Child Malnutrition In Bangladesh Research Articles

Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach

ObjectivesThis study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent...

Contribution of socio-economic and demographic factors to maternal and child malnutrition in Bangladesh: Insights from a nationwide survey.

Background: Malnutrition is a major global public health issue, especially for under five children and their mothers. Objective: This study examined the relationships between socio-economic and demographic characteristics and under- and over-nutrition in mothers and children of Bangladesh. Method: Using the Nationally representative Bangladesh Demographic and Health Survey (2017-18) data, we performed the multiple logistic regression analysis to assess the relationships between key outcome variables and predictors. The analysis included 8321 children aged 0-59 months and 7800 mothers aged 15-49 years. Findings: The prevalence of stunting, wasting, and overweight among children under five was 30.72%, 8.44%, and 2.21% respectively. About 2.74% of the children were both stunted and wasted, while 0.56% of the children were both stunted and overweight. The prevalence of underweight and overweight among mother was 14.09% and 26.35% respectively. Children who are stunted are significantly associated with the mother's BMI status, mothers' education, fathers' education, and wealth index, while children who are wasted are significantly associated with the mother's BMI status and the child's sex. A child's sex and birth order are significantly associated with children being overweight. Mother's age, mother's education, father's education, place of residence and wealth index are significant determinants for mothers being underweight, whereas mother's age, mother's occupation, father's education, father's occupation, place of residence and wealth index are significant determinants for mothers being overweight. Conclusion: In addition to essential nutrition interventions, it is vital to address the basic social-economic and demographic determinants.

Child malnutrition in Bangladesh: an evidence from multiple indicators cluster survey

Bangladesh has made significant progress in reducing child malnutrition over the years. However, malnutrition remains a considerable challenge in the country, particularly among children under the age of five years. This study aimed to determine the risk factors involved with child malnutrition (i.e. underweight, stunting and wasting) among children under five in Bangladesh. We examined the potential risk factors of child underweight, stunting and wasting using data based on multiple indicators cluster survey (MICS) conducted in Bangladesh in 2019. The data included 18,696 children (under the age of five years) respectively from 64,400 households. Binary logistic regression models were used to evaluate the potential risk factors associated with malnutrition in children. About 27% of children under age five are stunted (short for their age), 10% are wasted (thin for their height), and 22% are underweight in Bangladesh. The most critical risk factors of child malnutrition in Bangladesh were the mother’s education, mother’s age at birth, place of residence and wealth quantile.

Socioeconomic Inequalities in Child Malnutrition in Bangladesh: Do They Differ by Region?

Socioeconomic inequality in child malnutrition is well-evident in Bangladesh. However, little is known about whether this inequality differs by regional contexts. We used pooled data from the 2011 and 2014 Bangladesh Demographic and Health Survey to examine regional differences in socioeconomic inequalities in stunting and underweight among children under five. The analysis included 14,602 children aged 0–59 months. We used logistic regression models and the Concentration index to assess and quantify wealth- and education-related inequalities in child malnutrition. We found stunting and underweight to be more concentrated among children from poorer households and born to less-educated mothers. Although the poverty level was low in the eastern regions, socioeconomic inequalities were greater in these regions compared to the western regions. The extent of socioeconomic inequality was the highest in Sylhet and Chittagong for stunting and underweight, respectively, while it was the lowest in Khulna. Regression results demonstrated the protective effects of socioeconomic status (SES) on child malnutrition. The regional differences in the effects of SES tend to diverge at the lower levels of SES, while they converge or attenuate at the highest levels. Our findings have policy implications for developing programs and interventions targeted to reduce socioeconomic inequalities in child malnutrition in subnational regions of Bangladesh.

Analysing malnutrition status of urban children in Bangladesh: quantile regression modelling

This paper attempts to investigate the determinants of child malnutrition in Bangladesh by using a data set obtained from Urban Health Survey (UHS) 2013. The UHS 2013 followed a stratified three-stage sampling procedure. Information on maternal and child characteristics was collected from the last child born preceding three years of survey. Robust quantile regression (QR) models have been used to find out potential factors responsible for child malnutrition of urban areas of Bangladesh using standardized stunting score as dependent variable. Place of residence (Domain), mother’s age at birth of index child, gender of the child, wealth index, education of mother, working status of mother, access to media, antenatal care, and place of delivery were found to have significant association with the malnutrition of children of urban areas of Bangladesh. Some recommendations have been suggested to improve the nutrition status of children of urban areas of Bangladesh.

Maternal empowerment and child malnutrition in Bangladesh

ABSTRACTThe study examines the importance of maternal empowerment in reducing the prevalence of child malnutrition in Bangladesh. Maternal empowerment is measured by a composite index based on four proxy variables that promote maternal empowerment. Factor analysis technique is used in constructing empowerment index. Ordered probit models are specified and estimated using national-level household survey data. Maternal empowerment is found to be the third-most important predictor of child malnutrition in Bangladesh, preceded by maternal endowment and child characteristics. Household characteristics such as partner’s level of education and household income are also associated with child malnutrition. The study has a number of policy implications to address maternal empowerment and child malnutrition. Public policy should focus on factors of maternal empowerment and investment in maternal health in order to improve the health of the next generation.

Correlates of stunting among under-five children in Bangladesh: a multilevel approach

BackgroundChild malnutrition still remains a major cause of childhood morbidity and mortality in Bangladesh. This study aims to determine the prevalence and identify the associated risk factors of child malnutrition in Bangladesh using multilevel logistic regression model on data from the Bangladesh Demographic and Health Survey (BDHS), 2014.MethodsA total sample of 6965 children aged 0–59 months was extracted from BDHS 2014. We performed descriptive analysis and multilevel generalized linear regression analysis with clustered data structure.ResultsOur findings show that among children the prevalence of moderate and severe values was respectively: 25 and 12% for stunting; 11 and 3.1% for wasting; 25 and 7.9% for underweight. The probability of stunting increased with age, with highest rate among children aged 36–47 months, which was significantly higher than children aged less than 6 months (OR = 6.71, 95% CI = 4.46, 10.10). Female children are found to be 11% less likely to be stunted than male children (OR = 0.89, 95% CI = 0.78, 1.02). Children with birth interval less than 24 months were significantly more likely to be stunted than children of first birth by 36% (OR = 1.36, 95% CI = 1.11, 1.67). Mothers with a normal BMI were 16% less likely to have children with stunting compared to mothers who are underweight (OR = 0.84, 95% CI = 0.76, 0.93). Other factors which were associated with a higher risk of stunting included parents with lower educational levels, children from the poorest wealth index, and mothers aged less than 20 years as first birth.ConclusionGovernment and non-government organization should generate effective program to aware women of reproductive age about adverse effect of short birth interval, and to aware parents about standard height and weight according to age and gender of children. Overall, necessary steps may be taken to make people educated and to reduce household wealth inequality to improve nutritional status of children.

Reducing childhood malnutrition in Bangladesh: the importance of addressing socio-economic inequalities.

To obtain projections of the prevalence of childhood malnutrition indicators up to 2030 and to analyse the changes of wealth-based inequality in malnutrition indicators and the degree of contribution of socio-economic determinants to the inequities in malnutrition indicators in Bangladesh. Additionally, to identify the risk factors of childhood malnutrition. Cross-sectional study. A Bayesian linear regression model was used to estimate trends and projections of malnutrition. For equity analysis, slope index, relative index and decomposition in concentration index were used. Multilevel logistic models were used to identify risk factors of malnutrition. Household surveys in Bangladesh from 1996 to 2014. Children under the age of 5 years. A decreasing trend was observed for all malnutrition indices. In 1990, predicted prevalence of stunting, wasting and underweight was 55·0, 15·9 and 61·8 %, respectively. By 2030, prevalence is projected to reduce to 28·8 % for stunting, 12·3 % for wasting and 17·4 % for underweight. Prevalence of stunting, wasting and underweight were 34·3, 6·9 and 32·8 percentage points lower in the richest households than the poorest households. Contribution of the wealth index to child malnutrition increased over time and the largest contribution of pro-poor inequity was explained by wealth index. Being an underweight mother, parents with a lower level of education and poorer households were the key risk factors for stunting and underweight. Our findings show an evidence-based need for targeted interventions to improve education and household income-generating activities among poor households to reduce inequalities and reduce the burden of child malnutrition in Bangladesh.

Prevalence of malnutrition and associated factors affecting the nutritional status of Adivasi (tribal) children aged 24-59 months in Bangladesh

Despite of recent progress in reducing the incidence of child malnutrition in Bangladesh, there are large disparities exists across gender, geographical regions, ethnic and economic groups. Adivasi‟s (tribal people) are regarded as one of the most exploited and deprived section of the society and their children are one of the worst victims of under-nutrition. This study aimed to estimate the prevalence and associated factors of malnutrition in different tribal children aged 24-59 months. Data was extracted from a project named “Adivasi Fisheries Project (AFP)” and the study considered 125 children from four purposively selected household (HH) clusters of four ethnic groups (Santal, Garo, Oraon, and Hajong) by quota-sampling design using the farmer field school (FFS) as the sampling frame. Malnutrition status was determined by measuring underweight, stunting and wasting and the associations between variables and malnutrition status were found out. Regression analysis then confirmed the contributions of risk factors. The prevalence of underweight, stunting and wasting was 28%, 42% and 13% respectively. Malnutrition was found to be higher among Hajong and Oraon compared to Santal and Garo. Significant association was observed between family income and malnutrition status. Having a family income below 4000 BDT (~$50) significantly increased the risk for underweight, stunting and wasting. Moreover, younger mother‟s (age < 20 years) was more prone to have underweight and wasted children than their older counterparts. The study pinpointed that the standard of living of adivasi (tribal) people need to be improved and socio-demographic issues need to be addressed to tackle the malnutrition status of their children.Asian J. Med. Biol. Res. June 2018, 4(2): 178-185

Education of Household Members and Nutritional Status of Children in Bangladesh

Malnutrition is the burning question all over the world’s public health. Bangladesh is one of those countries where level of malnutrition of infant and child is very serious and many problems that results from malnutrition in Bangladesh. The aim of this study is to substantiate whether there exists any influence of parents’ education for child nutrition as well as to find out the potential effects of non-parental household member’s literacy level on child malnutrition. In this study we have found that parents’ education is an important factor for child nutrition. Also other household members’ education has significant impact on stunting (height for age) and underweight (weight for age). The results of this study focus the policies that encourage participation in schools and higher education program as well as improve economic condition of the households to dilute child malnutrition in Bangladesh.
 Dhaka Univ. J. Sci. 66(1): 1-7, 2018 (January)

An assessment of the association between antenatal care and child malnutrition in Bangladesh

An assessment of the association between antenatal care and child malnutrition in Bangladesh

Application of proportional odds model in identifying contributing factor of under-five child malnutrition in Bangladesh: A case study in Tangail district

Background: Children malnutrition is one of the major public health-related concerns in all over the world, especially in developing countries like Bangladesh. Several socioeconomic and demographic factors are responsible for this situation. Aims: The purpose of this research was to identify the contributing factors of malnutrition in Tangail district using primary data collected from rural Tangail. Materials and Methods: The sample was collected using the cluster sampling techniques. Villages were considered as a cluster, and the sample from cluster are selected using probability proportional to size method. In our study, we have categorized the child nutritional status as, “severely malnourished,” “moderately malnourished,” and “nourished” based on Weight-for-age z-score. Bivariate analysis was conducted by examining the gamma measurement for ordinal variables and to check the association between child nutrition status and selected individual variables; we have used the contingency table and Chi-square test. Statistical Analysis: Both univariate, bivariate, and multivariate analysis was conducted to meet the objectives of the study. The proportional odds model was selected to understand the stable effects of covariates influencing the child malnutrition. Results: Bivariate analysis shows significant (P

On exploring and ranking risk factors of child malnutrition in Bangladesh using multiple classification analysis

BackgroundLogistic regression analysis is widely used to explore the determinants of child malnutrition status mainly for nominal response variable and non-linear relationship of interval-scale anthropometric measure with nominal-scale predictors. Multiple classification analysis relaxes the linearity assumption and additionally prioritizes the predictors. Main objective of the study is to show how does multiple classification analysis perform like linear and logistic regression analyses for exploring and ranking the determinants of child malnutrition.MethodsAnthropometric data of under-5 children are extracted from the 2011 Bangladesh Demographic and Health Survey. The analysis is carried out considering several socio-economic, demographic and environmental explanatory variables. The Height-for-age Z-score is used as the anthropometric measure from which malnutrition status (stunting: below −2.0 Z-score) is identified.ResultsThe fitted multiple classification analysis models show similar results as linear and logistic models. Children age, birth weight and birth interval; mother’s education and nutrition status; household economic status and family size; residential place and regional settings are observed as the significant predictors of both Height-for-age Z-score and stunting. Child, household, and mother level variables have been ranked as the first three significant groups of predictors by multiple classification analysis.ConclusionsDetecting and ranking the determinants of child malnutrition through Multiple classification analysis might help the policy makers in priority-based decision-making.Trial registration“Retrospectively registered”

Socioeconomic inequalities of child malnutrition in Bangladesh

Purpose The purpose of this paper is to investigate how socioeconomic status and demographic factors were associated with child malnutrition as well as how these factors accounted for socioeconomic inequality of child malnutrition in Bangladesh during 2007-2011. Design/methodology/approach Data of this study come from two cross-sectional rounds (2007 and 2011) of the Bangladesh Demographic and Health Survey. This paper uses ordinary least square models to estimate the correlates of child malnutrition. The study further uses the concentration curve and the concentration index to estimate socioeconomic inequality of child malnutrition in Bangladesh. Finally, the decomposition method is used to explain socioeconomic inequality of child malnutrition in the study period. Findings Regression analysis indicates that child’s age, breast feeding, child’s birth order, the number of under-five child in the household, household wealth and parental education were strongly correlated with child malnutrition in Bangladesh. This study finds that absolute level of child malnourishment slightly decreased between 2007 and 2011, but socioeconomic inequality increased during this period. Children from the poorest household endured the burden of malnourishment more than those from the wealthiest households. The level of inequality also increased among the rural children, although it remained stagnant among the urban children. Decomposition analysis highlights that parental education had a significant negative relation with the average level of malnutrition, but its role was primarily centred among children from wealthier households. Practical implications An approach linking the ministry of health and education with other ministries may speed up the reduction of inequalities in social determinants of childhood undernourishment. Most importantly, there is a need for comprehensive government policies to reduce growing economic inequality and increase the relative income of the poor in Bangladesh. Originality/value This study is the first of its kind to apply the decomposition method to explain the socioeconomic inequality of child malnutrition in Bangladesh. This paper presents an enriched understanding of socioeconomic inequality of child malnutrition in Bangladesh during 2007-2011.

Analyzing Child Malnutrition in Bangladesh: Generalized Linear Mixed Model Approach

Child malnutrition is a serious issue for overall child health and future development. Stunting is a key anthropometric indicator of child malnutrition. Because of the nature of sampling design used in Bangladesh Demographic Health Survey, 2011, responses obtained from children under same family might be correlated. Again, children residing in same cluster may also be correlated. To tackle this problem, generalized linear mixed model (GLMM), instead of usual fixed effect logistic regression model, has been utilized in this paper to find out potential factors affecting child malnutrition. Model performances have also been compared.
 Dhaka Univ. J. Sci. 64(2): 163-167, 2016 (July)

Association of Low-Birth Weight with Malnutrition in Children under Five Years in Bangladesh: Do Mother's Education, Socio-Economic Status, and Birth Interval Matter?

BackgroundMalnutrition in children under five years remains a significant problem in Bangladesh, despite substantial socio-economic progress and a decade of interventions aimed at improving it. Although several studies have been conducted to identify the important risk factors of malnutrition, none of them assess the role of low birth weight (LBW) despite its high prevalence (36%). This study examines the association between LBW and malnutrition using data from the Bangladesh Demographic and Health Survey (BDHS) 2011 and provides practical guidelines for improving nutritional status of children.MethodsMalnutrition in children is measured in terms of their height-for-age, weight-for-height, and weight-for-age. Children whose Z-scores for either of these indices are below two standard deviations (–2SD) from median of WHO’s reference population are considered as stunted, wasted or underweight, respectively. The association between malnutrition and LBW was investigated by calculating adjusted risk-ratio (RR), which controls for potential confounders such as child’s age and sex, mother’s education and height, length of preceding-birth-interval, access to food, area of residence, household socio-economic status. Adjusted RR was calculated using both Cochran-Mantel-Haenszel approach and multivariable logistic regression models controlling for confounder.ResultsThe prevalence of malnutrition was markedly higher in children with LBW than those with normal birth-weights (stunting: 51% vs 39%; wasting: 25% vs 14% and underweight: 52% vs 33%). While controlling for the known risk factors, children with LBW had significantly increased risk of becoming malnourished compared to their counter part with RR 1.23 (95% CI:1.16–1.30), 1.71 (95% CI:1.53–1.92) and 1.47 (95% CI: 1.38–1.56) for stunting, wasting and underweight, respectively. The observed associations were not modified by factors known to reduce the prevalence of malnutrition, such as higher education of mother, better household socio-economic conditions and longer birth-interval.ConclusionsHigher education of mother, better household socio-economic conditions and prolonged birth intervals alone are not sufficient in bringing about substantial reductions in prevalence of child malnutrition in Bangladesh. Targeted interventions should be designed to reduce prevalence of LBW in addition to improving mother’s education and other socio-demographic conditions.

Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey

To identify the prevalence and risk factors of child malnutrition in Bangladesh. Data was extracted from the Bangladesh Demographic Health Survey (2011). The outcome measures were stunting, wasting, and underweight. χ(2) analysis was performed to find the association of outcome variables with selected factors. Multilevel logistic regression models with a random intercept at each of the household and community levels were used to identify the risk factors of stunting, wasting, and underweight. From the 2011 survey, 7568 children less than 5years of age were included in the current analysis. The overall prevalence of stunting, wasting, and underweight was 41.3% (95% CI 39.0-42.9). The χ(2) test and multilevel logistic regression analysis showed that the variables age, sex, mother's body mass index, mother's educational status, father's educational status, place of residence, socioeconomic status, community status, religion, region of residence, and food security are significant factors of child malnutrition. Children with poor socioeconomic and community status were at higher risk of malnutrition. Children from food insecure families were more likely to be malnourished. Significant community- and household-level variations were found. The prevalence of child malnutrition is still high in Bangladesh, and the risk was assessed at several multilevel factors. Therefore, prevention of malnutrition should be given top priority as a major public health intervention.

Association between order of birth and chronic malnutrition of children: a study of nationally representative Bangladeshi sample

Abstract This paper examines the net effect of birth order on child nutritional status in Bangladesh using data from the Bangladesh Demographic Health Survey, 2011 (BDHS). Analyses were restricted to 4,120 surviving, lastborn singleton children who were younger than 36 months at the time of the survey. Logistic regression was used to assess the association between birth order and child nutritional status. Results indicate 38.1% children are stunted and 8.2% children are fifth or higher order birth. Order of birth is one of the significant predictors of child being stunted. Third order, fourth order, and fifth or higher order children are 24%, 30%, and 72%, respectively, more likely to be stunted after adjusting for all other variables. Besides birth order, results also indicate that child age, size at birth, birth intention, maternal education, maternal body mass index, wealth index, place of residence and mass media access exert strong influences over child malnutrition. Reducing birth rates which limit number of births and birth order as well may reduce child malnutrition in Bangladesh.

Is Unwanted Birth Associated with Child Malnutrition in Bangladesh?

The association between unintended pregnancy and maternal and child health has been well documented. However, the relationship of unintended pregnancy with child malnutrition is not well understood, and may be important in countries such as Bangladesh that have high levels of these events. Data from the 2011 Bangladesh Demographic and Health Survey on 6,506 last-born, singleton children younger than five were used to investigate the relationship between pregnancy intendedness and the prevalence of stunting, wasting and underweight during early childhood. Multivariate logistic regression analyses were used to identify associations. Substantial proportions of children were stunted (40%), wasted (16%) and underweight (35%) at the time of the survey. Mothers reported that at the time of conception, 14% of their index pregnancies had been unwanted and 16% had been mistimed. Compared with children whose conception had been intended, those whose conception had been unwanted were more likely to be stunted (46% vs. 39%), wasted (19% vs. 15%) or underweight (43% vs. 33%). In regression analyses, children who had been unwanted at the time of conception had an elevated risk of being stunted (odds ratio, 1.4), wasted (1.4) or underweight (1.3). Maternal pregnancy intentions are associated with child stunting, wasting and underweight. If these associations are causal, preventing unwanted pregnancies may help reduce the prevalence of childhood malnutrition in Bangladesh.

Determinants of child malnutrition in Bangladesh - A Multivariate Approach

Objective: Malnutrition is referred as the greatest single threat to the world’s public health, especially for the developing countries. Nutritional status is determined anthropometrically and it is outcome of complex interactions between biological, socio-economical variables. This study is conducted to identify the significant determinants of child malnutrition in Bangladesh. Method: Using BDHS-2007 data, Total 5312 cases are included in the present study. Multivariate techniques have been applied in this study to obtain significant determinants of child malnutrition. Results: Factor analysis revealed six factors as covariate of malnutrition; where two factors are socio-economical, others are biological and bio-social. Hence linear discriminant analysis is used to clarify the efficiency of obtained factors in malnutrition scenario; which imply that the obtained factors are accurate for approximately 60 percent observations. Conclusion: The obtained results suggest that, consciousness should be raised to improve socio-economic and maternal health conditions to improve the scenario of child malnutrition. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10404 Asian Journal of Medical Sciences Vol.6(2) 2015 85-89