Socio-economic risk factors for early childhood underweight in Bangladesh

Tuhinur Rahman Chowdhury,Kendrick A Davis,Sue Saltmarsh,Sayan Chakrabarty,Muntaha Rakib

doi:10.1186/s12992-018-0372-7

Abstract

BackgroundUnderweight is a major cause of global disease burden. It is associated with child mortality and morbidity, and its adverse impact on human performance and child survival is well recognized. Underweight is a major public health problem in Bangladesh, which is amongst the highest underweight prevalent countries in the world. The objectives of our study were to determine the national and regional prevalence rates of underweight and severe underweight in Bangladesh, and to investigate the association of socioeconomic and demographic factors with child underweight and severely underweight among children under the age of five living in Bangladesh.MethodsWe performed a cross sectional study using Multiple Indicators Cluster Survey 2012–13, Bangladesh data on 17,133 children under 5 years of age. Weight-for-age Z scores based upon World Health Organization (WHO) guidelines were used to define child underweight and severe underweight. The association of underweight and severe underweight with household socioeconomic factors and demographic characteristics was investigated using binary logistic regression model.ResultsAn estimated 31.67% children were underweight and 8.81% children were severely underweight. Children of mothers with incomplete secondary education [Odds Ratio (OR) = 0.84, 95% CI: 0.75, 0.94] and mothers with completed secondary education [Odds Ratio (OR) = 0.77, 95% CI: 0.64, 0.93] were less likely to be underweight than children of uneducated mothers who had no formal schooling. A similar association exists for father’s education, children from households in the highest wealth index quintile had lower likelihood of underweight [Odds Ratio (OR) = 0.44, 95% CI: 0.37, 0.53] than children from households in the lowest quintile. Consumption of non-iodized salt had higher risk of severe underweight for children aged between 24 and 35 months [Odds Ratio (OR) = 2.32, 95% CI: 1.80, 3.00]. Other risk factors of child severe underweight included living in Sylhet division and increases in the number of children under the age of five in a household.ConclusionUnderweight was associated with lower parental education, household position in lower wealth index, living in Sylhet division and consumption of non-iodized salt. Strategies are discussed considering the relative importance of risk factors for child underweight.

Highlights

Underweight is a major cause of global disease burden
Similar findings have been observed in earlier studies carried out in Bangladesh, which have shown that children of uneducated mothers were significantly more likely to be severely underweight than children whose mothers had a relatively higher level of education [25, 38,39,40,41,42,43]
Due to the fact that it is more likely that underweight children who survive to adulthood will experience greater health problems, the prevalence of underweight may contribute to loss of productivity

Summary

Introduction

Underweight is a major cause of global disease burden. It is associated with child mortality and morbidity, and its adverse impact on human performance and child survival is well recognized. Developing countries have the greatest prevalence of early childhood malnutrition despite recent rapid economic development [1,2,3]. Malnutrition is the prime culprit for early childhood death, causing the deaths of 13 million infants and children under the age of five every year [4]. Weight for age is the WHO-recommended indicator to determine whether the child is underweight or not [11]. As underweight is a composite indicator that encompasses both stunting and wasting [14] implying that stunting, wasting or both can be reflected by underweight [15], our primary interest is to use weight for age indicator to measure early childhood underweight

Objectives

Results

Discussion

Conclusion