Double Burden of Malnutrition among Nepalese Ever Married Women: Findings from the Nepal Demographic and Health Survey, 2006, 2011, and 2016
Ramesh Prasad Adhikari1*, Ajay Acharya2, Emily N. Satinsky3, Keshav Prasad Adhikari4 and Nawaraj Upadhaya5
1Suaahara II, Helen Keller International Nepal, Lalitpur and Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
2Melbourne School Population and Global Health, University of Melbourne, Australia
3Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
4Central Department of Population Studies, Tribhuvan University, Kathmandu, Nepal
5Department of Research and Development, HealthNet TPO, Amsterdam, The Netherlands
*Corresponding Author: Ramesh Prasad Adhikari, Suaahara II, Helen Keller International Nepal, Lalitpur and Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal.
Received: March 08, 2021; Published: May 24, 2021
The double burden of malnutrition, or the co-existence of overnutrition and undernutrition, is a public health concern in Nepal. This paper examines the prevalence and determinants of the double burden of malnutrition among ever married women of reproductive age using data from three consecutive Nepal Demographic Health Surveys (NDHS). Data on ever married women (N = 17,073) from the 2006, 2011 and 2016 NDHS were used. Under-weight (BMI < 18.5) and overweight/obesity (BMI ≥ 25) were measured based on WHO BMI cutoff scores. We fitted multinomial regression models weighted and adjusted for possible socio-economic confounders. The results confirm the existence of a double burden of malnutrition among ever married women in Nepal. Between 2006 and 2016, the prevalence of overweight/obesity increased from 10% to 27% and the prevalence of underweight decreased from 24% to 14%. Women with higher educational attainment were at lower risk of underweight and at higher risk of overweight/obesity (underweight adjusted relative risk [ARR] = 0.97, 95% CI 0.96, 0.99: overweight/obesity ARR = 1.03, 95% CI 1.01,1.05). Compared to the poorest women, the richest women were at a significantly lower risk of underweight (ARR = 0.34, 95% CI 0.27, 0.43) and higher risk of overweight/obesity (ARR = 10.75, 95% CI 8.01, 14.43). Women belonging to the Dalit caste were at risk of both underweight and overweight/obesity. Education, wealth quintile and caste/ethnicity are risk factors for the double burden of malnutrition among ever married women in Nepal. Considering these factors during the design and implementation of nutritional interventions could support reductions in the prevalence of underweight and overweight/obesity among this population.
Keywords: Underweight; Overweight/Obesity; Married Women; Double Burden of Malnutrition; Nepal
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