Factors affecting stunting among under-five children in Bangladesh

Background
Stunting is a major contributor to child morbidity and mortality in developing countries. Knowledge about the risk factors of stunting among children under five years of age is important for devising nutritional intervention programs and strategies.

Objectives
This study attempts to uncover the risk factors associated with stunting status among children under five years of age in Bangladesh.

Material and methods
This study uses Bangladesh Demographic and Health Survey (BDHS) 2014 data collected from an observational study. The ordinal dependent variable, child stunting status (categorized as severely stunted, moderately stunted and normal) is constructed by calculating height-for-age Z scores (HAZ). The bivariate analyses were performed using chi-square test to explore possible associations between stunting status and selected covariates. To know the marginal effects of independent variables, the proportional odds (PO) model was considered.

Results
In bivariate setup, all the selected independent variables were found to be highly significant (p < 0.01). However, in multivariate analyses, child age, mother’s education, mother’s BMI and wealth index were found to be highly significant (p < 0.01) factors for the stunting status of children. The risk of having stunted children was found relatively higher in Chittagong (odds ratio = 1.466, p < 0.05), Sylhet (odds ratio = 1.345, p < 0.05) and Rangpur (odds ratio = 1.276, p < 0.1), compared to the Barisal division. Along with this, the birth interval of children (p < 0.05) and antenatal care service during pregnancy (p < 0.1) were found to be associated with child stunting status.

Conclusions
Child age, mother’s education, mother’s BMI and wealth index were the most significant determinants in this study. Hence, policy makers should consider these factors while devising child nutrition programs and intervention strategies.