DETERMINANTS OF NUTRITIONAL STATUS AMONG UNDER-FIVE CHILDREN IN RURAL BANGLADESH: A QUANTITATIVE ANALYSIS USING MULTILEVEL APPROACH

Determinants of nutritional status

Abstract

The present study examines the differential impact of some demographic, socioeconomic and health-related factors on the nutritional status among under-five children in rural Bangladesh using a nationally representative Bangladesh Demographic and Health Survey (BDHS) 2011 data. The BDHS follows a hierarchical data structure because the survey is based on two-stage stratified sampling. Two-level random intercept binary logistic regression models were used to capture the unobserved heterogeneity between clusters (communities) and to identify the determinants of under-five children’s malnutrition. The analyses found that 16% of the children were severely stunted and 26% were moderately stunted. Among the under-five children, 4% were severely wasted and 12% were moderately wasted. Furthermore, 11% of the children were severely underweight and 28% were moderately underweight. The potential factors having significant association with malnutrition were found to be division, child age in month, sex of child, twin child, preceding birth interval, child birth size, religion, mother’s   and father’s education, wealth index, household size, age of household head at first child birth, sources of drinking water and suffer from fever and diarrhea. Significant community-level variations were observed in the analyses which emphasis the need for extra attention on the poor performing communities. Specific policy recommendations have been suggested for the improvement of nutritional status of under-five children in rural Bangladesh.