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Global health
Original research
Risk factors and regional variations of malnutrition among children under 5 in Myanmar: cross-sectional analyses at national and subnational levels
  1. Hnin Thiri Khaing1,
  2. Shuhei Nomura1,
  3. Daisuke Yoneoka1,2,
  4. Peter Ueda1,3,
  5. Kenji Shibuya1,4
  1. 1 Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  2. 2 Institution of Statistical Mathematics, Tokyo, Japan
  3. 3 Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
  4. 4 Institute for Population Health, King’s College London, London, UK
  1. Correspondence to Dr Hnin Thiri Khaing; khaing.hninthiri{at}gmail.com

Abstract

Objective The levels, distributions of child malnutrition and its potential risk factors are not very well known in Myanmar. The objectives included in this study were: to estimate the current national and subnational prevalence of four types of malnutrition (stunting, wasting, underweight and overweight) among children under 5 in Myanmar; to identify potential risk factors associated with each type of malnutrition and to investigate how the identified risk factors’ distributions explained the regional disparities in malnutrition prevalence.

Design/methods Data from the Myanmar Demographic and Health Survey 2015–2016 were used to estimate the prevalence of four types of malnutrition at both national and subnational levels (15 regions). Logistic regression models were applied to examine the association between each type of malnutrition and its risk factors, including child’s factors, parental social status and household conditions. The risk factor-adjusted prevalence of the malnutrition was estimated at the subnational level based on the estimated parameters from the regression models.

Results The national prevalence of stunting, wasting, underweight and overweight in children under 5 was estimated to be 29.1% (95% CI 27.7% to 30.6%), 6.8% (6.0% to 7.6%), 18.3% (17.0% to 19.5%) and 1.5% (1.1% to 1.9%), respectively. Substantial regional variations in the prevalence of each type of malnutrition were observed. Several risk factors of each type of malnutrition were identified, including low birth weight (LBW) and inadequate maternal nutritional status. Except for overweight, regional variations largely persisted even after adjustment for the risk factors investigated.

Conclusion The prevalence of malnutrition among children under 5 is still high in Myanmar, most commonly stunting. Targeted interventions aimed at prevention of LBW, improving the maternal nutritional status, in addition to other sociodemographic conditions should be encouraged urgently. Further research is necessary to investigate the potential sources of regional variation in prevalence of malnutrition among children under 5 in the country.

  • malnutrition
  • overweight
  • regional variation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjopen-2019-030894

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    Footnotes

    • Contributors All authors conceived and designed the study and take responsibility for the accuracy of the data analysis. HTK, SN, DY, PU and KS analysed and interpreted the data. HTK conducted statistical analysis and drafted the article. All authors made critical revision of the manuscript for important intellectual content and gave final approval for the manuscript.

    • 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.

    • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Ethical approval for this study was not required as the data were extracted from the MDHS which did not contain any personally identifiable information.

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

    • Data availability statement Data are available upon reasonable request. No data are available.