Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh

Abstract Introduction Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the prop...

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Autores principales:	Asibul Islam Anik, Mohammad Rocky Khan Chowdhury, Hafiz T. A. Khan, Md Nazrul Islam Mondal, Nirmala K. P. Perera, Manzur Kader
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	CIAF CISAF Severe child undernutrition Maternal & child health Urban-rural disparity Bangladesh Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/7098f76e5ca640ceb507c32c5f7961ff
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spelling	oai:doaj.org-article:7098f76e5ca640ceb507c32c5f7961ff2021-11-28T12:12:53ZUrban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh10.1186/s12889-021-12038-31471-2458https://doaj.org/article/7098f76e5ca640ceb507c32c5f7961ff2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12038-3https://doaj.org/toc/1471-2458Abstract Introduction Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. Methods This study extracted the children dataset from the 2017–18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. Results The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children’s birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. Conclusion Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.Asibul Islam AnikMohammad Rocky Khan ChowdhuryHafiz T. A. KhanMd Nazrul Islam MondalNirmala K. P. PereraManzur KaderBMCarticleCIAFCISAFSevere child undernutritionMaternal & child healthUrban-rural disparityBangladeshPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	CIAF CISAF Severe child undernutrition Maternal & child health Urban-rural disparity Bangladesh Public aspects of medicine RA1-1270
spellingShingle	CIAF CISAF Severe child undernutrition Maternal & child health Urban-rural disparity Bangladesh Public aspects of medicine RA1-1270 Asibul Islam Anik Mohammad Rocky Khan Chowdhury Hafiz T. A. Khan Md Nazrul Islam Mondal Nirmala K. P. Perera Manzur Kader Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh
description	Abstract Introduction Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. Methods This study extracted the children dataset from the 2017–18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. Results The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children’s birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. Conclusion Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.
format	article
author	Asibul Islam Anik Mohammad Rocky Khan Chowdhury Hafiz T. A. Khan Md Nazrul Islam Mondal Nirmala K. P. Perera Manzur Kader
author_facet	Asibul Islam Anik Mohammad Rocky Khan Chowdhury Hafiz T. A. Khan Md Nazrul Islam Mondal Nirmala K. P. Perera Manzur Kader
author_sort	Asibul Islam Anik
title	Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh
title_short	Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh
title_full	Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh
title_fullStr	Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh
title_full_unstemmed	Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh
title_sort	urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (cisaf) in bangladesh
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7098f76e5ca640ceb507c32c5f7961ff
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Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh

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