Talukder Ashis
Statistics Discipline, Khulna University, Khulna 9208, Bangladesh.
Children (Basel). 2017 Oct 19;4(10):88. doi: 10.3390/children4100088.
Child malnutrition remains one of the major public health problems in many parts of the world, especially in a developing country like Bangladesh. Several socioeconomic and demographic factors are responsible for this condition. The present study was conducted to uncover the risk factors associated with malnutrition among under-five children in Bangladesh by analyzing the data from a nationally representative Bangladesh Demographic and Health Survey (BDHS) in 2014. The ordinal dependent variable-child nutrition status (severely malnourished, moderately malnourished, and nourished)-was developed by calculating weight-for-age Z score (WAZ). Bivariate analysis was conducted by performing gamma measure and chi-square test of independence to explore the association between child nutrition status and selected independent variables. To know the adjusted effects of covariates, a popular ordinal model-namely, the proportional odds (PO) model-was considered. All the selected covariates were found highly significant ( < 0.01) in the bivariate setup. However, in the multivariate setup, father's and mother's education, wealth index, mother's body mass index (BMI), and antenatal care service during pregnancy were found highly significant ( < 0.01) factors for child malnutrition. Among the divisions, only Dhaka had more control on child malnutrition, compared to the Sylhet division. Birth interval of children was also reported as a significant factor at a 5% level of significance. Finally, the results of this paper strongly highlighted the necessity of increasing parent's education level, improving the mother's nutritional status, and increasing facilities providing antenatal care service in order to achieve better nutrition status among under-five children in Bangladesh.
儿童营养不良仍然是世界许多地区的主要公共卫生问题之一,尤其是在像孟加拉国这样的发展中国家。多种社会经济和人口因素导致了这种情况。本研究通过分析2014年具有全国代表性的孟加拉国人口与健康调查(BDHS)的数据,来揭示孟加拉国五岁以下儿童营养不良的相关风险因素。通过计算年龄别体重Z评分(WAZ)得出有序因变量——儿童营养状况(重度营养不良、中度营养不良和营养良好)。通过进行伽马测量和独立性卡方检验进行双变量分析,以探索儿童营养状况与选定自变量之间的关联。为了解协变量的调整效应,考虑了一种常用的有序模型——比例优势(PO)模型。在双变量设置中,所有选定的协变量均具有高度显著性(<0.01)。然而,在多变量设置中,父亲和母亲的教育程度、财富指数、母亲的体重指数(BMI)以及孕期的产前护理服务被发现是儿童营养不良的高度显著(<0.01)因素。在各行政区中,与锡尔赫特行政区相比,只有达卡对儿童营养不良有更好的控制。儿童的出生间隔在5%的显著性水平上也被报告为一个显著因素。最后,本文的结果强烈强调了提高父母教育水平、改善母亲营养状况以及增加提供产前护理服务设施的必要性,以便在孟加拉国五岁以下儿童中实现更好的营养状况。