Table 2 Socio-demographic characteristics of the study participants (N=2,261)
A total of 2,261 mother-child pairs were included in the study (Fig 1). Table 2 shows socio-demographic information of the participants and different forms of malnutrition existing among the mother-child pairs at the same household level in Nepal. The mean (+SD) age of the mothers and age of the child was 26.36(+5.64) years and 29.01(+17.37) months respectively. About one-half of the mothers (49.22%) were in the 25-34 years age groups and more than half of the mothers (52.77%) were below 19 years of age at their first birth. One-third of the mothers (33.68%) and only 15.12% of the fathers did not receive any formal education and approximately one-third of the mothers (32.36%) and more than one-third of the fathers (43.86%) attained secondary level education. The majority of the mothers (46.69%) and only 19.32% of the fathers were involved in agriculture. Slightly more mothers (25.89%) were living in province number 2, More mothers (42.04%) belonged to poor wealth status and the majority of the mothers (90%) had normal height. Slightly more children (22.53%) were below 12 months of age groups, more than half of children (52.71%) were male, slightly more than two-thirds of the child (74.52%) received a vitamin A capsule in the previous six months and more than half of the child (59.82%) were taking deworming. About two-thirds of the child (67.72%) were born with average birth weight.
The prevalence of overweight/obese mother and stunted child (OM/SC) was 8.30(6.32-10.84) %, overweight/obese mother and wasted child (OM/WC) was 1.25(0.74-2.11) %, overweight/obese mother and underweight child (OM/UC) was 3.37(2.34-4.83) % and overweight/obese mother and anemic child (OM/AC) was 18.89(15.43-22.83) %. The prevalence of the DBM was 6.60(5.13-8.84) % and TBM was 7(5.42-8.99) % at the household level.
Table 3. Depicts bivariate and multivariate logistic regression model for the different forms of malnutrition and its associated factors among the mother-child pairs. The following results are the interpretation of the different forms of malnutrition and associated factors.
Prevalence and factors associated with the double burden of malnutrition
In the bivariate logistic regression model, several maternal factors were significantly associated with higher odds of the double burden of malnutrition: mother's short stature compared to normal height (COR=3.19, 95% CI: 1.59-6.40), mothers from the richest wealth status compared to poor wealth status (COR=2.89, 95% CI: 1.50-5.54), mothers whose occupation was services compared to agriculture (COR=2.82, 95% CI: 1.37-5.81), mother who had attended at least secondary level of education compared to no education (COR=2.43, 95% CI: 1.24-4.76), mothers whose last delivery done through cesarean section compared to normal delivery (COR=2.39, 95% CI: 1.18-4.48) and mothers aged of above 35 years compared to 15-24 years (COR=1.18, 95% CI: 0.38-3.61). In addition, child-related factors that were more likely to increase odds of double burden of malnutrition were as follows: Children who were 36-47 months compared to below 12 months (COR=2.19, 95 % CI: 1.01-4.73), children with no history of current breastfeeding compared to children being currently breastfed (COR=1.97, 95% CI: 1.10-3.51) and child's large size at birth compared to average birth weight (COR=1.93, 95% CI: 1.13-3.29). Mothers who were 20-29 years of age during first birth of their child compared to above 30 years (AOR=0.12, 95% CI=0.03-0.44), mothers living in province number 2 compared to province number 3 (AOR=0.08, 95% CI: 0.03-0.47), no history of vitamin A intake compared to intake of vitamin A intake among children (COR=0.45, 95% CI: 0.22-0.92) and no history of deworming compared to deworming among children (COR=0.54, 95% CI: 0.31-0.91) were found to have lower odds of DBM. Multivariable logistic regression model indicated that mothers with short stature compared to normal height (AOR=4.18, 95% CI:2.04-8.52), mothers from richest wealth status compared to poor wealth status (AOR=2.46, 95% CI: 1.17-5.15), age groups of above 35 years compared to 15-24 years of age groups (AOR=3.08, 95% CI: 1.20-7.86-4.77), mothers with secondary level of education compared to no education (AOR=2.05, 95% CI: 1.03-4.07) were more likely to have higher odds of DBM. While mothers living in province number 2 compared to province number 3 (AOR=0.13, 95% CI: 0.03-0.47), were found to had lower odds of DBM (Table 3).
Prevalence and factors associated with the triple burden of malnutrition
Bivariate logistic regression model (Table 3) indicated that the mother's height of short stature compared to normal height (COR=4.38, 95% CI: 2.17-8.86), mother's age groups of above 35 compared to 15-24 years (COR=3.11.19, 95% CI: 1.34-7.22), had child's age group of 24-35 months compared to below 12 months (COR=2.85, 95 % CI: 1.33-6.11), had the richest wealth status compared to poor wealth status (COR=2.61, 95% CI: 1.36-5.02), mothers who worked in services compared to agriculture (COR=2.61, 95% CI: 1.36-5.02), having at least secondary level of education compared to no education (COR=2.09, 95% CI: 1.05-4.16), and mothers who had no history of current breastfeeding (COR=1.93, 95% CI: 1.07-3.47) were more likely to have higher odds of TBM. Likewise, results in the multivariable logistic regression model shows mothers short stature compared to normal height (AOR=5.01, 95% CI: 2.45-10.24), mothers age groups of above 35 years compared to 15-24 years (AOR=3.41, 95% CI: 1.26-9.17), mothers from the richest wealth status compared to poor wealth status (AOR=2.66, 95% CI= 1.28-5.54), and mothers who attended at least secondary level of education compared to no education (AOR=2.05, 95% CI: 1.00-4.18) were found to have higher odds of TBM. Furthermore, mothers living in province number 2 compared to province number 3 (AOR=0.11, 95% CI: 0.03-0.41), children with no history of vitamin A intake compared to vitamin A intake (COR=0.40, 95% CI: 0.19-0.86), and no history of deworming drug intake (COR=0.49, 95% CI: 0.28-0.86) were found to have lower odds of TBM (Table 3).
Table 3 Bivariate and multivariable analysis of double and triple burden of malnutrition among mother-child pairs and its associated factors (n=2,261).