Md Rashedul Islam1,2, Md Shafiur Rahman1,2, Md Mahfuzur Rahman2, Shuhei Nomura1, Angela de Silva3, Pulani Lanerolle4, Jenny Jung2,5, Md Mizanur Rahman1. 1. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Hongo Campus, Medical Building 3, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan. 2. Global Public Health Research Foundation, Dhaka, Bangladesh. 3. Nutrition and Health for Development Unit, Department of Non-Communicable Diseases, World Health Organization Regional Office for South East Asia, New Delhi, India. 4. Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. 5. Graduate School of Arts and Sciences, Yale University, New Haven, CT, USA.
Abstract
OBJECTIVE: 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. DESIGN: 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. SETTING: Household surveys in Bangladesh from 1996 to 2014. PARTICIPANTS: Children under the age of 5 years. RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVE: 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. DESIGN: 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. SETTING: Household surveys in Bangladesh from 1996 to 2014. PARTICIPANTS: Children under the age of 5 years. RESULTS: 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. CONCLUSIONS: 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.
Entities:
Keywords:
Bangladesh; Child malnutrition; Decomposition analysis; Health inequality; Projection
Authors: Asibul Islam Anik; Mohammad Rocky Khan Chowdhury; Hafiz T A Khan; Md Nazrul Islam Mondal; Nirmala K P Perera; Manzur Kader Journal: BMC Public Health Date: 2021-11-23 Impact factor: 3.295
Authors: Mueni Mutunga; Alexandra Rutishauser-Perera; Arnaud Laillou; Sophonneary Prak; Jacques Berger; Frank T Wieringa; Paluku Bahwere Journal: PLoS One Date: 2021-11-18 Impact factor: 3.240