A total of 8402 under-5 children were considered in this study. Among them, 31.0%, 8.8%, 22.0% and 2.4% suffered from stunting, wasting, underweight, and overweight, respectively. The prevalence of these nutritional statuses for different socio-demographic factors is given in Table 1.
(Table 1)
Preceding birth interval of a child was found to be significantly associated with both stunting and underweight of a child. Child with lower preceding birth interval were more likely to be stunted and underweight. Frequency of antenatal visits, mother’s age at first cohabitation and birth parity were also found associated at 5% significance level with child stunting and underweight. Mothers who paid lower number of visits for antenatal care and mothers who made their first cohabitation before 18 years of age were more likely to have their child to be stunted and/or overweight. Higher birth parity (>4) was associated with higher percentage of stunting and underweight in child.
Sex of a child was identified to be associated with both wasting and overweight. Interestingly, male children were more likely to be wasted as well as overweight than their female counterparts. In other words, since wasting and overweight are two opposite indicators calculated from the same weight-for-height data, one may say that male children were less likely to be normal weighted than female children.
Significant associations were also exhibited between the factors- age of child, administrative division where a child lived, type of place of residence, wealth status of the child’s family, mother’s access to information and mother’s height with three of the malnutrition types- stunting, underweight and overweight. A higher percentage of middle-aged children are found to be stunted, a higher fraction of older children was found as underweight and a higher proportion of younger children was found as overweight. A much higher percentage of children in Sylhet division were found to be stunted as well as underweight, while a higher percentage of children residing in Dhaka division found to be overweight compared to other administrative divisions. Children residing in rural residence were in higher percentages to be stunted and underweight than those in urban residence, who again in turn were found in higher percentages to be overweight than their rural counterparts. Children from less wealthy family were found associated with more stunting and underweight and those from much wealthy family were associated with more overweight problems. Mothers who had no access to information about maternal and child care, mothers who were shorter (<145cm) and mothers who were working (in time of the survey) had higher percentages of children to be stunted and underweight. On the other hand, mothers having access to information, tall stature and not working had higher percentages of overweight child.
Both of mother’s educational attainment and mother’s BMI were found associated with all of the four malnutrition indicators. Lower educational achievement and lower BMI of mothers were associated with higher percentage of stunted, wasted and underweight children, whereas for the opposite scenarios, there were more overweight children. (Table 1).
(Table 2)
Determinants of stunting
Table 2 demonstrated that odds of being stunted at age 12-23 months and 24-35 months were 2.53 (OR: 2.53, CI: 1.99-3.21, p< 0.001) and 3.51 (OR: 3.52, CI: 2.73-4.51, p<0.01) times to the children aged <12 months. The children residing in Dhaka were 34% (OR: 0.66, CI: 0.46-0.95, p<0.05) less likely to being stunted as compared to the children from Sylhet division. Odds of being stunted were 39% (OR: 0.61, CI: 0.42-0.88, p<0.01) lower for children living in Rangpur division when compared to children from Sylhet division. Children with primary and secondary educated mothers had 75% (OR: 1.75, CI: 1.13-2.73, p<0.01), and 67% (OR: 1.67, CI: 1.10-2.53, p<0.01) higher odds of stunting as compared to children whose mothers had higher education. Children whose mother had height less than 145 cm were 3.68 (OR: 3.68, CI: 2.84-4.77, p<0.001) times likely to be stunted as compared to their counterparts from taller mothers. Similarly, children from underweight mother had 31% (OR: 1.31, CI: 1.00-1.71, p<0.05) higher risk of stunting than children from normal weight mother.
Determinants of wasting
The odds of wasting were 1.24 (OR: 1.24, CI: 1.03-1.48, p<0.05) times for male children as compared to females. Children with uneducated, primary and secondary educated mothers had 87% (OR: 1.87, CI: 1.28-2.75, p<0.01), 41% (OR: 1.41, CI: 1.04-1.91, p<0.05) and 34% (OR: 1.34, CI: 1.01-1.79, p<0.05) higher odds of wasting as compared to children whose mothers had higher education. Similarly, children from underweight mother had 2.99 (OR: 2.99, CI: 1.62-5.50, p<0.001) times risk of wasting than children from normal weight mother.
Determinants of underweight
The odds of being underweight in age 12-23 months, 24-35 months were 1.46 (OR: 1.46, CI: 1.13-1.89, p<0.01) and 2.46 (OR: 2.46, CI: 1.90-3.18, p<0.01) times as compared to age <12 months children. For the underweight case, the odds were 0.63 (OR: 0.63, CI: 0.41-0.95, p<0.05), 0.56 (OR: 0.56, CI: 0.38-0.86, p<0.01), 0.56 (OR: 0.56, CI: 0.37-0.88, p<0.05) and 0.59 (OR: 0.59, CI: 0.39-0.90, p<0.05) times in children living in Barisal, Dhaka, Rajshahi and Rangpur division respectively as compared to children from Sylhet division. Odds of being underweight for children whose mother were uneducated (OR: 2.52, CI: 1.37-4.62, p<0.01), primary (OR: 1.76, CI: 1.01-3.05, p<0.05) and secondary educated (OR: 1.74, CI: 1.02-2.98, p<0.05) were higher as compared to higher educated mother. The other important significant variables to underweight were mothers’ height and mothers’ BMI. Children whose mother had height less than 145 cm were 2.41 (OR: 2.41, CI: 1.88-3.09, p<0.001) times likely to be stunted as compared to their counterpart. Similarly, children from underweight mother had 87% (OR: 1.87, CI: 1.41-2.45, p<0.001) times odds of underweight than children from normal weight mother. Children with obese mother had 41% (OR: 0.59, CI: 0.38-0.99, p<0.05) lower risk of being underweight than normal weight mother.
Determinants of overweight
The odds of overweight were 55% (OR: 1.55, CI: 1.06-2.25, p<0.05) higher for male children as compared to females. The odds of being overweight in age 12-23 months, 24-35 months, 36-47 months and 48-59 months were 0.57 (OR: 0.57, CI: 0.34-0.95, p<0.01), 0.39 (OR: 0.39, CI: 0.23-0.64, p<0.001), 0.38 (OR: 0.38, CI: 0.21-0.72, p<0.01) and 0.48 (OR: 0.48, CI: 0.28-0.84, p<0.05) times as compared to age <12 months children. Children living in Dhaka had 3.31 (OR: 3.31, CI: 1.04-10.55, p<0.05) times odds of being overweight as compared to Sylhet. For overweight cases, the odds were 0.57 (OR: 0.57, CI: 0.33-0.98, p<0.05) times in children from the middle-income family as compared to those from the rich family. Children whose mother had height less than 145 cm were 50% (OR: 0.50, CI: 0.26-0.97, p<0.05) less likely to be overweight as compared to their counterpart. Similarly, children from overweight and obese mother had 1.83 (OR: 1.83, CI: 1.25-2.70, p<0.001) and 2.74 (OR 2.74, CI: 1.50-5.03, p<0.001) times odds of being overweight than those children from normal-weight mother.