Institutional Repository
Thesis Issued 2026-09-03 EN

Small Area Estimation of Nutritional Status of Under-Five Children in Rural Bangladesh: Determinants and Association with Food Security

Author: Mohammod Kamruj Jaman Bhuiyan

Abstract

Under nutrition is one of the severe problems around the globe and finds its place in the global agenda. Sustainable Development Goals (SDGs) highlight the need for special attention to eradicate malnutrition. Bangladesh having high prevalence of malnutrition is committed to fulfill the targets of SDGs. Though Bangladesh achieved remarkable success in improving nutritional status of under-five children at national level, there have been regional variations. Government is planning to target need based resource allocation to small administrative levels. To do that real time small area level estimates of nutrition will be required. Nutritional status often linked with food security condition of the households hence, these two should be addressed together. For effective policy planning alongside accurate estimates, underlying factors need to be identified to make the interventions more focused and sustainable for the long run. This research tried to address these issues using both secondary (e.g., Census 2011 and BDHS 2011) and primary data. Statistical Package for Social Science (SPSS), STATA and R software have been used to analyse the data. The study found that about 42% children under five in rural Bangladesh were stunted, 39% were underweight and 16% were wasted. Two-level binary logistic regression analyses identified division, child age in month, twin childs, preceding birth interval, religion, mother's education, father's education, wealth index, household size, age of household head, mother's age at first child birth, sources of drinking water, child birth size, sex of child and child suffered from fever and diarrhea as significant determinants of malnutrition among the under five children in rural Bangladesh. An attempt was made to investigate the linkage between malnutrition and food security alongside identifying the determinants of nutritional status. A primary sample of size 300 was collected from Dharampasha upazila of Sunamgonj district of Sylhet division for in-depth analysis. Though in all the three models (stunting, wasting and underweight) we didn't find any direct association between foop security and child nutritional status, there was an indirect and significant effect of food security mediated by father's occupation. M-Quantile estimation method was used to identify small area estimates at upazila level of Sylhet division. The upazilas exhibiting poorest nutritional status were identified in maps for comparison. Special care should be given to help these upazilas to come out of the cycle of malnutrition in addition to the common national programmes. Preceding birth interval, education and source of drinking water are the major determinants of stunting, wasting and underweight which may be taken into consideration for policy implications in the current nutrition programmes. Community effects were found significant in all the three models. Specific programme addressing special needs of the communities should be ensured to overcome the problem. As there is a link between food security and malnutrition in different subsections of the population, interventions addressing food security and nutrition should have synergies. M-quantile method has been used in Bangladesh for the first time for nutrition estimates. The results are efficient and may be adopted in future, especially where we have doubt in the distributional assumption of the data