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Dynamics in child undernutrition in Bangladesh: Evidence from nationally representative surveys between 1997 and 2014
Md Masud Hasan1, Ali Quazi2, Alice Marion Richardson1
1National Centre for Epidemiology and Population Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia.
Insights
Parental education remains a key factor in child nutrition in Bangladesh, while wealth disparities in nutritional status are widening. Targeted interventions for socioeconomically disadvantaged mothers are recommended.
Area of Science:
- Public Health
- Nutritional Epidemiology
- South Asian Studies
Background:
- Childhood undernutrition in Bangladesh poses significant risks to physical and mental development, increasing morbidity and mortality.
- Addressing childhood undernutrition is a critical public health challenge in Bangladesh.
Purpose of the Study:
- To analyze temporal changes in the association between various factors and the nutritional status of children in Bangladesh.
- To identify key covariates influencing childhood nutrition trends over time.
Main Methods:
- Utilized data from six waves of Bangladesh Demographic and Health Surveys (1997-2014).
- Employed multivariable binary logistic regression models for individual survey waves.
- Applied forest plots for overall association analysis and meta-regression to assess changes over time.
Main Results:
- Consistent association observed between parental education and children's nutritional status; lower parental education correlated with higher undernutrition risk.
- The association between household wealth and childhood nutrition has widened, with children from poorer households showing significantly higher undernutrition rates.
- Place of residence also demonstrated a consistent association with nutritional status.
Conclusions:
- Findings highlight the need for targeted public health policies and interventions for mothers from disadvantaged socioeconomic backgrounds.
- Recommendations include nutritional education programs emphasizing the importance of childhood nutrition and promoting access to affordable nutritious foods.
Background:
Bangladesh has been struggling to reduce the prevalence of childhood undernutrition, which impedes physical and mental capability and accelerates morbidity and mortality.
Objectives:
The objective of the paper is to examine the changes over time in the association between potential covariates and nutritional status of Bangladeshi children.
Methods:
The study combined and analyzed data from six waves of Demographic and Health Surveys between 1997 and 2014. Multivariable binary logistic regression models have been fitted to data from individual waves. Overall association has been investigated using forest plots, and meta-regression has been utilized to assess the pace of change in the association over time.
Results:
Parental education and place of residence showed a consistent association with nutritional status of children. Children from parents with no little education were more likely to be undernourished than those from parents with secondary or higher level of education (odds ratio [OR] in 1997 = 3.34, 95% confidence interval [CI] = 2.65-4.22, OR in 2004 = 1.93, 95% CI = 1.58-2.37). On the other hand, gaps in the association of wealth and childhood nutrition have been widening consistently so that in 2014 children from households from the lowest 40% wealth category were 2.66 times (OR = 2.66, 95% CI = 2.13-3.33) as likely as to be undernourished than those from upper 20%.
Conclusions:
The findings have policy implications in terms of developing programs directed to mothers with a relatively poor socioeconomic background. A specific example would be providing nutritional education in relation to importance of childhood nutrition or cheaper nutritious food.
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