Prevalence and factors associated with double and triple burden of malnutrition among mothers and children in Nepal: evidence from 2016 Nepal Demographic and Health Survey
Abstract Background: Malnutrition among mothers and children is a major public health challenge in developing countries like Nepal. Although undernutrition among children has been gradually decreasing, the coexistence of different forms of malnutrition among mothers and children has continued to rise globally. There is a gap in knowledge of the coexistence of such multiple burdens of malnutrition in the Nepalese context. The aims of this study were to explore the coexistence of different forms malnutrition among children and associated factors among the mother-child pairs in the same household. Methods: A total sample of 2,261 mother-child pairs from the Nepal Demographic and Health Survey (NDHS) 2016 was included in the study. Anthropometric measurements and hemoglobin levels of the children and anthropometric measurements of their mothers were taken. The bivariate and multivariable logistic regression were performed to assess the factors associated with the double burden of malnutrition (DBM) and the triple burden of malnutrition (TBM). Results: Prevalence of DBM and TBM was 6.60(5.13-8.84) % and 7(5.42-8.99) % respectively in the same household. In the adjusted multivariable logistic regression, mothers with short stature compared to normal height (AOR=4.18, 95% CI: 2.04-8.52), from the richest wealth status compared to poor wealth status (AOR=2.46, 95% CI= 1.17-5.15), from age group of above 35 years compared to 15-24 years (AOR=3.08, 95% CI:1.20-7.86), and those who had attended at least a secondary level of education compared to no education (AOR=2.05, 95% CI: 1.03-4.07) were more likely to suffer from the DBM. Similarly, mothers with short stature compared to normal height (AOR=5.01, 95% CI:2.45-10.24), from the richest wealth status compared to poor wealth status (AOR=2.66, 95% CI=1.28-5.54), age groups of above 35 years compared to 15-24 years (AOR=3.41, 95% CI:1.26-9.17), and those who had attended at least a secondary level of education compared to no education (AOR=2.05, 95% CI: 1.00-4.18) were more likely to suffer from the TBM. Conclusions: There is a low prevalence of double and triple burden of malnutrition among mother-child pairs in Nepal. Mothers with short stature, belonging to the richest family and in older age were more prone to double and triple burden of malnutrition