Prevalence and determinants of wasting of under-5 children in Bangladesh: Quantile regression approach

Background: Wasting is perhaps one of the signs of malnutrition that has been linked to the deaths of children suffering from malnutrition. As a result, understanding its correlations and drivers is critical. Using quantile regression analysis, this research aims to contribute to the discussion on under-5 malnutrition by analyzing the predictors of wasting in Bangladesh.

Methods and materials: The dataset was extracted from the 2017-18 Bangladesh demographic and health survey (BDHS) data. The weight-for-height (WHZ) z-score based anthropometric indicator was used in the study as the target variable. The weighted sample constitutes 8,334 children of under-5 years. However, after cleaning the missing values, the analysis is based on 8,321 children. Sequential quantile regression was used for finding the contributing factors.

Results: The findings of this study depict that the prevalence of wasting in children is about 8 percent and only approximately one percent of children are severely wasted in Bangladesh. Age, mother's BMI, and parental educational qualification, are all major factors of the WHZ score of a child. The coefficient of the female child increased from 0.1 to 0.2 quantiles before dropping to 0.75 quantile. For a child aged up to three years, the coefficients have a declining tendency up to the 0.5 quantile, then an increasing trend. Children who come from the richest households had 16.3%, 3.6%, and 15.7% higher WHZ scores respectively than children come from the poorest households suggesting that the risk of severe wasting in children under the age of five was lower in children from the wealthiest families than in children from the poorest families. The long-term malnutrition indicator (wasting) will be influenced by the presence of various childhood infections and vaccinations. Furthermore, a family's economic position is a key determinant in influencing a child's WHZ score.

Conclusions: It is concluded that socioeconomic characteristics are correlated with the wasting status of a child. Maternal characteristics also played an important role to reduce the burden of malnutrition. Thus, maternal nutritional awareness might reduce the risk of malnutrition in children. Moreover, the findings disclose that to enrich the nutritional status of children along with achieving Sustainable Development Goal (SDG)-3 by 2030, a collaborative approach should necessarily be taken by the government of Bangladesh, and non-governmental organizations (NGOs) at the community level in Bangladesh.