Child undernutrition and its association with household environmental conditions in Bangladesh.

Objectives: Child undernutrition among under 5 aged children is a prevalent global issue, especially in Bangladesh. This study aimed to explore relationships of household environmental conditions (HECs) with child under-nutrition in Bangladesh, with a specific focus on rural-urban differences.

Design: We analysed children's data from the 2017/18 Bangladesh Demographic Health Survey (BDHS). The outcome variable considered were measures of child under-nutrition, including stunting, wasting, and underweight. The major exposure variable considered was indicators of HECs. We used a hierarchical Poisson regression model to explore the association between outcomes and exposures adjusted for potential confounders.

Setting: Nationally representative cross-sectional survey.

Participants: 8,057 under-5 aged children.

Results: The prevalence of stunting, wasting and underweight in Bangladesh was 31%, 8% and 22%, respectively, with significant urban-rural variations. Under-5 children who lived in houses constructed with unimproved materials (aRR: 1.17), exposed to household air pollution (HAP) (aPR: 1.37), had unimproved drinking water sources (aPR: 1.28), or had poor handwashing facilities (aPR: 1.24) had a greater likelihood of stunting compared to their counterparts. Similar associations were observed for underweight. The likelihood of stunting and underweight increased with increasing scores of poor HECs, varying significantly across urban-rural areas.

Conclusion: The high prevalence of stunting and underweight in Bangladesh is linked to poor HECs. Therefore, policies and programs aimed at reducing child undernutrition need to account for household environmental conditions, with a particular focus on children in poor household environments.