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  What were the drivers of improving child nutritional status in Bangladesh? An analysis of national household data from 1992 to 2005 guided by the UNICEF framework

Waid, J. L., Sinharoy, S. S., Ali, M., Alam, M. M., Wendt, A., Gabrysch, S. (2021 online): What were the drivers of improving child nutritional status in Bangladesh? An analysis of national household data from 1992 to 2005 guided by the UNICEF framework. - The Journal of Nutrition.
https://doi.org/10.1093/jn/nxaa425

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Item Permalink: https://publications.pik-potsdam.de/pubman/item/item_24888 Version Permalink: https://publications.pik-potsdam.de/pubman/item/item_24888_4
Genre: Journal Article

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 Creators:
Waid, Jillian Lee1, Author              
Sinharoy, Sheela S.2, Author
Ali, Masum2, Author
Alam, Md. Mashud2, Author
Wendt, Amanda1, Author              
Gabrysch, Sabine1, Author              
Affiliations:
1Potsdam Institute for Climate Impact Research, ou_persistent13              
2External Organizations, ou_persistent22              

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 Abstract: Background Bangladesh has experienced rapid reductions in child undernutrition and poverty, increases in maternal education, and dietary change over the past 3 decades. Objective We aimed to quantify the determinants of the improvement in child nutritional status among preschool-aged children in Bangladesh from 1992 to 2005. Methods We utilized data from 4 rounds of 2 linked and seasonally balanced survey systems: the Bangladesh Household [Income and] Expenditure Surveys (H[I]ES) and the Child [and Mother] Nutrition Survey (C[M]NS). We analyzed 10,780 children aged 6–59 mo, divided into 2 age groups (6–23 mo and 24–59 mo). We used Blinder–Oaxaca decomposition to assess the impact of changing determinants on nutritional status over time, guided by the UNICEF conceptual framework for the causes of child malnutrition. Results There were significant improvements in child growth over time for all z-score measures—length/height-for-age (LAZ/HAZ), weight-for-length/height (WLZ/WHZ), and weight-for-age (WAZ)—and in many potential determinants of child growth across domains of the UNICEF framework. Among younger children, decomposition explained 67% of the observed change in LAZ, 130% of WLZ, and 73% of WAZ. Among older children, decomposition explained 41% of the observed change in HAZ and 36% of WAZ. Drivers varied, with improvements in care of children as the only driver in both age groups and for all growth measures. Declines in disease prevalence drove improvements in weight-based measures. For younger children, household diets and household environments were significant drivers of improvement in LAZ and WAZ. For older children, increasing income was the largest driver of HAZ and WAZ. Conclusions Increasing income did not independently drive improvements for younger children but drove improved growth among children aged 2–4 y. This points to the need to focus on nutrition-specific and nutrition-sensitive interventions to decrease child undernutrition in the vulnerable first 1000 days of life.

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 Dates: 2020-12-052021-03-09
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: MDB-ID: No data to archive
DOI: 10.1093/jn/nxaa425
PIKDOMAIN: RD2 - Climate Resilience
Organisational keyword: RD2 - Climate Resilience
Research topic keyword: Health
Research topic keyword: Economics
Research topic keyword: Food & Agriculture
Research topic keyword: Inequality and Equity
Research topic keyword: Sustainable Development
Regional keyword: Asia
 Degree: -

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Title: The Journal of Nutrition
Source Genre: Journal, SCI, Scopus
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Pages: - Volume / Issue: - Sequence Number: - Start / End Page: - Identifier: ISSN: 0022-3166
Other: 1541-6100
CoNE: https://publications.pik-potsdam.de/cone/journals/resource/journal-of-nutrition
Publisher: Oxford University Press