Factor associated with anthropometric failure among under-five Bengali children: A comparative study between
Ramendra Nath Kundu1, Md Golam Hossain2, Md Ahshanul Haque3
1Department of Anthropology, West Bengal State University, Kolkata, West Bengal, India.
Insights
Child undernutrition is a major concern in Bangladesh and India, affecting half of Bengali children in India and two-fifths in Bangladesh. Key factors include maternal undernutrition, lack of education, and poor wealth index, necessitating targeted interventions.
Area of Science:
- Public Health
- Global Health
- Child Nutrition
Background:
- Child undernutrition poses a significant burden and is a leading cause of mortality in low- and middle-income countries, impacting Sustainable Development Goals (SDGs).
- The study addresses the critical issue of child undernutrition in Bangladesh and India, focusing on the Bengali population.
Purpose of the Study:
- To determine the factors contributing to child undernutrition using a single composite index of anthropometric failure (CIAF).
- To analyze undernutrition indicators (stunting, wasting, underweight) and their predictors among children under five in Bangladesh and India.
Main Methods:
- Utilized unit-level data from the Bangladesh Demographic and Health Survey (BDHS 2017-18) and India's National Family Health Survey (NFHS-4) for 14,055 children under five.
- Applied WHO guidelines to calculate height-for-age, weight-for-height, and weight-for-age, combining them into a composite anthropometric failure (anth-failure) index.
- Employed Z-proportional and Chi-square tests for frequency differences and binary logistic regression to identify predictors of anth-failure, with a significance level of p < 0.05.
Main Results:
- Significant inter-country disparities were observed, with approximately half of Bengali children in India and two-fifths in Bangladesh experiencing anth-failure.
- Stunting and underweight were more prevalent than wasting in both nations. Common contributing factors included maternal undernutrition, low maternal education, and poor wealth index.
- In Bangladesh, anth-failure was linked to inadequate nutritious food post-breastfeeding and lack of antenatal care. In India, lack of maternal education was a key factor, particularly for firstborns.
Conclusions:
- The study enhances understanding of the multifactorial nature of child undernutrition.
- Recommendations include improving maternal education and nutrition, enhancing child food security and household wealth, and increasing access to healthcare.
- Financial investment by the governments of Bangladesh and India in malnutrition prevention is strongly recommended to achieve the SDGs.
Background:
Child undernutrition is a burden and the leading cause of child mortality in low-and middle-income countries like Bangladesh and India. Currently, this issue is a matter of great concern, inasmuch as achieving the Sustainable Development Goals (SDGs). The study intends to determine the factors of child undernutrition using a single composite index of anthropometric failure (CIAF) among the Bengali population.
Methods:
Unit level data on 14055 under 5 children were extracted from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the 4th National Family Health Survey of India (NFHS-4). To understand child undernutrition and generate CIAF, data on height-for-age (stunting), weight-for-height (wasting), and weight-for-age (underweight) were used by WHO guidelines. These three undernutrition indicators were combined into a single undernutrition indicator called anthropometric failure (anth-failure) using the CIAF concept. Explanatory factors of anth-failure included data on maternal health, socio-demographic and birth-related variables. Differences of frequency were determined by Z-proportional and Chi-square tests; predictors of anth-failure were determined by binary logistic regression. Cut off point of p-value was taken as 0.05 to test the significance.
Results:
Inter-country disparities were revealed, about half of Bengali children in India and two-fifths in Bangladesh being prone to anth-failure. Stunting and underweight were more prevalent in both countries than wasting. Maternal undernutrition, lack of maternal education, and poor wealth index were common factors of anth-failure for both countries. Children in Bangladesh developed anth-failure after the end of breastfeeding period, indicating a lack of nutritious food. Lack of antenatal care was another significant factor in Bangladesh. In India, the first child suffered from anth-failure due to lack of maternal education.
Conclusions:
This study provides a better understanding of multifactorial impact on child undernutrition. It is proposed that the emphasis should be on initiatives that improve maternal education and nutrition, child food security, boost household wealth index, and enhance mothers' access to health care. The study strongly recommends that the governments of Bangladesh and India invest financially in preventing child malnutrition, which will contribute to achieving the first four SDGs.
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