Socioeconomic Inequalities in Women’s Undernutrition: Evidence from Nationally Representative Cross-Sectional Bangladesh Demographic and Health Survey 2017–2018

Abstract

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.

Rural-urban disparities in nutritional status among ever-married women in Bangladesh: A Blinder-Oaxaca decomposition approach

“…According to data from the Bangladesh Demographic and Health Survey, 2017–18, the overall prevalence of women’s undernutrition in Bangladesh was reported as 12 percent. This finding aligns with a previous study conducted in Bangladesh [ 11 ]. Examining the residential aspect, it is evident that the prevalence of undernutrition among ever-married women in Bangladesh is higher in rural residences (13.3 percent) compared to urban residences (8.6 percent).…”

“…These results indicate the presence of socioeconomic disparities in the prevalence of undernutrition among ever-married women of reproductive age in Bangladesh, consistent with findings observed in other low- and middle-income countries [ 25 ]. These conclusions align with a previous study conducted in Bangladesh, which also highlighted the disproportionate vulnerability of women from lower-income households to undernourished compared to their counterparts from rich families [ 11 ]. Similar results have been reported in other studies conducted in Tanzania and Ethiopia, with the state of malnutrition decreasing as the wealth index increases [ 24 , 26 ].…”

“…The findings indicate that urban households in Bangladesh accounted for around 26% of the socioeconomic inequality among undernourished women, while rural households in Bangladesh had a concentration index value of -0.28. Previous studies estimated and analyzed the levels of socioeconomic inequalities in nutritional status among ever-married women of reproductive age in overall Bangladesh using the concentration index, and they found that undernutrition was more common in Bangladesh’s socioeconomically weakest (poorest) group (C = 0.26) [ 11 ].…”

“…Efforts have been made in Bangladesh to address the issue of malnourishment among reproductive-aged women. For example, recent studies based on Bangladesh Demographic and Health Survey have highlighted the prevalence of underweight and overweight women in Bangladesh, with estimates of 12 percent and 24 percent, respectively [ 11 , 12 ]. However, despite these findings, there remains a high prevalence of low nutritional status among rural Bangladeshi women of reproductive age, highlighting regional disparity [ 13 ].…”

Double burden of malnutrition among women of reproductive age in Bangladesh: A comparative study of classical and Bayesian logistic regression approach

“…Earlier studies have reported that the prevalence of the double burden of household‐level malnutrition was high in LMICs (Doku & Neupane, 2015 ; Onyango et al, 2019 ). We estimate the prevalence of undernutrition to be approximately 12% women in Bangladesh being underweight, which was consistent with another recent study conducted in Bangladesh (Rahman et al, 2022 ). Compared to undernutrition, approximately 33% women experienced overnutrition (i.e., overweight and obese), which was higher than several South Asian countries (He et al, 2016 ; Hong et al, 2018 ).…”