Spatial analysis and associated factors of underweight, overweight and obesity among non-pregnant women of reproductive age in Zambia

Introduction: Malnutrition in women in reproductive age (WRA) is associated with distinct types of public health problems such as preterm birth, low birth weight, malnourished children, poor psychological health and high mortality. The study aimed at investigating the risk factors associated with underweight, overweight and obesity among WRA and map their spatial distribution. Methods: The study used the 2013/2014 Zambia Demographic Health Survey (ZDHS) data and survey proportional odds model was fitted to the data. Spatial effects were modeled using Quantum Geographic Information System (QGIS) version 2.18.1 to develop univariate choropleth maps. Results: 14,377 WRA were enrolled into the study. Overweight was more prevalent (15.87%) compared to underweight (10.22%) and obesity (6.47%). The findings revealed that a higher wealth index, age, having a car, using contraceptives, being married or divorced similarly increased the odds of being at or beyond a particular category of nutrition status. The spatial analysis also suggested Lusaka and Copperbelt were more prone to overweight and obesity, whereas Western had increased prevalence of underweight. Conclusion: Appropriate nutritional and economic programs are highly recommended in specific provinces of Zambia. Programs to curb overweight and obesity should be directed more to Lusaka and Copperbelt while underweight programs to Western