational entry points for implementation. By integrating processing into agricultural policies, investment, education, and monitoring systems, stakeholders and policymakers can reimagine agriculture as a platform for resilience and nutritional equity. Strategic recommendations emphasize multisectoral collaboration, localized solutions, and evidence-informed interventions to drive the transformation toward sustainable, nutrition-oriented food systems.

West Africa faces persistent food and nutrition insecurity despite agricultural efforts, exacerbated by population growth, climate change, and socio-economic vulnerabilities. This study argues that integrating food processing principles with nutrition-sensitive agriculture (NSA) and nutrition-smart agriculture (NSmartAg) offers a transformative solution for human health. Therefore, we delineate these interconnected concepts and highlight their synergistic potential for a nutrition-focused food system. Likewise, critical analysis of key regional challenges, including infrastructural weaknesses, policy gaps, and gender inequities, was made prior to identifying significant opportunities for leveraging food processing as a strategic entry point to accelerate the implementation of NSA and NSmartAg. Based on these insights, six strategic pathways are proposed to achieve this objective: (i) integrating food processing into policies; (ii) investing in interdisciplinary R&D that puts nutrition and health benefits at the forefront of desired outcomes along with others; (iii) strengthening farmer and food processor capacities; (iv) improving agri-food infrastructure; (v) fostering multi-sectoral collaboration; and (vi) prioritizing youth engagement and market development. By adopting these integrated strategies, West African countries can build more resilient, equitable, and nutrition-centered food systems, ultimately improving public health outcomes and fostering sustainable regional development.