Differences in the socio-demographic determinants of undernutrition in children aged <5 years in urban and rural areas of Bangladesh measured by the Composite Index of Anthropometric Failure

Objectives: This study investigates the prevalence and determinants of undernutrition among children <5 years living in Bangladesh using the Composite Index of Anthropometric Failure (CIAF) and highlights the differences between urban and rural areas. Study design: Data are drawn from three cross-sectional Bangladesh Demographic Health Surveys conducted from 2007 to 2014. Methods: A Chi-square test was used to assess the prevalence of <5 years child undernutrition. Logistic regression analysis was performed to identify various sociodemographic risk factors. Results: The prevalence of undernutrition based on the CIAF was 52% among children <5 years in Bangladesh. The prevalence of undernutrition in children living in urban areas and rural areas were found to be 45% and 54%, respectively. As per the CIAF, undernutrition was highly prevalent among children in the older age group, children of uneducated and currently working mothers, those of underweight mothers, children of fourth and above in the birth order, children of fathers who were manual labourers, children of households who had no access to television and those in the poorest households whether in urban or rural areas. Children in the older age group, children of uneducated mothers, those with underweight mothers and those from the poorest households provided common key risk factors for undernutrition in both urban and rural areas. Children of fourth and above birth order and not watching television at all were additional risk factors of child undernutrition in rural areas. Conclusion: Half of the children in rural areas and two-fifths of them in urban areas are suffering undernutrition in Bangladesh, and several sociodemographic factors heighten the risks. Also, birth order and watching television were identified as the differential risk factors. This study therefore concludes that evidence-based interventions are needed to reduce the burden of undernutrition in children in the country. (C) 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.