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Factors associated with low birth weight in Afghanistan: a cross-sectional analysis of the demographic and health survey 2015
  1. Rajat Das Gupta1,2,
  2. Krystal Swasey3,
  3. Vanessa Burrowes4,
  4. Mohammad Rashidul Hashan5,
  5. Gulam Muhammed Al Kibria3
  1. 1 Centre for Science of Implementation and Scale-Up, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
  2. 2 Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
  3. 3 Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD-21201, United States of America
  4. 4 Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD-21205, United States of America
  5. 5 Dhaka Medical College and Hospital, Dhaka, Bangladesh
  1. Correspondence to Dr. Rajat Das Gupta; rajat89.dasgupta{at}


Objectives This study aimed to investigate the factors associated with low birth weight (LBW) in Afghanistan.

Design Cross-sectional study.

Setting This study used data collected from the Afghanistan Demographic and Health Survey 2015.

Participants Facility-based data from 2773 weighted live-born children enrolled by a two-stage sampling strategy were included in our analysis.

Primary and secondary outcome measures The primary outcome was LBW, defined as birth weight <2.5kg.

Results Out of 2773 newborns, 15.5% (n=431) had LBW. Most of these newborns were females (58.3%, n=251), had a mother with no formal schooling (70.5%, n=304), lived in urban areas (63.4%, n=274) or lived in the Central region of Afghanistan (59.7%, n=257). In multivariable analysis, residence in Central (adjusted OR (AOR): 3.4; 95% CI 1.7 to 6.7), Central Western (AOR: 3.0; 95% CI 1.5 to 5.8) and Southern Western (AOR: 4.0; 95% CI 1.7 to 9.1) regions had positive association with LBW. On the other hand, male children (AOR: 0.5; 95% CI 0.4 to 0.8), newborns with primary maternal education (AOR: 0.5; 95% CI 0.3 to 0.8), birth interval ≥48 months (AOR: 0.4; 95% CI 0.1 to 0.8), belonging to the richest wealth quintile (AOR: 0.2; 95% CI 0.1 to 0.6) and rural residence (AOR: 0.3; 95% CI 0.2 to 0.6) had decreased odds of LBW.

Conclusions Multiple factors had association with LBW in Afghanistan. Maternal, Neonatal and Child Health programmes should focus on enhancing maternal education and promoting birth spacing to prevent LBW. To reduce the overall burden of LBW, women of the poorest wealth quintiles, and residents of Central, Central Western and South Western regions should also be prioritised. Further exploration is needed to understand why urban areas are associated with higher likelihood of LBW. In addition, research using nationally representative samples are required.

  • Afghanistan
  • global health
  • low birth weight
  • birth weight
  • factors
  • determinants

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  • Contributors RDG, KS and GMAK conceptualised the study. RDG, KS, VB and GMAK designed the study and acquired the data. RDG, MRH and GMAK conducted the data analysis. RDG, KS, VB and GMAK interpreted the data. RDG and GMAK prepared the first draft. RDG, KS, VB, MRH and GMAK participated in critical revision of the manuscript and contributed to its intellectual improvement. All authors went through the final draft and approved it for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The authors are alone responsible for the integrity and accuracy of data analysis and the writing the manuscript.

  • Competing interests None declared.

  • Ethics approval This study was exempt from collecting ethical approval because the AfDHS 2015 received ethical approval from the ICF Institutional Review Board and the Ministry of Public Health of Afghanistan.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available at: Following instruction, data are available to download.

  • Patient consent for publication Not required.

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