The Effect of Gender and Social Capital on the Dual Burden of Malnutrition: A Multilevel Study in Indonesia

Abstract

IntroductionThe paradoxical phenomenon of the coexistence of overweight and underweight individuals in the same household, referred to as the “dual burden of malnutrition”, is a growing nutrition dilemma in low- and middle-income countries (LMICs).AimsThe objectives of this study were (i) to examine the extent of the dual burden of malnutrition across different provinces in Indonesia and (ii) to determine how gender, community social capital, place of residency and other socio-economic factors affect the prevalence of the dual burden of malnutrition.MethodsThe current study utilized data from the fourth wave of the Indonesian Family Life Survey (IFLS) conducted between November 2007 and April 2008. The dataset contains information from 12,048 households and 45,306 individuals of all ages. This study focused on households with individuals over two years old. To account for the multilevel nature of the data, a multilevel multiple logistic regression was conducted.ResultsApproximately one-fifth of all households in Indonesia exhibited the dual burden of malnutrition, which was more prevalent among male-headed households, households with a high Socio-economic status (SES), and households in urban areas. Minimal variation in the dual burden of malnutrition was explained by the community level differences (<4%). Living in households with a higher SES resulted in higher odds of the dual burden of malnutrition but not among female-headed households and communities with the highest social capital.ConclusionTo improve household health and reduce the inequality across different SES groups, this study emphasizes the inclusion of women's empowerment and community social capital into intervention programs addressing the dual burden of malnutrition.

Double burden of diseases worldwide: coexistence of undernutrition and overnutrition‐related non‐communicable chronic diseases

“…Obesity was more prevalent in urban and high socio‐economic status (SES) populations, while undernutrition was more prevalent in rural and low‐SES populations. The obesity–undernutrition ratio was higher in urban (e.g. urban 1.4 vs. rural 0.9) and non‐slum areas than the ratio in rural and slum areas .…”

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How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis

“…Thirteen studies provided insight into the risk factor overweight/obesity [20, 21, 48, 67, 79, 80, 84, 97, 102, 139, 142, 143, 155]. National data estimate that 16–21% of all Indonesian men and 26–31% of all women were overweight; almost 5% of the whole population was obese [97, 139, 142, 143].…”

“…Fig 6 shows that most of the 130 included studies considered age (n = 115) [14–17, 22–29, 31–50, 53, 55, 56, 59–64, 66–73, 75–77, 80–92, 95–102, 104–108, 110–129, 131, 133–143, 155, 156] and/or sex (n = 112) [15–19, 21–26, 28, 29, 31–38, 40–50, 53, 55, 56, 58–92, 95–108, 110–112, 114–116, 118–123, 125–129, 131, 133–143, 155, 156] in their analyses. On average around 40% of all studies included some sort of socioeconomic indicator mirroring educational attainment [15, 17, 21–24, 32, 34, 35, 37–…”

The Double Burden of Undernutrition and Overnutrition in Developing Countries: an Update

“…Studies focusing on Asia Pacific region 9 Haddad et al (2014) [26•] DBMN in southeast (SE) Asia and the Pacific Overweight rates have risen fast in the regions of SE Asia andthe Pacific, which also are burdened with high and often stagnant levels of undernutrition. DBMN has significant implications for the political agenda but also has created some opportunities for a leadership agenda within the region to address it.10 Vaezghasemi et al (2014) [27] …”