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

Child 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.

A 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.

Our 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.

Government 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.