Determinants of under- and over- nutrition among reproductive-age women in Bangladesh: trend analysis using spatial modelling

Bangladesh is facing a double burden of malnutrition which varies spatially and is shifting rapidly over time. The current study aims to analyze the spatial and temporal dependence of under-and over-weight/obesity among Bangladeshi reproductive-age women. The nationally representative cross-sectional data from the Bangladesh Demographic and Health Surveys 2014 and 2017-18 were utilized to study the change in under- and over-weight among 15-49 years women. Bayesian geoadditive regression model was fitted to account for non-linear and linear effects of continuous and categorical covariates and accounted for spatial effects of geographical divisions. The prevalence of overweight/obese in rural, city corporation and other urban areas has increased significantly over the four-year period from 2014 to 2017-18. Women of the richer and richest categories were more likely to be overweight/obese. Women from Sylhet were more likely to be underweight in both years 2014 and 2017-18, however, the result was also significant for underweight in Mymensingh for the year 2017-18. Women in the Rajshahi and Khulna were more likely to be overweight/obese in 2014. Along with Khulna, women from Barishal and Chittagong were likely to be overweight/obese in the year 2017/18. Underweight and overweight are uneven across the country, with highly urbanized areas overburdened by overweight/obesity. Intervention targeting vulnerable age groups should be a high priority to deal with the increasing burden of obesity.