Determinants of undernutrition and overnutrition among reproductive-age women in Bangladesh: Trend analysis using spatial modeling

BACKGROUND: Bangladesh is facing a dual burden of malnutrition, with high rates of undernutrition and increasing rates of overnutrition. The complex scenario of malnutrition in Bangladesh varies across different regions, making it a challenging public health concern to address. OBJECTIVES: This study analyzes the spatial and temporal dependence of underweight and overweight Bangladeshi women of reproductive age. METHODS: Nationally representative cross-sectional data from the Bangladesh Demographic and Health Surveys in 2014 and 2017–18 were utilized to study the changes in weight status in 15–49-year-old women who were either underweight or overweight. A Bayesian geo-additive regression model was used to account for non-linear and linear effects of continuous and categorical covariates and to incorporate spatial effects of geographical divisions. RESULTS: The prevalence of overweight or obese women in rural, city corporations, and other urban areas increased significantly over the four years from 2014 to 2017–18. Women in the categories ‘richer’ and ‘richest’ were more likely to be overweight or obese. Women from Sylhet were more likely to be underweight in both survey years; however, the spatial effects were significant for underweight women in Mymensingh for the year 2017–18. Women in Rajshahi and Khulna were more likely to be overweight or obese in 2014, and women from Barishal and Chittagong were more likely to be overweight in the year 2017–18. CONCLUSIONS: Underweight and overweight statuses in women vary unevenly across Bangladesh, with a substantially higher prevalence of overweight or obese women in more urbanized areas. The growing burden of overweight and obesity among Bangladeshi women should be addressed with interventions aimed at those in the reproductive age group.