Abstract
BackgroundUnderweight prevalence continues to be major public health challenge worldwide, particularly in developing countries like Pakistan. This study is focused on socio-economic and demographic aspects of underweight prevalence among children under-five in Punjab.MethodsIn this study, several socioeconomic and demographic factors are considered using MICS-4 data-set. Only those variables which are usually described in the nutritional studies of children were picked. Covariates include: the age of children, sex of the children, age of mother, total number of children born to women, family wealth index quintile, source of drinking water, type of sanitation, place of residence, parents’ education and occupation. All Categorical variables are effect coded. The child’s age and the mother’s age are assumed to be nonlinear, geographical region is spatial effect, while other variables are parametric in nature.Since, the response is binary, covariate comprises linear terms, nonlinear effects of continues covariates and geographic effects, so we have use Geo-additive models (based on Fully Bayesian approach) with binomial family under logit link. Statistical analysis is performed on Statistical package R using Bayes X and R2 Bayes X Libraries.ResultsUnderweight status of children was found to be positively associated with number of under-five children in household, total number of children ever born to women and age of mother when the child was born. Whereas, it negatively associated with place of residence, parent’s education and family wealth index quintile. On the regional effect, the Southern Punjab has higher prevalence of underweight compared to Central and Northern Punjab.ConclusionSimilarity of our results with several other studies demonstrate that the Geo-additive models are an ideal substitute of other statistical models to analyze the underweight prevalence among children. Moreover, our findings suggest the Punjab Government, to introduce target-oriented programs such as poverty reduction and enhancement of education and health facilities for poor population and disadvantaged regions, especially Southern Punjab.
Highlights
Underweight prevalence continues to be major public health challenge worldwide, in developing countries like Pakistan
Addition of every single child into the total number of children ever born to a woman increases the log odds of underweight by 0.04 (Table 2)
Our study has found positive relationship between the number of children ever born to a woman and underweight prevalence
Summary
Underweight prevalence continues to be major public health challenge worldwide, in developing countries like Pakistan. Underweight children have lesser immunity against infections and have higher chance to die According to MICS-2014 [1], the prevalence of underweight among under-five children in Punjab is 33.7%, Farooq et al BMC Public Health (2020) 20:1817 which is higher than the overall the underweight prevalence in the country (Fig. 1). It is a point of serious concern, because Punjab is comparatively most developed province of Pakistan regarding health and educational facilities. To the best of our knowledge, not even a single research study has been conducted in Punjab so far, to explore and analyze the impact of factors influencing such a high proportion of underweight
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