Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996–2018

Abstract

Objective: Examining the height-for-age z-score (HAZ) of 0-35 months children along with stunting prevalence to identify trends, changes, and available nutrition-sensitive and specific determinants that could help explain the long-term variation in child linear growth using successive Bangladesh Demographic and Health Surveys (BDHS) data from 1996 to 2018. Design: The BDHS pooled data is used for determining the key outcome variables HAZ, stunting, and severe stunting. Trends, kernel-weighted local polynomial smoothing illustrations, pooled multivariable Linear Probability Model (LPM), Ordinary Least Squares method (OLS), and regression decomposition were used. Participants: Mothers having 0-35 months children, the most critical age range for growth faltering. Results: The mean HAZ increased by 0.91(±1.53) with 0.041 annual average change, while the percentages of stunting (-26.63 ±0.54) and severe stunting (-21.12 ±0.48) showed a reduction with 1.21 and 0.96 average annual changes, respectively. The average HAZ improvement (0.42 ±1.56) in urban areas was less than the rural areas (1.16 ±1.44). Similar patterns followed for stunting and severe stunting. The prenatal doctor visits (3064.65%), birth in a medical facility (1054.32%), breastfeeding initiation (153.18%), and asset index (144.73%) demonstrated a huge change. The findings of OLS, PLS, and regression decomposition identified asset index, birth order, paternal and maternal education, bottle-fed, prenatal doctor visit, birth in a medical facility, vaccination, maternal BMI, and ever-breastfed as influencing factors to predict the long-term changes of stunting and severe stunting. Conclusion: The nutrition-sensitive and specific factors identified through regression decomposition describing long-term variation in child linear growth should be focused further to attain the sustainable development goals (SDGs).