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The Effects of Birth Spacing on Nutritional Status in the Form of Stunting of Under Five Children in Bangladesh: Evidence Based on Bdhs, 2014 Data

Mahfuzur Rahman Khokan
Department of Statistics, Dhaka University, Dhaka-1000, Bangladesh

Abstract/ Executive Summary:

In this paper, it has been examined the effect of preceding birth interval on nutritional status in the form of Stunting of the children aged under years of age in Bangladesh.For the purpose of the analysis, Bangladesh Demographic and Health Survey (BDHS), 2014 data has been used. The study cases are the children under years aged born during last delivery of their mother. The response variable is Nutritional Status of under year children in the form of stunting. The key independent variables is the length of the preceding birth interval, measured as the number of months between the births of the child under study.Bivariate analysis along with a Chi-square test has been performed to examine the association between preceding birth interval and stunting of the children. To determine the effect of preceding birth interval, three different logistic regression models (Model-I: considering only the preceding birth intervals, Model-II: covariate of model-I along with demographic and socioeconomic factors and Model-III: covariates of model-II along with health related factors) were considered. The occurrence of stunting has been found to be inversely related with the preceding birth interval for the children aged under years in Bangladesh. This inverse association has been found statistically significant for three models.After adjusting the demographic, socio-economic and health-related factors, the OR (odds ratio) shows that the percentage of being stunted is higher for the children whose preceding birth interval is less than while it is higher for the children whose preceding birth interval is between months compared to whose birth interval is more than months with confidence interval and respectively.

Keywords: OR, AOR, Preceding birth interval, Chi-square test, P-value

Location: Bangladesh Demographic and Health Survey (BDHS).

Start Date: 00-01-2014

End Date: 00-12-2014

Program Area: Socio-economic and Policy

Commodity: Nutrition

Objectives:

To determine the Effects of Birth Spacing on Nutritional Status in the form of Stunting of Under Five Children in Bangladesh: Evidence Based on BDHS, 2014 Data

Methodology:

The study used the data of 2014 Bangladesh Demographic and Health Survey (BDHS), a nationally representative sample survey of men and women of reproductive age that provides information on childhood mortality levels, fertility preferences, use of family planning methods, and maternal, child, newborn health and on many other health-related issues16-17. In the dataset, the number of cases for the study has been found who has the information on last born child for ages under 5 having valid anthropometric information and preceding birth interval. The dependent variable for this study is nutritional status of under 5 children in the form of stunting. During the DHS survey, the information regarding height and weight of the alive and under five years of aged children were measured along with their respective age to calculate the nutritional status and evaluate against the referenced standard and according to this standard, the nutritional status are considered stunting if the height-forage Z-score is less than -2SD18. The main covariate of interest in this paper is preceding birth interval and it is found that shorter birth interval has a strong association with stunting for the children under 5 years of age. The cut-off point for the preceding birth interval has been done as “≥ 60 months (ref)”, "24-59 months", and "< 24 months . Beside the preceding birth interval, other demographic factors (Sex of child, Age of Child, maternal Age at birth, Region, Residence), socioeconomic factors (Mother’s education, Wealth Index, media Exposure) and health related factors (ANC visit, size of child, Duration of breast feeding, maternal height) has also been taken as a consideration to determine whether there is any significant association with the occurrence of stunting. To examine the association of preceding birth interval and other factors with stunting, first a bivariate analyzing along with Chi-square test has been done. Since the main exposure variable is preceding birth interval, three multivariate logistic regression model has been performed. These are Model-I: considering only preceding birth interval to find the impact on stunting, Model-II: covariate of Model-I with demographic (Sex of child, Age of Child, Maternal age at birth, Region) and socioeconomic (Mother’s education, Wealth Index, Media exposure) factors to examine the effect of preceding birth interval on stunting after controlling the demographic and socioeconomic variables, and Model-III: covariates of Model-II along with health related factors (ANC visit, Duration of breast feeding, Maternal height) to examine the effect of health related factors. To analyze the result, STATA is used.

Source of Information: Dhaka Univ. J. Sci. 67(2): 139-144, 2019 (July)

Article Link (Online Journal):

Funding Source:

Budget:

Total Budget (Tk.) :

Achievement/Findings:

In this study, it has been found a clear association between preceding birth interval and chance of being stunted for the children under five years of age considering other demographic, socioeconomic and heath related factors. So it is very necessary to take proper steps to enhance the awareness among the people in Bangladesh. It is also important to counsel the married couples of reproductive ages to be more conscious about the necessity of birth spacing and reasons of being a child stunted. As the other factors like region, mother’s education, antenatal care visits has clear relation with being a child stunted, so policy makers needs to take different initiatives and should follow up the situation to gain the desired expectation by improving nutritional status in Bangladesh.

Knowledge Management: Journal