Factors associated with child hunger among food insecure households in Bangladesh

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Abstract

Background

Hunger is associated with food insecurity at the household level and is considered as a global public health problem with long term adverse consequences on children’s health. This study aims to determine the factors associated with child hunger from a nationally representative sample in Bangladesh among food insecure households.

Methods

Data was derived from the Food Security and Nutritional Surveillance Project; 14,712 children aged 6–59 months belonging to food insecure households contributed to the analysis. Information on food security at the household level was collected for 30 days preceding the survey. Descriptive statistics served to illustrate the variables studied and multiple logistic regression analysis was conducted to identify the significant risk factors for child hunger.

Results

Overall 10% of the children were found to be hungry. After adjusting for seasonality, residence type and education level of household head, the variables - female headed households [OR: 1.87 (1.43–2.45); p < 0.001], severely food insecure households [OR: 10.5 (1.43–76.6); p < 0.05], households having women with no education [OR: 1.56 (1.27–1.92); p < 0.05], poorest asset quintile [OR: 1.50 (1.11–2.15); p < 0.05] and the amount of rice consumed per household per week [OR: 0.94 (0.92–0.96); p < 0.001] were found to be significantly and independently associated with child hunger.

Conclusions

Out of the potential risk factors examined, our study found significant and independent association of five variables with child hunger: sex of the household head, household food insecurity status, educational status of household women and asset index. Despite all sampled household being food insecure, degree of household food insecurity status appeared to be the strongest predictor of child hunger.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4108-z) contains supplementary material, which is available to authorized users.

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Most cited references 24

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Food security: definition and measurement

Per Pinstrup-Andersen (2009)

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Does birth spacing affect maternal or child nutritional status? A systematic literature review.

Kathryn Dewey, Roberta J Cohen (2007)

This review addresses the question of whether a short birth interval is associated with adverse nutritional outcomes for the mother or the child. Indices of anthropometric status (maternal weight or body mass index; child growth) and micronutrient status (e.g. iron or vitamin A) were included as outcomes. A computerized search of all relevant papers published since 1966 was completed, and the 'snowball' method was used to identify additional relevant published or unpublished papers. In total, 57 papers were found to contain data regarding the relationship between birth spacing and nutritional outcomes (35 for child nutrition, 11 for maternal anthropometric status, and 11 for maternal anaemia or micronutrient status). Of these, 23 papers were excluded from further consideration because they did not include any multivariate analysis, leaving 34 papers that met the criteria for the review (22 for child nutrition, eight for maternal anthropometric status, and four for maternal anaemia or micronutrient status). The studies on child nutrition outcomes indicate that a longer birth interval is associated with a lower risk of malnutrition in some populations, but not all. In those countries in which the relationship was significant, the reduction in stunting associated with a previous birth interval >or=36 months ranged from approximately 10% to 50%. Some of this reduction may be due to residual confounding, i.e. to factors not included in the analysis (such as breastfeeding and maternal height). The studies on maternal anthropometric outcomes yielded mixed results. Because the nutritional burden on the mother between pregnancies depends on the extent of breastfeeding, the interpregnancy interval is not the best measure of whether the mother has had a chance to recover from the pregnancy, in terms of repleting her nutritional status. Therefore, some studies examined the 'recuperative interval' (duration of the non-pregnant, non-lactating interval) instead. Taken as a whole, the studies do not provide clear evidence of a link between interpregnancy or recuperative interval and maternal anthropometric status. This may be due, in part, to changes in the hormonal regulation of nutrient partitioning between the mother and the fetus when a mother is malnourished. Only four papers were identified that related to micronutrient status, three of which examined maternal anaemia. One study showed an increased risk for maternal anaemia when the interpregnancy interval was <6 months, but the analysis did not control for iron supplementation during pregnancy. The other two studies did not show a significant association between interpregnancy interval and maternal anaemia. One study of micronutrient status indicated no significant relationship between interpregnancy interval and maternal serum zinc, copper, magnesium, ferritin, folate or thyroid-stimulating hormone. Important methodological limitations were apparent in most of the studies. Thus, further research with more comprehensive control of potentially confounding variables is needed.

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Household dietary diversity and food expenditures are closely linked in rural Bangladesh, increasing the risk of malnutrition due to the financial crisis.

Klaus Kraemer, Richard Semba, Natalie Valpiani … (2010)

In Bangladesh, rice prices are known to be positively associated with the prevalence of child underweight and inversely associated with household nongrain food expenditures, an indicator of dietary quality. The collection of reliable data on household expenditures is relatively time consuming and requires extensive training. Simple dietary diversity scores are increasingly used as measures of food security and as proxies for nutrient adequacy. This study examines associations between a simple dietary diversity score and commonly used indicators of socioeconomic status in Bangladesh. Data representative of rural Bangladesh was collected from 188,835 households over 18 rounds of bi-monthly data collection from 2003-2005. A simple household dietary diversity score was developed by summing the number of days each household consumed an item from each of 7 food groups over a 7-d period. The dietary diversity score was associated with per capita nongrain food expenditures (r = 0.415), total food expenditures (r = 0.327), and total household expenditures (r = 0.332) using Spearman correlations (all P < 0.0001). The frequency of meat and egg consumption showed greater variation across quintiles of total monthly expenditure than other items contributing to the dietary diversity score. After controlling for other measures of socioeconomic status in multiple linear regression models, the dietary diversity score was significantly associated with monthly per capita food and total expenditures. Low dietary diversity during the period prior to major food price increases indicates potential risk for worsening of micronutrient deficiencies and child malnutrition in Bangladesh.

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Author and article information

Contributors

Md Ahshanul Haque: ahshanul.haque@icddrb.org

Fahmida Dil Farzana: fahmidaf@icddrb.org

Sabiha Sultana: sabiha2930@gmail.com

Mohammad Jyoti Raihan: raihan@icddrb.org

Ahmed Shafiqur Rahman: ashafiq@icddrb.org

Jillian L. Waid: jwaid@hki.org

Nuzhat Choudhury: 880-2-9827202 , nuzhat@icddrb.org

Tahmeed Ahmed: tahmeed@icddrb.org

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 16 February 2017

Publication date PMC-release: 16 February 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 205

Affiliations

[1 ]ISNI 0000 0004 0600 7174, GRID grid.414142.6, Nutrition and Clinical Services Division, , International Centre for Diarrhoeal Disease Research, Bangladesh, ; 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, Bangladesh

[2 ]ISNI 0000 0001 0746 8691, GRID grid.52681.38, , James P Grant School of Public Health, BRAC University, ; Dhaka, 1212 Bangladesh

[3 ]Helen Keller International, Dhaka, 1212 Bangladesh

Article

Publisher ID: 4108

DOI: 10.1186/s12889-017-4108-z

PMC ID: 5314696

PubMed ID: 28209154

SO-VID: 95df45b9-3f23-480f-bf2a-daa0161263c5

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 15 June 2016

Date accepted : 4 February 2017

Funding

Funded by: James P Grant School of Public Health, BRAC University

Award ID: 1116

Award Recipient : Nuzhat Choudhury

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ScienceOpen disciplines: Public health

Keywords: child hunger,food insecurity,bangladesh,under 5 children

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ScienceOpen disciplines: Public health

Keywords: child hunger, food insecurity, bangladesh, under 5 children

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Factors associated with child hunger among food insecure households in Bangladesh

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Abstract

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Electronic supplementary material

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SDG 2: Zero Hunger

Most cited references 24

Food security: definition and measurement

Does birth spacing affect maternal or child nutritional status? A systematic literature review.

Household dietary diversity and food expenditures are closely linked in rural Bangladesh, increasing the risk of malnutrition due to the financial crisis.

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Cited by 13

Most referenced authors 492