Significant Risk Factors for Childhood Malnutrition: Evidence from an Asian Developing Country
Science Journal of Public Health
Volume 4, Issue 1-1, January 2016, Pages: 16-27
Received: Oct. 9, 2015; Accepted: Oct. 9, 2015; Published: Oct. 28, 2015
Views 5029      Downloads 142
Azizur Rahman, School of Computing and Mathematics, Charles Sturt University, Wagga Wagga, Australia
Article Tools
Follow on us
Protein Energy Malnutrition (PEM) is a major health problem in developing countries and it affects the physical growth and logical development of children. Data from the Demographic and Health Survey Bangladesh were used to evaluate the influences of several significant socioeconomic, demographic, health system and community factors on the current status of malnutrition among 5333 under-5 years children. Results reveal that older age, smaller birth size and maternal poor nutritional status were most significant factors for high prevalence of malnutrition which was assessed using three standard anthropometric indicators, such as underweight, stunting and wasting each of two kinds severe and moderate, following the WHO guidelines and cut-off points. The variables that were associated with severe as well as moderate underweight and stunting were father’s poor education, household lower economic condition and division of residence. Mother’s poor education and increased age of household head were associated with severe underweight and stunting. Low media exposure and respiratory sickness had significant effects on severe as well as moderate underweight and wasting. Some factors such as fathers occupation, number of under-5 children, place of delivery, feeding practice of liquids and feeding practice of solid foods were significantly associated with severe underweight, among these factors some had significant effect on severe stunting, or moderate stunting or both, and also significant effect on severe wasting or moderate wasting or both. In addition, measles vaccine had strong positive effect on child nutritional status but higher level of months of breastfeeding had negative effect. The overall underweight stunting and wasting were observed in 47.1%, 44% and 10.4% (respectively among them 12.8%, 17.9% and1.1% were severely underweight, stunting and wasting) of the children respectively. A vast majority of Bangladeshi children (56.5%) were suffered some degree of PEM. Appropriate intervention programs should be formulated to improve socioeconomic and maternal conditions collaborated with vaccination and childcare to reduce the overall malnutrition.
Childhood Malnutrition, Significant Variables, Stunting, Underweight, Wasting
To cite this article
Azizur Rahman, Significant Risk Factors for Childhood Malnutrition: Evidence from an Asian Developing Country, Science Journal of Public Health. Special Issue:Childhood Malnutrition in Developing Countries. Vol. 4, No. 1-1, 2016, pp. 16-27. doi: 10.11648/j.sjph.s.2016040101.14
Ending Malnutrition by 2020: an Agenda for Change in the Millennium. Final Report to the ACC/SCN by the Commission on the Nutrition Challenges of the 21th Century, February 2000
Data from ‘Supplement on methods and statistics to the first report on the nutrition situation’. ACC/SCN 1988 Table AIII.
FAO (1970). FAO: Production Yearbook, Rome. No. 50. 1992.
UNICEF (1998). The State of the World’s Children 1998, Oxford: Oxford University Press.
UNICEF (1997). Malnutrition in South ASIA; A Regional Profile, UNICEF. November - 1997 p-8.
Jelliffe D. B. & Jelliffe E. F. P. (1989). ‘Dietary Management of Young Children with Acute Diarrhoea World Health Organization, Geneva.
Rahman, A. and Chowdhury, S. (2007). Determinants of chronic malnutrition among preschool children in Bangladesh, Journal of Biosocial Science, 39(2): 161-173.
Megabiaw B, and Rahman A. (2013) Prevalence and determinants of chronic malnutrition among under-5 children in Ethiopia. International Journal of Child Health and Nutrition, 2(3): 230-236.
Mosley W. H. & Gray R. (1993) Childhood precursors of adult morbidity and mortality in developing countries: implications for health programs. In: The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Edited by J. N. Gribble & S. H. Preston. National Academy Press, Washington, DC.
Pollitt E, Gorman KS, Engle PL, Martorell R, Rivera J. (1993). Early supplementary feeding and cognition: effects over two decades. Monogr Soc Res Child Dev, 58:1-99 {discussion appears in pages 111-8}.
Pellet PL. (1981). Malnutrition, Wealth and Development. Food Nutri. Bull. 31. 17-19.
Rahman, A., Chowdhury, S., Karim, A. and Ahmed, S. (2008). Factors associated with nutritional status of children in Bangladesh: A multivariate analysis. Demography India, 37(1): 95-109.
Rahman, A., Chowdhury, S., and Hossain, D. (2009). Acute malnutrition in Bangladeshi children: levels and determinants. Asia-Pacific Journal of Public Health, 21(3): 294-302.
Steinhoff. M. C., Hilder. A. S., Srilatha. V. L. & Mukarji. D. (1986). Prevalence of malnutrition in Indian preschool-age children: a survey of wasting and stunting in rural Tamil Nadu. Bull. Wld Hlth Org. 64, 457.
D’Souza M. R. (1997). Housing and Environmental Factors and Their Effects on the Health of Children in the Slums of Karachi, Pakistan. J. Biosoc. Sci., 29, 271-281.
Vella V, Tomkins A, Borghesi A, Migliori GB, Adriko BC, Crevatin E (1992). Determinants of child nutrition and mortality in Northwest Uganda, Bull WHO; 70(5): 637-43
Vella V, Tomkins A, Borghesi A, Migliori G. B., & Oryem, V. Y. (1994). Determinants of stunting and recovery from stunting in Northwest Uganda.Int. J. Epidemiol. 23, 782
L. Jeyaseelan and M. Lakshman (1997). Risk Factors for Malnutrition in South Indian Children. J. biosoc. Sci., 29, 93-100.
El-Sayed N., Mohammed A. G., Nofal L., Mahfuz A. and Zeid H. A. (2001). Malnutrition among Pre-school Children in Alexandria, Egypt. J. Health Popul. Nutr., 19(4): 275-280.
Forste. R. (1998). Infant Feeding Practices and Child Health in Bolivia. J. biosoc. Sci., 30, 107-125.
Roy N. C. (2000): Use of Mid-upper Arm Circumference for Evaluation of Nutritional Status of Children and foe Identification of High-risk Groups for Malnutrition in Rural Bangladesh. J. Health Popul. Nutr., 18(3): 171-180.
Chowdhury A Y and Bhuiya A. (1993). Effects of Biosocial variables on changes in nutritional status of Rural Bangladeshi Children, Pre and Post Monsoon Flooding J biosoc. Sci., 25, 351-357.
Rahman, A. and Biswas, S. C. (2009). Nutritional status of under-5 children in Bangladesh. South Asian Journal of Population and Health 2(1): 1-11.
Bhuiya A. Zamicki S. and D’Souza S. (1986). Socioeconomic differentials in child nutrition and morbidity in rural area of Bangladesh. J. Trop. Pediatr. 36.17.
Sultana N., Ahmed K. S. and Ali S. M. K. (1997). Intellectual Development of Malnourished Children. Nutrition Society of Bangladesh, 7th Bangladesh Nutrition Conference, March 15-17.
M. Rahman, S. K. Roy, M. Ali, A. K. Mitra, A. N. Alam, and M. S. Akbar (1993). Maternal Nutritional Status as a Determinant of Child Health. Journal of Tropical Pediatrics, 39, 196-203.
UNICEF (1990). Situation of children and Priorities for Action in Bangladesh. Background for the 1990s Dhaka pp. 1-6
Oni G. A. (1986). The effects of maternal age, education and parity on birth weight in a Nigerian community: The comparison of results from bivariate and multivariate analysis. Journal of Tropical Pediatrics, 32, 295-300.
WHO, (1984). The incidence of low birth weight; an update weekly epidemiological record. WHO 59, 205-211.
Akhter H. H. (1992). Breastfeeding in Bangladesh. Bangladesh Journal of Child Health, 16: 31-35.
Desai. S. (1993). The impact of family size on children’s nutritional status: Insights from a comparative perspective. In: Fertility, Family Size, and Structure: Consequences for Families and Children. Edited by C. B. Lloyd. The Population Council, New York.
Mitra S. N., Al-Sabir A., Saha T., and Kumar S., (2001). Bangladesh Demographic and Health Survey, 1999-2000. National Institute of Population Research and Training (NIPORT) & Mitra and Associates, Dhaka, Bangladesh. May 2001.
Waterlow, J. C., Buzina, R. and Keller, W. (1977). The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years. In: Bulletin of World Health Organization (WHO). 1977. 55, no. 4: 489-498.
World Health Organization (1986). Use and interpretation of anthropometric indicators of nutritional status. Bull WHO; 64:929-41.
Chauliac, M. Marrie, A. and Raimbault, M. (1989). Children in the Tropics. Review of the International Children’s centre; Nutritional Status; The interpretation of indicators, Report No-181/182: 26-35.
Hosmer, D. W. and Lemeshow S. (1989). Applied Logistic Regression. A Wiley-Interscience Publication, John Wiley & Sons, New York.
Mitra S. N., Al-Sbir, A., Cross, A. R. and Jamil, K. (1997). Bangladesh Demographic and Health Survey, 1996-1997. Calverton, Maryland and Dhaka, Bangladesh: NIPORT, Mitra and Associates and Macro International Inc.
Bangladesh Demographic and Health Survey, 1999-2000. National Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh.
Martin. C. T. and Juarez, F. (1995) The impact of womens education on fertility in Latin America: searching for explanations. Int. Fam. Plann. Perspect. 21. 52-57. 80.
Caldwell. J. C. (1979). Maternal Education as a Factor in Child Mortality, World Health Forum; 2(1): 75-78.
Caldwell, J. and Caldwell, P. (1993). Roles of women, families and communities in preventing illness and providing health services in developing countries. In: The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Edited by J. N. Gribble and S. H. Preston. National Academy Press, Washington, DC.
Henry, F. J., Briend, A., Fauveau. V., Huttly, S. R. A., Yunus, M., and Chakraborty, J. (1992). Risk Factors for clinical Marasmus: a case control study of Bangladeshi children. Int. J. Epidemiol. 22, 278
Bairagi, R. (1980). Is income the only constraint on child nutrition in rural Bangladesh? Bull. Wld Hlth Org. 58, 767
Bouvier, P. Papart, J. P. Wanner, P. Picquent, M. and Rougemont, A. (1995). Malnutrition of children in Sikasso (Mali): Prevalence and socio-economic determinants. Sozial-und Preventiv medizin; 40(1): 17-34
Cunningham, A. S. (1977). Morbidity in breastfed and artificially fed infants. J. Pediat. 90, 726
Waterlow, J. C. and Thomson, A. M. (1979). Observations on the adequacy of breastfeeding, Lancet 2, 238-242
Nazneen, C. Ataharul, M. I. and Nitai, C. (1997). Infant and Child Feeding Practices in Bangladesh: Evidence from Bangladesh Demographic and Health Survey, 1993-94, Demography India, Vol. 26, No. 2(1997), pp. 275-286
Brown, K., Creed-Kanashiro, H. and Dewey, K. (1994). Optimal Complementary Feeding Practices to Prevent Childhood Malnutrition in Developing Countries. Paper presented at Cornell/UNICEF Colloquium on Care and Nutrition for the Young Child, Aurora, NY.
Jelliffe, D. B. and Jelliffe, E. F. P. (1978). Human Milk in the Modern World. Oxford: Oxford University Press.
Victora, C. G., Vaughan, J. P., Lombardi, C., Fuchs, S. M. C., Gigante, L. P., Smith, P. G., Nobre, L. C., Teixeira, A. M. B., Moreira, L. B. and Barros, F. C. (1987). Evidence for protection by breastfeeding against infant deaths from infectious diseases in Brazil. Lancet 2, 319-321.
Puffer, R. and Serrano, C. (1973). Patterns of Mortality in Childhood. Pan American Health Organization, Washington, DC.
Kitagawa E. M. and Phillip M. H. (1973). Differential mortality in the United States: a study in socio-economic epidemiology, Cambridge: Harvard University Press.
Foster, S. (1984). Immunizable and respiratory diseases and child mortality. In: Child Survival: Strategies for Research. Edited by W. H. Mosley & L. Chen. Popul. Dev. Rev. 10, (Supplement).
Palloni A. (1981). Mortality in Latin America: emerging patterns. Popul. Dev. Rev. 7, 623.
Chen I. C., Huq E. and D’Souza S. (1981). Sex bias in the family allocation of food and health care in rural Bangladesh. Pop Dev Rev., 7: 55-70
Chowdhury AKMA. (1987). Changes in maternal nutritional status in a chronically malnourished population in rural Bangladesh, Ecol Food Nutr., 19: 201-11.
Williams, C. D., Baumslag, M. and Jelliffe, D. B. (1994). Mother and Child Health. Oxford University Press, New York.
Gissler C., Calloway D. H., and Margen, S. (1978). Lactation and pregnancy in Iran. II. Diet and nutritional status, Am J Clin Nutr., 31: 341-54.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186