Planning of births and childhood undernutrition in Nepal: evidence from a 2016 national survey

Abstract

Background Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study. Methods We used the Nepal Demographic and Health Survey (NDHS) 2016 data, a nationally representative cross-sectional household survey. We used two anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor. We used binary logistic regression with sampling weights to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between the PoB and childhood undernutrition. Unless stated, the significant association between the variables is calculated with p < 0.001. Results The overall prevalence of stunting was 35.8%, and underweight was 27.1% in children under 5 years of age in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order > 3 and < 2 years of the interval between birth and subsequent birth (IBBSB). The association between the children’s birth order and the prevalence of undernutrition had strong statistical significance. Mother’s age at marriage (p = 0.001), underweight mother, mother’s education, father’s education, wealth quintile, no exposure to mass media, children’s age, and place of residence(p = 0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12–24 months of the interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting than those children with birth order one and < 12 months of IBMFB (OR 0.6, 95% CI 0.4–0.9). Conclusion The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12–24 months after marriage was found to be associated with reduced childhood stunting odds. To mitigate childhood undernutrition, Nepal’s government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.

Hubungan Pengetahuan Ibu Tentang Gizi Dan Berat Badan Lahir Rendah Dengan Kejadian Stunting Pada Anak Di Kabupaten Takalar

“…Babies whose birth weight is less than 2,500-grams will carry the risk of stunting, growth disorders, and risk becoming short if not treated properly (Rahman, 2016). This is also supported by research conducted by Tiwari which states that children with a history of LBW birth are at risk of stunting compared to children who do not suffer from LBW (Tiwari et al, 2020).…”

Effects of short birth interval on child malnutrition in the Asia‐Pacific region: Evidence from a systematic review and meta‐analysis

“…Among the 56 studies included in this review, the largest proportion of studies were conducted in Bangladesh ( n = 20 studies) (Akram et al, 2018; Anwar et al, 2013; Bhowmik & Das, 2017, 2019; Das & Hossain, 2008; Das & Rahman, 2011; Das et al, 2020; Goyal & Canning, 2018; Huda et al, 2018; Islam & Biswas, 2020; Kamal & Moniruzzaman, 2021a; Khan & Gulshan, 2020; Khan & Raza, 2014; Khan et al, 2021; Mozumder et al, 2000; Rayhan & Khan, 2006; Siddiqi et al, 2011; Sultana et al, 2019; Talukder, 2017; Talukder et al, 2018). The second most common country was India ( n = 18 studies) (Ansuya et al, 2018; Ashok et al, 2015; Basit, 2012; Bharathi, 2021; Chungkham et al, 2020; Gupta & Santhya, 2020; Ishwarji et al, 2018; Khan & Raza, 2016; Patel et al, 2021; Rachana et al, 2020; Rajaram et al, 2003; Rana et al, 2021; Sengupta et al, 2010; Singh et al, 2017; Sk et al, 2021; Som et al, 2006, 2007; Yadav & Nilima, 2021), followed by Nepal ( n = 7 studies) (Adhikari et al, 2017; Alelign et al, 2015; Dahal et al, 2021; Hanley‐Cook et al, 2022; Karki et al, 2021; Pravana et al, 2017; Tiwari et al, 2020) (see Supporting Information S1: Table S6). Additionally, 11 studies were conducted in multiple countries (Achakzai & Khan, 2016; Angeles‐Agdeppa et al, 2019; Farid‐ul‐Hasnain & Sophie, 2010; Gribble et al, 2009; Ikeda et al, 2013; Mendes Kiik & Saleh Nuwa,…”

“…The second most common country was India (n = 18 studies) (Ansuya et al, 2018;Ashok et al, 2015;Basit, 2012;Bharathi, 2021;Chungkham et al, 2020;Gupta & Santhya, 2020;Ishwarji et al, 2018;Khan & Raza, 2016;Patel et al, 2021;Rachana et al, 2020;Rajaram et al, 2003;Rana et al, 2021;Sengupta et al, 2010;Singh et al, 2017;Sk et al, 2021;Som et al, 2006Som et al, , 2007Yadav & Nilima, 2021), followed by Nepal (n = 7 studies) (Adhikari et al, 2017;Alelign et al, 2015;Dahal et al, 2021;Hanley-Cook et al, 2022;Karki et al, 2021;Pravana et al, 2017;Tiwari et al, 2020) (see Supporting Information S1: Table S6). Additionally, 11 studies were conducted in multiple countries (Achakzai & Khan, 2016;Angeles-Agdeppa et al, 2019;Farid-ul-Hasnain & Sophie, 2010;Gribble et al, 2009;Ikeda et al, 2013;Mendes Kiik & Saleh Nuwa, 2021; F I G U R E 1 Schematic presentation of the studies included and excluded in the systematic review.…”

“…Short birth interval, which accounts for over one‐quarter of all live births, can also significantly contribute to child malnutrition (Islam, Islam, et al, 2022 ). However, studies conducted in Asia‐Pacific countries have reported contradictory findings on the association between short birth interval and child malnutrition (Achakzai & Khan, 2016 ; Jahidur Rahman Khan & Gulshan, 2020 ; Khan & Raza, 2014 ; Manzoor & Saeed, 2021 ; Tiwari et al, 2020 ). Analysed data from small‐scale surveys and variations in the methodologies considered in these studies were the reasons for such contradictions (Karki et al, 2021 ; Khan & Raza, 2014 , 2016 ; Naz et al, 2020 ).…”

Effects of poor water, sanitation, and hygiene on child health in Godawari Municipality, Lalitpur, Nepal, with special reference to diarrheal disease and nutritional status: a cohort study

“…5 Malnutrition among children is a public health problem in Nepal. 6 According to the Nepal Demography and Health Survey (NDHS, 2016), 36% of children under age 5 are stunted, 10% are wasted, 27% are underweight, and 1% are overweight. 7 This shows that Nepal faces a critical problem with child malnutrition.…”