Risk factors associated with wasting among under-5 children residing in urban areas of Bangladesh: a multilevel modelling approach

Abstract

The main aim of this study was to uncover the risk factors associated with wasting status of under-5 children residing in urban areas of Bangladesh. For analysis purposes, the necessary information was extracted from the Bangladesh Urban Health Survey (BUHS) 2013. The outcome measure was wasting. Chi-square analysis was performed to assess the association between outcome variables and selected factors. Multilevel logistic regression models with a random intercept at each of the individual and regional levels were considered to identify the risk factors of wasting. A total of 10,511 urban children aged 0 to less than 60 months were included in this study. The overall prevalence of wasting was 17.2%. In the bivariate setup, all the selected covariates except child age were found to be significant for wasting status of children (p < 0.05). According to the two-level logistic regression model, the odds of wasting status of children increase with the age of the child and decrease with the increasing level of mother’s education. Compared to children from poor income families, the odds of being wasted were 18% and 47% lower for children coming from middle and rich income families. Among the domains, the odds of having wasted children was higher in the city-corporation slum compared to the city-corporation non-slum. Mothers receiving ANC services had lower odds of having a wasted child. Moreover, a mother who regularly breastfed her baby had 57% lower odds of having a wasted child, compared to a mother who never breastfed her baby. The prevalence of wasting among under-5 children in Bangladesh is still high, and the risk was examined at various multilevel factors. Therefore, top priority should be given to reducing the rate of wasting as a major public health intervention.