Prevalence of child undernutrition measures and their spatio-demographic inequalities in Bangladesh: an application of multilevel Bayesian modelling

BMC Public Health. 2022 May 18;22(1):1008. doi: 10.1186/s12889-022-13170-4.

Abstract

Micro-level statistics on child undernutrition are highly prioritized by stakeholders for measuring and monitoring progress on the sustainable development goals. In this regard district-representative data were collected in the Bangladesh Multiple Indicator Cluster Survey 2019 for identifying localised disparities. However, district-level estimates of undernutrition indicators - stunting, wasting and underweight - remain largely unexplored. This study aims to estimate district-level prevalence of these indicators as well as to explore their disparities at sub-national (division) and district level spatio-demographic domains cross-classified by children sex, age-groups, and place of residence. Bayesian multilevel models are developed at the sex-age-residence-district level, accounting for cross-sectional, spatial and spatio-demographic variations. The detailed domain-level predictions are aggregated to higher aggregation levels, which results in numerically consistent and reasonable estimates when compared to the design-based direct estimates. Spatio-demographic distributions of undernutrition indicators indicate south-western districts have lower vulnerability to undernutrition than north-eastern districts, and indicate significant inequalities within and between administrative hierarchies, attributable to child age and place of residence. These disparities in undernutrition at both aggregated and disaggregated spatio-demographic domains can aid policymakers in the social inclusion of the most vulnerable to meet the sustainable development goals by 2030.

Keywords: Rural-urban disparities; Small area estimation; Spatial and cross-sectional correlations; Stunting; Underweight; Wasting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bangladesh / epidemiology
  • Bayes Theorem
  • Child
  • Child Nutrition Disorders* / epidemiology
  • Cross-Sectional Studies
  • Growth Disorders / epidemiology
  • Humans
  • Infant
  • Malnutrition* / epidemiology
  • Prevalence
  • Thinness / epidemiology