Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

Abstract

BackgroundMalnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable.MethodsThe data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model.ResultsThe GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother’s education, father’s education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman.ConclusionsConsistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh.

Prevalence and predictors of undernutrition among underfive children in Arusha District, Tanzania

“…This finding is consistent with other studies conducted in Africa which suggested paternal education to be a protective factor against childhood stunting (Agho et al., 2009; Amsalu & Tigabu, 2008; Wamani, Tylleskär, Åstrøm, Tumwine, & Peterson, 2004). The rationale attributed to this linkage appears to align with the increased economic power to provide quality food and services for the family (Islam et al., 2013), as in most developing contexts the presence of a father contributes to the economic power of the family.…”

Statistical Modeling of the Number of Deaths of Children in Bangladesh

“…Regression (NBR) model and Generalized Poisson Regression (GPR) model had been addressed in the literature [3]. Applications of these models are based on the assumptions that the mean and variance of the response variable are equal under the standard Poisson model.…”

“…Although the country achieved significant improvement in public health and in controlling the morbidities and mortalities from preventable diseases, child mortality is still a major public health issue. Every year between 8 and 11 million children die worldwide before reaching their fifth birthday [3]. The underlying cause for 60% of the deaths of children under the age five in Bangladesh is malnutrition [3,4].The primary objective of the current study is to identify socioeconomic and demographic risk factors/ predictors of the number of children's death for women aged 12-49 from the Bangladesh Health and Demographic Survey (BDHS) administered in 2011.…”

“…Every year between 8 and 11 million children die worldwide before reaching their fifth birthday [3]. The underlying cause for 60% of the deaths of children under the age five in Bangladesh is malnutrition [3,4].The primary objective of the current study is to identify socioeconomic and demographic risk factors/ predictors of the number of children's death for women aged 12-49 from the Bangladesh Health and Demographic Survey (BDHS) administered in 2011. It is useful for the policymakers to have a set of risk factors of the number of children's death in order to develop guidelines and address these risk factors with proper intervention.…”

Prevalence and Major Contributors of Child Malnutrition in Developing Countries: Systematic Review and Meta-Analysis

“…Under-five under-nutrition was associated with food or water borne diseases [16,17]. Food and water-borne disease contribute for malnutrition by reducing consumption, increases loss and altered digestion and absorption of menials and nutrients due to disturbed integrity and function of the gastrointestinal system.…”