scholarly journals Double burden of malnutrition in children aged 24 to 59 months by socioeconomic status in five South Asian countries: evidence from demographic and health surveys

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032866 ◽  
Author(s):  
Fariha Binte Hossain ◽  
Md Shajedur Rahman Shawon ◽  
Md Shehab Uddin Al-Abid ◽  
Sultan Mahmood ◽  
Gourab Adhikary ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
South Asian ◽  
Health Surveys ◽  
Task Force ◽  
Wealth Index ◽  
Socioeconomic Inequalities ◽  
Demographic And Health Surveys ◽  
Overweight Children ◽  
Asian Countries ◽  
Double Burden

ObjectivesWe aimed to investigate the socioeconomic inequalities in the burden of underweight and overweight among children in South Asia. We also examined other factors that were associated with these outcomes independently of household’s socioeconomic status.DesignNationally-representative surveys.SettingsDemographic and Health Surveys from Bangladesh, India, Pakistan, Maldives and Nepal, which were conducted between 2009 and 2016.ParticipantsChildren aged 24 to 59 months with valid measurement for height and weight (n=146 996).Primary exposure and outcome measuresPrimary exposures were household’s wealth index and level of education. Underweight and overweight were defined according to the WHO and International Obesity Task Force definitions, respectively.ResultsUnderweight prevalence was 37% in Bangladesh, 38% in India, 19% in Maldives, 29% in Nepal and 28% in Pakistan. Bangladesh, India and Nepal had similar overweight prevalence (between 2% and 4%) whereas Pakistan (7%) and Maldives (9%) had higher prevalence. Households with higher wealth index or education had lower odds of having underweight children. Adjusted ORs of underweight for richest versus poorest households were 0.4 (95% CI: 0.3 to 0.5), 0.5 (95% CI: 0.5 to 0.6), 0.5 (95% CI: 0.2 to 1.4), 0.5 (95% CI: 0.3 to 0.8) and 0.7 (95% CI: 0.5 to 1.1) for Bangladesh, India, Maldives, Nepal and Pakistan, respectively. Compared with poorest households, richest households were more likely to have overweight children in all countries except Pakistan, but such associations were not significant after adjustment for other factors. There were higher odds of having overweight children in households with higher education in Bangladesh (OR 2.1 (95% CI: 1.3 to 3.5)), India (OR 1.2 (95% CI: 1.2 to 1.3)) and Pakistan (OR 1.8 (95% CI: 1.1 to 2.9)) when compared with households with no education. Maternal nutritional status was consistently associated with children’s nutritional outcomes after adjustments for socioeconomic status.ConclusionsOur study provides evidence for socioeconomic inequalities for childhood underweight and overweight in South Asian countries, although the directions of associations for underweight and overweight might be different.

scholarly journals Double burden of malnutrition in children aged 24-59 months by socioeconomic status in five South Asian countries: evidence from Demographic and Health Surveys

2019 ◽  
Author(s):  
Fariha Binte Hossain ◽  
Md Shajedur Rahman Shawon ◽  
Md Shehab Uddin Al-Abid ◽  
Sultan Mahmood Sami ◽  
Gourab Adhikary ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
South Asian ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Socioeconomic Conditions ◽  
Asian Countries ◽  
Double Burden ◽  
Lower Odds ◽  
Double Burden Of Malnutrition

ABSTRACTBackgroundDeveloping countries are now facing double burden of undernutrition and overnutrition among children and adults. We aimed to explore the double burden of malnutrition among children aged 24-59 months by household’s socioeconomic status in South Asian context.MethodsChildren with valid information on height and weight from the latest Demographic and Health Survey from Bangladesh, India, Pakistan, Maldives, and Nepal were included in this study. Underweight and overweight were defined according to definitions of World Health Organisation and International Obesity Task Force, respectively. We used multiple logistic regressions to estimate the association of socioeconomic status with childhood underweight and overweight.ResultsSouth Asian countries had significant burden of underweight, ranging from 19% in Maldives to 38% in India. Bangladesh, India, and Nepal had prevalence of overweight between 2% and 4%, whereas Pakistan and Maldives had prevalence of 7% and 9%, respectively. Households with higher wealth index and education were consistently associated with lower odds of underweight children. When compared to poorest households, richest households had higher odds of being overweight in Bangladesh (OR 1.96, 95% CI 1.27-3.02) and India (OR 1.53, 95% CI 1.41-1.66) while lower odds of being overweight in Pakistan (OR 0.22, 95% CI 0.14-0.34). Households with higher education were more likely to have overweight children in Bangladesh and India.ConclusionsChildhood underweight is associated with lower socioeconomic conditions while there is a substantial burden of childhood overweight in higher socioeconomic groups. These disparities by socioeconomic conditions should be considered while developing national nutrition programs and strategies.KEY MESSAGESIn South Asia, there is a substantial burden of undernutrition among under-five children while a differential burden of overnutrition is also seen.Household wealth and educational attainment were inversely associated with childhood underweight.Children in households with higher levels of wealth and educational attainment were more likely to be overweight in Bangladesh and India, while evidence supporting such association was not clear for other South Asian countries.The urban-rural difference in the burden of childhood underweight and overweight can be explained by the distributions of households’ socioeconomic status.

scholarly journals Wasting and Associated Factors among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

2021 ◽  
Vol 18 (9) ◽  
pp. 4578
Author(s):  
Nidhi Wali ◽  
Kingsley E. E. Agho ◽  
Andre M. N. Renzaho
Keyword(s):  
South Asia ◽  
South Asian ◽  
Health Surveys ◽  
Associated Factors ◽  
Common Factor ◽  
Household Wealth ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Sampling Weights

Child wasting continues to be a major public health concern in South Asia, having a prevalence above the emergency threshold. This paper aimed to identify factors associated with wasting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent demographic and health surveys (2014–2018) of five countries in South Asia was combined. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. Wasting prevalence was higher for children aged 0–23 months (25%) as compared to 24–59 months (18%), with variations in prevalence across the South Asian countries. The most common factor associated with child wasting was maternal BMI [adjusted odds ratio (AOR) for 0–23 months = 2.02; 95% CI: (1.52, 2.68); AOR for 24–59 months = 2.54; 95% CI: (1.83, 3.54); AOR for 0–59 months = 2.18; 95% CI: (1.72, 2.77)]. Other factors included maternal height and age, household wealth index, birth interval and order, children born at home, and access to antenatal visits. Study findings suggest need for nutrition specific and sensitive interventions focused on women, as well as adolescents and children under 2 years of age.

Age heaping among individuals in selected South Asian countries: evidence from Demographic and Health Surveys

2021 ◽  
pp. 1-10
Author(s):  
Manish Singh ◽  
Gyan Chandra Kashyap ◽  
Madhumita Bango
Keyword(s):  
South Asian ◽  
Health Surveys ◽  
Education Level ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Digit Preference ◽  
Innovative Methods ◽  
Urban Rural ◽  
Rural Place ◽  
Using Data

Abstract Age misreporting is a common phenomenon in Demographic and Health Surveys, and there are numerous reasons for this. The trend and pattern of disparity in age heaping vary between countries. The present study assesses age heaping in the selected South Asian countries of Afghanistan, India, Nepal, Bangladesh and Pakistan using data from the most recent round of the Demographic and Health Survey. The respondent sample sizes were 203,703 for Afghanistan, 2,869,043 for India, 49,064 for Nepal, 81,618 for Bangladesh and 100,868 for Pakistan. Age heaping was assessed by respondent’s age, education level, sex and level of education. Whipple’s index was calculated to assess systematic heaping on certain ages as a result of digit preference. Bangladesh, Afghanistan and India showed stronger preference for ages ending with the digits ‘0’ and ‘5’ compared with Pakistan and Nepal among uneducated respondents. On the other hand, strong avoidance of ages ending in the digits ‘1’, ‘4’ and ‘9’ was observed in Bangladesh, Afghanistan and India. However, urban–rural place of residence was not found to be associated with digit preference in the study countries. Among males, age misreporting with the final digits ‘0’ and ‘5’ was highest in Bangladesh, followed by Afghanistan and India, and Nepal showed the least displacement. Strong digit preference and avoidance, and upper age displacement, were witnessed in the surveys conducted in Bangladesh, Afghanistan and India on the parameters of sex and education level. Innovative methods of data collection with the measurement and minimization of errors using statistical techniques should be used to ensure accuracy of age data.

Effect of neighbourhood socioeconomic status on overweight and obesity in children 2–15 years of different ethnic groups

2019 ◽  
Vol 29 (4) ◽  
pp. 796-801 ◽  
Author(s):  
J A de Wilde ◽  
M Eilander ◽  
B J C Middelkoop
Keyword(s):  
Socioeconomic Status ◽  
Ethnic Groups ◽  
South Asian ◽  
Ethnic Differences ◽  
Task Force ◽  
Overweight And Obesity ◽  
Obesity Prevalence ◽  
Negatively Associated ◽  
Neighbourhood Socioeconomic Status ◽  
Dutch Children

Abstract Background Studies on the influence of neighbourhood socioeconomic status (N-SES) on overweight and obesity rates in children from different ethnic backgrounds are scarce. This study investigated the differential effect of N-SES on overweight (including obesity) and obesity prevalence in different ethnic groups, and if N-SES explains ethnic differences in the prevalence of overweight and obesity. Design A population based study of 109 766 body mass index (BMI) measurements of 86 209 children 2–15 years of Dutch, Turkish, Moroccan and South Asian descent. BMI class was determined with The International Obesity Task Force, and South Asian specific BMI cut-offs. WHO BMI criteria were applied for reference purposes. The effect of N-SES on prevalence rates was studied with generalized linear mixed models. Results Neighbourhood SES was negatively associated with overweight and obesity. However, the effect of N-SES on overweight was stronger in Dutch children (OR 0.75, 95% CI 0.73–0.77) than in Turkish (OR 0.86, 95% CI 0.82–0.90), Moroccan (OR 0.91, 95% CI 0.86–0.97) and South Asian (OR 0.90, 95% CI 0.84–0.96) children. The influence of N-SES on obesity showed a similar pattern, except for Moroccan children in whom obesity prevalence remained stable over the whole N-SES range. At the same N-SES, overweight and obesity prevalence was significantly higher in Turkish, Moroccan and especially South Asian children compared with Dutch children. Adjusting for N-SES attenuated the ethnic differences. Conclusions Neighbourhood SES was negatively associated with overweight and obesity rates in all ethnic groups, but only partly explained the ethnic differences in overweight and obesity prevalence.

scholarly journals Socio-economic differentials in minimum dietary diversity among young children in South-East Asia: evidence from Demographic and Health Surveys

2018 ◽  
Vol 21 (16) ◽  
pp. 3048-3057 ◽  
Author(s):  
Chloe M Harvey ◽  
Marie-Louise Newell ◽  
Sabu S Padmadas
Keyword(s):  
Young Children ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Surveys ◽  
Dietary Diversity ◽  
East Asian ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Minimum Dietary Diversity

AbstractObjectiveTo investigate the socio-economic differentials underlying minimum dietary diversity (MDD) among children aged 6–23 months in three economically diverse South-East Asian countries.DesignThe outcome variable MDD was defined as the proportion of children aged 6–23 months who received foods from four of the seven recommended food groups within the 24 h prior to interview. The association between socio-economic factors and MDD, adjusting for relevant characteristics, was examined using logistic regression.SettingWe used cross-sectional population data from recent Demographic and Health Surveys from Cambodia (2014), Myanmar (2015–16) and Indonesia (2012).SubjectsTotal of 8364 children aged 6–23 months.ResultsApproximately half of all children met the MDD, varying from 47·7 % in Cambodia (n1023) to 58·2 % in Indonesia (n2907) and 24·6 % in Myanmar (n301). The likelihood (adjusted OR; 95 % CI) of meeting MDD increased for children in the richest households (Cambodia: 2·4; 1·7, 3·4; Myanmar: 1·8; 1·1, 3·0; Indonesia: 2·0; 1·6, 2·5) and those residing in urban areas (Cambodia: 1·4; 1·1, 1·9; Myanmar: 1·7; 1·2, 2·4; Indonesia: 1·7; 1·5, 1·9). MDD deprivation was most severe among children from the poorest households in rural areas. The association between mother’s labour force participation and MDD was positive in all three countries but reached significance only in Indonesia (1·3; 1·1, 1·5).ConclusionsMDD deprivation among young children was significantly high in socio-economically disadvantaged families in all three study settings. MDD requirements are not being met for approximately half of young children in these three South-East Asian countries.

scholarly journals Determinants of newborn care utilization in Pakistan: Findings from the Demographic and Health Surveys

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1061
Author(s):  
Sathirakorn Pongpanich ◽  
Abdul Ghaffar ◽  
Najma Ghaffar ◽  
Hafiz Abdul Majid
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Postnatal Care ◽  
Health Surveys ◽  
Newborn Care ◽  
Wealth Index ◽  
Maternal Health Services ◽  
Care Utilization ◽  
Demographic And Health Surveys ◽  
Cross Sectional

Background: Information on determinants of postnatal care is essential for maternal health services, and this information is scarce in Pakistan. This study aimed to determine the factors of newborn postnatal care utilization from the Pakistan Demographic and Health Surveys (PDHS) conducted from 2006–2018. Methods: We analyzed data from three rounds of cross-sectional, nationally representative PDHS 2006–07, 2012–13, and 2017–18. Multivariable logistic regression models were applied to explore factors associated with utilization of newborn postnatal care within two months. Results: This study included 5724 women from the 2006–07 PDHS, 7461 from the 2012–13 survey, and 8287 from the 2017–18 survey. The proportion of women receiving newborn postnatal care within the first two months of delivery increased from 13% in 2006–07 to 43% in 2012–13 but dropped to 27% in 2017–18. Respondent’s occupation and prenatal care utilization of maternal health services were common factors that significantly influenced newborn postnatal care utilization within two months. The utilization of postnatal care was greater among women having educated husbands and where the first child was a male in PDHS 2007 round. Higher wealth index and educated respondent had higher postnatal care utilization odds in DHS 2012 and DHS 2018. However, the odds of using postnatal care decreased with the number of household members and total number of children ever born in DHS 2012 and 2018 rounds. Conclusions: There was a general increase in the proportion of women who utilized postnatal care for their newborns during 2006–2013 but a decrease in 2018. The decreased utilization in 2018 warrants further investigation. Improving women’s economic status, education, employment, and antenatal care attendance and reducing parity may increase newborn postnatal care utilization.

scholarly journals Enablers of vitamin A coverage among children under five years of age from multi-country analyses of global demographic and health surveys in selected LMIC and LIC countries in Africa and Asia: a random forest analysis

2018 ◽  
Vol 6 (1) ◽  
pp. 395 ◽  
Author(s):  
Manoj Kumar Raut ◽  
J. C. Reddy ◽  
Debabrata Bera ◽  
Kirti Warvadekar
Keyword(s):  
Random Forest ◽  
Mass Media ◽  
Vitamin A ◽  
Health Surveys ◽  
Vitamin A Deficiency ◽  
Wealth Index ◽  
Demographic And Health Surveys ◽  
Vitamin A Supplementation ◽  
Mother’S Education ◽  
Mother's Education

Background: Vitamin A deficiency is a common form of micronutrient malnutrition. The estimated relative risks associated with vitamin A deficiency in children were 1.86 (95% CI 1.32–2.59) for measles mortality, 2.15 (95% CI 1.83–2.58) for diarrhoea mortality, 1.78 (95% CI 1.43–2.19) for malaria mortality, 1.13 (95% CI 1.01–1.32) for other infectious disease mortality. Vitamin A supplementation reduces night blindness, child morbidity and mortality.Methods: This paper tries to explore the socio-demographic causes of receipt of vitamin A in selected lower-middle-income and low income countries by analysing the data of the demographic and health surveys from 2012 and 2016 using PASW 18.0 software. Multivariate binary logistic regressions were conducted to explore the role of socio-demographic covariates in the receipt of vitamin A supplementation. In addition, random forest (RF) analyses were conducted using Python 3.6.Results: After adjusting for related socio-economic and demographic factors, mother’s work status and education and among mass media channels, exposure to television seems to play an important role in predicting receipt of vitamin A in the selected countries in Asia, while education of the mother was significantly associated with the receipt of vitamin A in the selected countries of Africa. In all the selected countries, the RF analyses revealed mother’s education followed by wealth index and mass media (TV), as the variable of most importance.Conclusions: It can be concluded that mother’s education and mass media seems to be working well in making the mothers aware about the vitamin A campaign, especially, the exposure to television. It also figures in the variable importance matrix in addition to wealth index.

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