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Accepted manuscript

Prevalence and determinants of double and triple burden of malnutrition among mother-child pairs in Malawi: a mapping and multilevel modelling study

Published online by Cambridge University Press:  21 October 2024

Jessie Jane Khaki Open the ORCID record for Jessie Jane Khaki [Opens in a new window] ,
Peter M. Macharia ,
Lenka Beňová ,
Emanuele Giorgi  and
Aline Semaan
Jessie Jane Khaki*
Affiliation:
Centre for Health Informatics, Statistics and Computing (CHICAS), Lancaster University, Lancaster, United Kingdom Malawi Liverpool Wellcome (MLW) Programme School of Global and Public Health, Kamuzu University of Health Sciences, Malawi
Peter M. Macharia
Affiliation:
Centre for Health Informatics, Statistics and Computing (CHICAS), Lancaster University, Lancaster, United Kingdom Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Population & Health Impact Surveillance Group, Kenya Medical Research Institute-Wellcome Trust Research programme, Kenya
Lenka Beňová
Affiliation:
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
Emanuele Giorgi
Affiliation:
Centre for Health Informatics, Statistics and Computing (CHICAS), Lancaster University, Lancaster, United Kingdom
Aline Semaan
Affiliation:
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
*
*Corresponding author: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

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Objective:

To establish the prevalence of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among mother-child pairs in Malawi and explore their geographical distribution and associated multilevel factors.

Design:

Cross-sectional study using secondary data from the 2015-16 Malawi Demographic and Health Survey using a mixed effects binomial model to identify multilevel factors associated with DBM and TBM. Georeferenced covariates were used to map the predicted prevalence of DBM and TBM.

Setting:

All 28 districts in Malawi.

Participants:

Mother-child pairs with mothers aged 15 to 49 years and children aged below 59 months (n=4,618 pairs) for DBM and between 6 and 59 months (n=4,209 pairs) for TBM.

Results:

Approximately 5.5% [95% confidence interval (CI): 4.7%, 6.4%] of mother-child pairs had DBM and 3.1% [95% CI: 2.5%, 4.0%] had TBM. The subnational-level prevalence of DBM and TBM was highest in cities. The adjusted odds of DBM were threefold higher [Adjusted Odds Ratio, AOR: 2.8, 95% CI: 1.1, 7.3] with a higher proportion of wealthy households in a community. The adjusted odds of TBM were 60% lower [AOR: 0.4; 95% CI: 0.2, 0.8] among pairs where the women had some education compared to women with no education.

Conclusions:

Although the prevalence of DBM and TBM is currently low in Malawi, it is more prevalent in pairs with women with no education and in relatively wealthier communities. Targeted interventions should address both maternal overnutrition and child undernutrition in cities and these demographics.

Keywords

Double burdenTriple burdenMalnutritionMalawiMother-child pairs
Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 28
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Authors 2024