Prevalence and correlates of the composite index of anthropometric failure among children under 5 years old in Bangladesh

Abstract

The prevalence of stunting, wasting, and underweight are reported separately. However, the data of the multiple anthropometric failures combinations of these conventional indicators are scant. This study attempted to estimate the overall burden of undernutrition among children under 5 years old, using the composite index of anthropometric failure (CIAF), and to explore the correlates. The study used secondary data from the Bangladesh demographic and health surveys (BDHS), undertaken in 2014. CIAF provides an overall prevalence of undernutrition, which gives six mutually exclusive anthropometric measurements of height‐for‐ age, height‐for‐weight, and weight‐for‐age. Multivariable logistic regression was used to explore the correlates of CIAF. The overall prevalence of undernutrition using the CIAF was 48.3% (95% CI [47.1%, 49.5%]) among the children under 5 years old. The prevalence of anthropometric failure due to a combination of both stunting and underweight was 18.2%, wasting and underweight was 5.5%, and wasting, underweight, and stunting was 5.7%. The odds of CIAF were higher among young maternal age, having the poorest socio‐economic status, living in rural areas, higher order of birth, and received no vaccination compared with other counterparts. In Bangladesh, one out of two children has undernutrition, which is preventing the potential of the millions of children. Mothers who gave birth before age 20 living in the rural areas with belonging to lower socio‐economic status and whose children had a higher order of birth and receive no vaccination were observed as the main determinants of undernutrition. Nutrition sensitive interventions along with social protection programmes are crucial to deal the underlying causes of undernutrition.

The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure

“…Our study found that children living in urban areas are less likely to experience anthropometric failure compared to rural children. This is consistent with previous studies conducted in Bangladesh [15] and Myanmar [26] and is most likely linked to better living conditions, and adequate all years-round food accessibility in urban areas. In addition, our ndings show that children from poorer households are at increased risk of anthropometric failure compared with children from richer households.…”

“…In addition, our ndings show that children from poorer households are at increased risk of anthropometric failure compared with children from richer households. This corresponds to many other studies done previously in developing countries like Ethiopia [17],Bangladesh [15] and India [33]. Pomati et al [34] analysed the data of several West and Central African countries found that the risk of anthropometric failure among children in wealthier households is half than that of the poorest households.…”

“…This is higher compared to the prevalence reported by conventional indices of stunting wasting and underweight. In other countries the prevalence of CIAF was 47.8% in India [12]; 48.4% in Ethiopia [17], 48.3% in Bangladesh [15] and 21.7% in China [14].…”

“…Furthermore, the above model has been used in several studies [10,11], and it has been concluded that CIAF identi es a greater percentage of undernourished children compared to conventional indices [12,13]. Countries such as China, Malawi and others have adopted the CIAF model to rede ne their children's nutrition situation [8,9,[14][15][16][17][18]; but such national wide studies are lacking in Tanzania.…”

“…According to the UNICEF conceptual framework [21], undernutrition can be caused by insu cient diet intake, infections, poor breastfeeding or inadequate complementary foods. To date, numerous studies have been conducted to examine the determinants of undernutrition in Tanzania [2,[22][23][24] and elsewhere [15,17,[25][26][27]. However, available studies in the country have used conventional indices, rather than aggregated indicator of CIAF.…”