Drivers and distribution of the household-level double burden of malnutrition in Bangladesh: analysis of mother-child dyads from a national household survey.

Abstract

The double burden of malnutrition (DBM) has become an emerging public health issue in many low- and middle-income countries. This study aims to provide important evidence for the prevalence of different types of DBM at the national and subnational levels in Bangladesh. The study utilised data from the latest Bangladesh Demographic and Health Survey (BDHS) 2017-2018. Multivariable logistic regression was performed to identify the sociodemographic factors associated with DBM. Nationally representative cross-sectional survey. 8697 mothers aged 15 to 49 years with <5 children. The overall prevalence of the DBM was approximately 21 %, where the prevalence of overweight mother (OWM) & stunted child/wasted child/underweight child (SC/WC/UWC) and underweight mother (UWM) & overweight child (OWC) was 13·35 % and 7·69 %, respectively, with a higher prevalence among urban households (OWM & SC/WC/UWC = 14·22 %; UWM & OWC = 10·58 %) in Bangladesh. High inequality was observed among UWM & OWC dyads, concentration index (CI) = -0·2998, while low level of inequality of DBM were observed for OWM & SC (CI = 0·0153), OWM & WC (CI = 0·1165) and OWM & UWC (CI = 0·0135) dyads. We observed that the age and educational status of the mother, number of children, fathers' occupation, size and wealth index of the household, and administrative division were significantly associated with all types of DBM. Health policymakers, concerned authorities and various stakeholders should stress the prevalence of DBM issues and take necessary actions aimed at identifying and addressing the DBM in Bangladesh.