Descriptive characteristics of the sample
Table 1 shows the socioeconomic and background characteristics of the sample and the bivariate distribution of stunting and severe stunting with sample characteristics. Data were available for 17490 children aged <5 years. A total 25.96% children were estimated to be stunted, and 7.97% severely stunted. More than half of the children were male (52.53%). Children from Dhaka division comprised the highest proportion (18.93%) and the lowest percentage of study children were from Mymensingh division (6.11%). Most of the children (68.64%) were living in households with 4-6 family members. Approximately one quarter of mothers had not gone to school, however the highest proportion of mothers (49.17%) had attended secondary school. An overwhelming majority of children (80.32%) came from rural areas. Nearly one quarter (21.93%) children were aged between 12-35 months and 12.24 % children were less than six months of age. The highest percentage of children (26.18%) lived in poorest households and the lowest percentage of children (14.96%) lived in richest households in the category of wealth index quintile. 42.68% children had access to a flush toilet, whereas a majority (57.32%) households had access to a pit toilet or hanging latrine. Around 21% of fathers had not undertaken any formaleducation, however, approximately 16% of fathers were found to have completed secondary or higher secondary education.
Table 1 should be pasted here
Risk factors for child stunting
Similar proportions of male children (26.46%) and female children (25.42%) were classified as stunted (Table 1). The prevalence rate of stunting was highest for those children whose parents had no education and whose family used a hanging toilet. Half of the children classified as stunted were aged between 24-35 months. The greatest proportion of children stunted, were from Sylhet division (34.24%) and the lowest proportion from Khulna division (20.01%).
In bivariate analysis, the following variables were significantly associated with stunting prevalence: age (p<0.001), gender (p<0.001), area (p<0.001), division (p<0.001), education of mother (p<0.001), education of father (p<0.001), wealth index quintile (p<0.001), type of toilet facility (p<0.001) and salt iodization test outcome (p<0.001).
Table 2 shows the results for binary logistic regression analysis on the risk factors associated with child stunting. Children’s age was a significant predictor of stunting. Those aged twelve months to less than twenty-four months had significantly higher odds for stunting [OR: 2.16, 95% CI: 1.88-2.48], compared to children below six months of age. Children aged twenty-four to less than thirty-six months had almost three-fold odds on stunting [OR: 2.65, 95% CI: 2.30-3.05], compared to the children aged less than six months. Children living in Khulna division were significantly less likely to be stunted [OR: 0.71, 95% CI: 0.62-0.81], compared with the children who lived in Dhaka division. Children from Sylhet division had significantly higher odds in developing stunting compared with children from Dhaka division [OR: 1.26, 95% CI: 1.09-1.46]. Across categories of parental education, children whose mothers had completed secondary level education or higher were less likely to be stunted in comparison with the children whose mothers had no formal education [OR: 0.66, 95% CI: 0.56-0.79]. There were significantly lower odds of stunting for the children whose fathers had completed secondary education or higher [OR: 0.74, 95% CI: 0.63-0.87], compared to those children whose father had no formal education. Children from households with middle category in wealth index quintile were less likely to be stunted [OR: 0.69, 95% CI: 0.62-0.77] than the children.
Table 2 should be pasted here
from households with poorest category. Children of wealthiest families had 59% lower odds of stunting [OR: 0.49, 95% CI: 0.41-0.58], compared to those from poorest families. Children from families which used hanging toilet had greater odds of stunting [OR: 1.21, 95% CI: 1.03-1.41], compared with those from those families that used flush toilet.
Table 3 shows the effects of parental combined level of education on the risk of child stunting after adjustment for; household member, age, gender, area, division, wealth index, type of toilet facility, salt iodization test outcome and number of under five children. The results suggest that one parent with primary school and one with secondary school and above [OR: 0.73, 95% CI: 0.63 – 0.84] and both parents with secondary school and above [OR: 0.59, 95% CI: 0.52 – 0.69] had significantly lower likelihood on stunting among their children when compared with children of parents who both had no education.
Risk factors for severe stunting
Table 1 shows the proportion of children classified as severely stunted. The proportion of male children severely stunted (8.18%) was similar to that of female children (7.73%). A slightly higher percentage of rural children were severely stunted (8.15%) compared with the urban children (7.23%). The highest proportion of severely stunted children was found in the Sylhet division (10.93%) and the lowest in the Khulna division (3.85%). Approximately one-tenth of children, with their mothers had no education were severely stunted (10.93%), and ~6% were severely stunted if their mothers completed secondary education or higher. Similarly only 5.88 percent children were severely stunted whose fathers had completed secondary or higher education and more than one-tenth (10.72%) children were severely stunted whose
Table 3 should be pasted here
father didn’t go to school. Only 5.85% children from wealthiest families were severely stunted and 11.03% children from poorest families were severely stunted. The highest rate of severe stunting prevalence was found for children age between 24-35 months (10.37%) and the lowest rate for age less than six months (6.21%).
In bivariate analysis, the following variables were significantly associated with the prevalence of severe stunting: age (p<0.001), division (p<0.001), education of mother (p<0.001), education of father (p<0.001), wealth index (p<0.001), type of toilet facility (p<0.001) and salt iodization test outcome (p<0.001).Table 4 shows the results on the binary logistic regression analysis on the risk factors that associated with the risk for severe stunting among the children five years and below. Children aged twenty-four to less than thirty six months were almost two times more likely to be severely stunted [OR: 1.85, 95% CI: 2.37-3.52], compared with the children below six months of age. There was 44% higher the risk of severe stunting for children who were aged thirty six to less than forty eight months [OR: 1.44, 95% CI: 1.15-1.80], compared to those who were less than six month of age. Children with a mother with formal education either secondary incomplete [OR: 0.68, 95% CI: 0.57-0.82] or secondary complete or higher [OR: 0.59, 95% CI: 0.44-0.77] were significantly less likely to be severely stunted, compared with the children whose mothers had not any formal education. Moreover, children whose fathers had education level secondary incomplete had 19% lower odds that they could be severely stunted. Children had 57% lower odds to be severely stunted if they lived in Khulna division [OR: 0.43, 95% CI:0.34-0.54], compared with the children who lived in Dhaka division. Across categories of wealth, those who were in the fourth category in wealth index quintile had 37% lower odds on severe stunting relative to children from poorest families. Children from wealthiest families had 44% lower odds of severe stunting than the children who lived in poorest families.
The results from table 5 suggests that after adjustment for; household member, age, gender, area, division, wealth index, type of toilet facility, salt iodization test outcome and number of under five children in a household, any increase in the level of parental education is associated with lower odds of severe stunting among children below 5 years.