Abstract
Objectives: This research investigates the association of malnutrition with social and economic factors in general and environmental factors in specific such as sanitation facilities and drinking water sources for Pakistan. Methods: Authors used the latest data of 1010 Under-Three children from Pakistan Demographic and Health Survey (PDHS) 2017–2018. Cumulative Index of Anthropometric Failure (CIAF) was developed to measure the malnutrition status among children based on z-scores of WHZ, WAZ, and HAZ, respectively. The study has applied the discrete-choice logistic methodology to find the relationship of malnutrition with socio-economic characteristics. The interaction terms of drinking water source and sanitation facility have been measured to see the impact of environmental factors on child malnutrition. Results: The study results depict that the likelihood of malnutrition increases when the child had diarrhea recently and the child belongs to the deprived region such as KPK, Sind, and Baluchistan. However, the chances of child malnutrition drop with (1) an escalation of mothers’ education, (2) a rise in wealth status of the household, and (3) the improved water source and sanitation facility in the household. The only water-improved sanitation category of the interaction term is significant in the model which depicts that households having both improved water and improved sanitation facilities had very fewer chances of malnutrition among their children. Conclusion: Authors conclude that malnutrition in younger children is associated with improved water as well as sanitation facilities, maternal education, and household wealth in Pakistan.
Highlights
Malnutrition is a multi-dimensional problem that is caused by multiple socio-economic and environmental determinants
This research examined the impact of sanitation and water quality on child malnutrition
Pakistan Demographic and Health Survey (PDHS) data were analyzed for each variable
Summary
Malnutrition is a multi-dimensional problem that is caused by multiple socio-economic and environmental determinants. In the South Asian region, the stunting prevalence is highest with 26.9 million (38.9%) of the global wasted children [2]. Malnutrition prevalence in India, Bangladesh, and Pakistan has been over the threshold limit of 15% wasting (weight for height), 30% stunting (height for age), and 10% underweight (weight for age) [3,4]. In Pakistan, according to the PDHS 2017–2018 report, 38% of children are stunted, 23% are underweight, and 8% are wasted. The economic loss of malnutrition is very high in developing countries. In Asian and African regions nearly 11% of loss in GDP is due to different forms of malnutrition such as stunting and being underweight [8]. Investing USD 1 in stunting reduction intervention in developing countries, an economic return of USD 30 is expected [9]
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