The objective of this study was to explore the socioeconomic inequalities in undernutrition among ever-married women of reproductive age. We used nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey, 2017–2018. Undernutrition was defined as a body mass index (BMI) of <18.5 kg/m2. The concentration index (C) was used to measure the socioeconomic inequality in the prevalence of women’s undernutrition. A multiple binary logistic regression model was carried out to find out the factors associated with women’s undernutrition. The prevalence of undernutrition among women of 15–49 years was 12%. Among them, 8.5% of women were from urban and 12.7% of women were from rural areas. The prevalence of undernutrition was highest (21.9%) among women who belonged to the adolescent age group (15–19 years). The C showed that undernutrition was more prevalent among the socioeconomically worst-off (poorest) group in Bangladesh (C = −0.26). An adjusted multiple logistic regression model indicated that women less than 19 years of age had higher odds (adjusted odds ratio, AOR: 2.81; 95% confidence interval, CI: 2.23, 3.55) of being undernourished. Women from the poorest wealth quintile (AOR: 3.93, 95% CI: 3.21, 4.81) had higher odds of being undernourished. On the other hand, women who had completed secondary or higher education (AOR: 0.55; 95% CI: 0.49, 0.61), married women who were living with their husbands (AOR: 0.72, 95% CI: 0.61, 0.86), and women exposed to mass media (AOR: 0.87, 95% CI: 0.79, 0.97) were less likely to be undernourished. Intervention strategies should be developed targeting the poorest to combat undernutrition in women of reproductive age in Bangladesh.

The International Code of Marketing of Breast‐milk Substitutes (BMS) instituted to protect breastfeeding against unethical marketing, has been adopted by many countries, including Bangladesh. Despite national adoption, evidence suggests violations occur and inadequate BMS Code implementation is an issue. The study aimed to assess violations of the International BMS Code and the national ‘Breast‐milk Substitutes, Infant Foods, Commercially Manufactured Complementary Foods and the Accessories Thereof (Regulation of Marketing) Act, 2013’ of Bangladesh in commercial settings (retail outlets and media) in Bangladesh, for different types of milk, bottles, and teats using a standardized Network for Global Monitoring and Support for Implementation of the Code and Subsequent relevant World Health Assembly Resolutions (NetCode) protocol. This cross‐sectional quantitative study was conducted in Bangladesh from January to September 2018 in Dhaka, Chattogram, and Sylhet cities. Descriptive statistics were reported and χ2 tests were conducted to assess differences between categorical variables of interest. Data were analysed using SPSS version 20. In retail outlets, there were higher proportion of violations observed in Dhaka than in Sylhet and Chattogram (p < 0.001). Significantly greater proportion of violations in product labels occurred among products sold without local distributors compared to others (p < 0.05); violations were higher among “other milk” for children aged 0 to <36 months compared to formulas and growing‐up milk (p < 0.05). Among media channels, internet clips had significantly higher proportions of violations compared to television, radio and newspaper (p < 0.001). BMS Code violations were prevalent in product labels and promotion of products through retail outlets. The study findings highlight the need for specific multisectoral strategies for better enforcement of BMS Code and points to the need for periodic assessment of Code violations.

Introduction Despite high prevalence of malnutrition little is known about the quality of nutrition services provided through urban health systems. This study aimed to fill in knowledge gaps on quality of nutrition service provision at public primary health care facilities in urban Dhaka. Method This cross-sectional study was conducted from April-July 2019 in Dhaka City. Fifty-three health facilities were sampled following NetCode protocol. Quality of nutrition services was assessed in terms of structural readiness, process, and client satisfaction. Structural readiness included equipment, guidelines, and registers, and knowledge of health professionals (n = 130). For process, client provider interaction was observed (ANC: n = 159, Pediatric: n = 150). For outcome assessment, client’s satisfaction with nutrition service provision was measured through interviews with pregnant women (n = 165) and caregivers of 0–24 month-old children (n = 162). Bivariate and multivariate analyses were conducted using SPSS. Results There were gaps in availability of equipment and guidelines in health facilities. Only 30% of healthcare providers received basic nutrition training. The mean knowledge score was 5.8 (range 0–10) among ANC providers and 7.8 for pediatric service providers. Process: Only 17.6% health facilities had dedicated space for counselling, 48.4% of pregnant women received four key nutrition services; 22.6% of children had adequate growth monitoring; and 38.7% of caregivers received counselling on exclusive breastfeeding. Outcome: The mean satisfaction with services was 4.3 for ANC and 4.0 for paediatric visits (range 1–5). Participants attending public facilities had significantly lower satisfaction compared to those attending private and NGO health facilities. Conclusion There were gaps in facility readiness, and implementation of nutrition services. The clients were more satisfied with services at private facilities compared to public. The gaps in nutrition service delivery need to be adequately addressed to ensure promotion of good nutrition and early detection and management of malnutrition among pregnant women and children in urban Bangladesh.

BackgroundBangladesh faces a double burden of malnutrition, with a rising prevalence of overweight and obesity among children parallel to existing undernutrition.ObjectiveThe current study was designed to assess the determinants of double burden of malnutrition among urban school children from Dhaka, Bangladesh.MethodsA cross-sectional survey was conducted among 2,690 students from 14 schools in Dhaka city from January to June 2018. Anthropometric measurements were taken during school hours, and self-administered questionnaires were sent to the parents. We performed multi-level multiple logistic regression analyses to assess the determinants of underweight, overweight, and obesity.FindingsThe prevalence of overweight (33%) and obesity (23%) was highest among children and adolescents from high tuition schools but the prevalence of underweight (4%) was lowest compared to those from low (underweight 19%, overweight 17%, and obesity 6%) and medium (underweight 18%, overweight 15%, and obesity 6%) tuition schools. Children from high-tuition schools had higher odds of being overweight/ obese (AOR: 2.92; 95% CI: 1.90, 4.49). Parental NCDs and overweight were negatively associated with underweight but positively associated with overweight and obesity among children. Lack of physical activity inside schools was positively associated (AOR: 1.26; 95% CI: 1.02, 1.55) with overweight and obesity among school children.ConclusionOur results point to opportunities in and outside schools to address the rising prevalence of underweight, overweight, and obesity among urban school children.

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