Double Burden of Malnutrition Among Women of Reproductive Age in Low- and Middle-Income Countries: Progress Achieved and Opportunities for Meeting the Global Target

Abstract

Abstract Objectives To monitor progress, make projections and examine inequalities in women's underweight and overweight in low- and middle- income countries (LMICs). Methods We used nationally representative Demographic and Health Survey (DHS) data of 2,337,855 women of reproductive age (15–49 years, mean age 29.7 y, SD ± 9.6) from 55 LMICs, to study the current and projected prevalence of underweight (Body Mass Index < 18.5 kg/m2) and overweight (BMI ≥ 25.0 kg/m2). Bayesian linear regression analyses were performed for trend and projection analysis. Current and projected trends of women's malnutrition were studied, and national as well as subnational level variations, particularly in the context of sociodemographic factors, were explored. Results In 2030, over 20% of women in eight LMICs will be underweight, with Madagascar (36.8%), Senegal (32.2%) and Burundi (29.2%) projected to experience the highest burden of underweight. Whereas, over 50% women in 22 LMICs are projected to be overweight, with Egypt (94.7%), Jordan (75.0%), and Pakistan (74.1%) projected to have the highest burden of overweight. We project that in 2030, 24 LMICs would experience DBM. There is considerable variation in the prevalence of underweight and overweight across national and subnational levels. Wealth, education, and place of residence are seen to have the highest impact on the current and future prevalence of underweight and overweight. It is projected that between 2020 and 2030, socioeconomically disadvantaged groups in LMICs will experience the sharpest increase in the prevalence of overweight. We also found none of the 55 LMICs will be able to eradicate overweight or underweight (barring Egypt) by 2030. Conclusions Overall, the prevalence of underweight in women of reproductive age in LMICs has declined in the past three decades. However, the decrease in the rate of underweight has been superseded by the dramatic increase in the prevalence of overweight. Therefore, it is unlikely that any of the 55 LMICs will be successful in eradicating malnutrition by 2030. Funding Sources None.