Estimating lifetime malnourished period and its statistics based on the concept of Markov chain with reward

Seyifunmi M Owoeye,Bamidele M Oseni,Ezra Gayawan

doi:10.1016/j.heliyon.2020.e04073

Abstract

Malnutrition among women, accessed through body mass index, has great consequences for achieving key national targets. This study introduces the concept of lifetime malnourished period (LMP): the number of years a woman would remain malnourished, either as underweight or overweight given that she is currently malnourished, and its measures of variation. Markov chain with rewards was used to compute the moments of LMP based on age-specific mortality rates and proportion of women of reproductive age that were either underweight or overweight using data from the 2013 Nigeria Demographic and Health Survey. Each of the two malnutrition status was treated as a Bernoulli-distributed reward with probability taken as the proportion of overweight or underweight women at specific age. Findings indicate that the average LMP for an underweight woman in Nigeria at age 15 years is 2.3 years but 5.8 for overweight. The remaining LMP for underweight is lower among women who attain higher level of education than for those with no or primary level of education with standard deviation reducing with age. Further, we found overweight women from the richest households and those from urban areas to have longer years of remaining in that state of health than their other counterparts, and that longevity contributes more to the variance in LMP for overweight than for underweight women.

Highlights

The nutritional status of individuals in a nation is a reflection of the country’s developmental and health challenges, and it can determine the nation’s accomplishment of key global objectives and targets
Of the 15, 300 respondents who lived in urban areas, 8.7% were underweight while about 40% were overweight
This study contributes by introducing the concept of lifetime malnourished period (LMP), a perspective that quantifies the number of years a woman would remain either overweight or underweight given her current malnutrition status, and its statistics using the concept of Markov chain with rewards

Summary

Introduction

The nutritional status of individuals in a nation is a reflection of the country’s developmental and health challenges, and it can determine the nation’s accomplishment of key global objectives and targets. Battling the different forms of malnutrition has remained one of the world’s most serious health challenges (Müller and Krawinkel, 2005; World Health Organization, 2002). Malnutrition exacerbates the burden of morbidity and mortality especially among women and young children (Gordon et al, 2004). The multifaceted effects of malnutrition whether in the form of under- and over-weight include poor pregnancy and birth outcomes, high vulnerability to infectious disease, lethargy and general body weakness leading to reduction in productivity, increased risk of maternal complications and it can, in the extreme case, lead to death (Müller and Krawinkel 2005; Denison et al 2010; Gayawan et al 2019)

Methods

Results

Conclusion