BackgroundEvidences show that the burden of overweight and obesity is escalating in developing countries with predominant burden of underweight. The coexistence of underweight and overweight/obesity is known as double burden of malnutrition. Recent scanty studies confirmed that Bangladesh is currently experiencing augmented overweight and obesity as well as abating underweight. The present study aimed at assessing the changes of prevalence of overweight/obesity and underweight from 2004 to 2014 and investigated the socio-demographic correlates of being overweight/obese and underweight among ever-married women age 15–49 years.MethodsData were collected from four consecutive Demographic and Health Surveys conducted in Bangladesh in 2004 (N = 11,173), 2007 (N = 10,993), 2011 (N = 17,749), 2014 (N = 17,690). Multinomial logistic regression model has been used to determine association between different socio-demographic predictors with overweight/obesity and underweight among ever-married women age 15–49 years considering normal weight as reference category.ResultsThe prevalence of underweight decreased by 43.2% (from 32.2% in 2004 to 18.3% in 2014) and 130.5% increase in overweight and obesity (from 10.5% in 2004 to 24.2% in 2014) were found over the ten years period. Age, educational status, wealth index and year were positively associated with overweight and obesity and negatively associated with underweight. Also, ‘not being married’ status for rural women were positively associated with underweight and negatively associated with overweight and obesity. Rural women were less likely to be overweight and obese (OR = 0.7, 95% CI: 0.7–0.8) while more likely to be underweight (OR = 1.1, 95% CI: 1.1–1.2) relative to urban women respectively. The likelihood of being overweight and obese was 4.5 times (95% CI: 4.1–4.9) higher among women who were in richest quintile compared to poorest women. They were also less likely to be underweight (OR = 0.4, 95% CI: 0.3–0.4) relative to same reference category.ConclusionThe double burden of malnutrition is evidently prevailing in Bangladesh. Over the ten years period, overweight and obesity has been raised tremendously but underweight did not fall significantly. This study suggests that strategies for preventing both underweight and overweight/obesity simultaneously among reproductive women need to be implemented considering regional context and their socioeconomic status (SES).

Background The escalating prevalence of overweight and obesity globally is reflected amongst urban women in many low-to-middle income countries. Evidence also shows that overweight and obesity is an increasing trend in Bangladesh. The present study assessed the prevalence and socioeconomic determinants of overweight and obesity among urban women in Bangladesh. Methods Data were extracted from Bangladesh Demographic and Health Survey (BDHS) 2014. A two-stage stratified sampling technique has been used for data collection in this cross-sectional survey. A sample of 1701 ever-married non-pregnant urban women aged 15–49 years was selected for statistical analysis. Descriptive analysis, multiple binomial logistic regression analysis were executed in this study. Results The prevalence of overweight and obesity was 34% (95% CI, 0.30–0.38) among urban Bangladeshi women. The probability of being overweight and obese increased with increasing age and wealth index. The likelihood of being overweight and obese among the oldest women surveyed (40–49 years) was 4.3 times (OR = 4.3, 95% CI: 2.1–8.8) higher relative to the youngest women (15–19 years). The wealthiest women had 4.1 times (OR = 4.1, 95% CI: 2.5–6.7) higher likelihood of being overweight and obese compared to the reference group of poorest women. Women having higher education (OR = 1.7, 95% CI: 1.0–2.6) were more likely to be overweight and obese. However, women who were no longer living with their husband or separated from their husband were (OR = 0.4, 95% CI: 0.2–0.8) less likely to be overweight and obese. Conclusion This study provides evidence that a large number of urban women were overweight and obese in Bangladesh. Women having higher levels of education, being older and belonging in both poorer and richest wealth quintile were at risk of being overweight and obese. Appropriate health promoting interventions based on these factors should be envisaged to reduce this problem.

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BackgroundUnderweight is a major cause of global disease burden. It is associated with child mortality and morbidity, and its adverse impact on human performance and child survival is well recognized. Underweight is a major public health problem in Bangladesh, which is amongst the highest underweight prevalent countries in the world. The objectives of our study were to determine the national and regional prevalence rates of underweight and severe underweight in Bangladesh, and to investigate the association of socioeconomic and demographic factors with child underweight and severely underweight among children under the age of five living in Bangladesh.MethodsWe performed a cross sectional study using Multiple Indicators Cluster Survey 2012–13, Bangladesh data on 17,133 children under 5 years of age. Weight-for-age Z scores based upon World Health Organization (WHO) guidelines were used to define child underweight and severe underweight. The association of underweight and severe underweight with household socioeconomic factors and demographic characteristics was investigated using binary logistic regression model.ResultsAn estimated 31.67% children were underweight and 8.81% children were severely underweight. Children of mothers with incomplete secondary education [Odds Ratio (OR) = 0.84, 95% CI: 0.75, 0.94] and mothers with completed secondary education [Odds Ratio (OR) = 0.77, 95% CI: 0.64, 0.93] were less likely to be underweight than children of uneducated mothers who had no formal schooling. A similar association exists for father’s education, children from households in the highest wealth index quintile had lower likelihood of underweight [Odds Ratio (OR) = 0.44, 95% CI: 0.37, 0.53] than children from households in the lowest quintile. Consumption of non-iodized salt had higher risk of severe underweight for children aged between 24 and 35 months [Odds Ratio (OR) = 2.32, 95% CI: 1.80, 3.00]. Other risk factors of child severe underweight included living in Sylhet division and increases in the number of children under the age of five in a household.ConclusionUnderweight was associated with lower parental education, household position in lower wealth index, living in Sylhet division and consumption of non-iodized salt. Strategies are discussed considering the relative importance of risk factors for child underweight.

BackgroundContingent valuation (CV) is used to estimate the willingness to pay (WTP) of consumers for specific attributes to improve the quality of health care they received in three hospitals in Bangladesh.MethodsRandom sample of 252 patients were interviewed to measure their willingness to pay for seven specified improvements in the quality of delivered medical care. Partial tobit regression and corresponding marginal effects analysis were used to analyze the data and obtain WTP estimates.ResultsPatients are willing to pay more if their satisfaction with three attributes of care are increased. These are: a closer doctor-patient relationship, increased drug availability and increased chances of recovery. The doctor patient relationship is considered most important by patients and exhibited the highest willingness to pay.ConclusionsThis study provides important information to policy makers about the monetary valuation of patients for improvements in certain attributes of health care in Bangladesh.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0678-6) contains supplementary material, which is available to authorized users.

Child undernutrition has been a major concern for Bangladesh as it is amongst the highest stunting and wasting prevalent countries in the world. The objective of our study was to explore the socioeconomic determinants of stunting and wasting in children under two years. This study explored nationally representative sample of 7,230 children ranging in age from 0 to <24 months using two separate binary logistic regression models to determine the risk factors associated with child stunting and wasting. Our study estimated approximately 33 percent children to be stunted and 11 percent to be wasted. Our analysis found that, 12 to <24 months old children's height-for-age-z-score and weight-for-height-z-score deteriorated in comparison to those of below 6 months. Female children had significantly lower odds of stunting and wasting compared with male children. Study revealed that children from wealthier families were at lower risk of being stunted and wasted compared to children from poorer households. Parental education was determined as a significant predictor of stunting. Children who lived in Sylhet division were 1.26 times more likely to be stunted than the children of Dhaka division [OR = 1.26; 95% CI: 1.02–1.55]. Our study revealed age, gender, geographic distribution, and household's position in wealth index as common determinants of child stunting and wasting in Bangladesh. While parental education was significant predictor for child stunting, type of toilet facility was found as statistically significant determinant of child wasting in children of less than two years age.

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BackgroundA central aim of Universal Health Coverage (UHC) is protection for all against the cost of illness. In a low income country like Bangladesh the cost burden of health care in tertiary facilities is likely to be significant for most citizens. This cost of an episode of illness is a relatively unexplored policy issue in Bangladesh. The objective of this study was to estimate an outpatient’s total cost of illness as result of treatment in private and public hospitals in Sylhet, Bangladesh.MethodsThe study used face to face interviews at three hospitals (one public and two private) to elicit cost data from presenting outpatients. Other socio-economic and demographic data was also collected. A sample of 252 outpatients were randomly selected and interviewed. The total cost of outpatients comprises direct medical costs, non-medical costs and the indirect costs of patients and caregivers. Indirect costs comprise travel and waiting times and income losses associated with treatment.ResultsThe costs of illness are significant for many of Bangladesh citizens. The direct costs are relatively minor compared to the large indirect cost burden that illness places on households. These indirect costs are mainly the result of time off work and foregone wages. Private hospital patients have higher average direct costs than public hospital patients. However, average indirect costs are higher for public hospital patients than private hospital patients by a factor of almost two. Total costs of outpatients are higher in public hospitals compared to private hospitals regardless of patient’s income, gender, age or illness.ConclusionOverall, public hospital patients, who tend to be the poorest, bear a larger economic burden of illness and treatment than relatively wealthier private hospital patients. The large economic impacts of illness need a public policy response which at a minimum should include a national health insurance scheme as a matter of urgency.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0458-x) contains supplementary material, which is available to authorized users.