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

Abstract 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...

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Main Authors: Jessie Jane Khaki, Peter M Macharia, Lenka Beňová, Emanuele Giorgi, Aline Semaan
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:Public Health Nutrition
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Online Access:https://www.cambridge.org/core/product/identifier/S1368980024002064/type/journal_article
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author Jessie Jane Khaki
Peter M Macharia
Lenka Beňová
Emanuele Giorgi
Aline Semaan
author_facet Jessie Jane Khaki
Peter M Macharia
Lenka Beňová
Emanuele Giorgi
Aline Semaan
author_sort Jessie Jane Khaki
collection DOAJ
description Abstract 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 2015–2016 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 twenty-eight districts in Malawi. Participants: Mother–child pairs with mothers aged 15–49 years and children aged below 60 months (n 4618 pairs) for DBM and between 6 and 59 months (n 4209 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 with 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.
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spelling doaj-art-6bac9277bacf4f79bb863b4597487f412024-11-25T11:54:10ZengCambridge University PressPublic Health Nutrition1368-98001475-27272024-01-012710.1017/S1368980024002064Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling studyJessie Jane Khaki0https://orcid.org/0000-0001-5202-5339Peter M Macharia1Lenka Beňová2Emanuele Giorgi3Aline Semaan4Centre for Health Informatics, Statistics and Computing (CHICAS), Lancaster University, Lancaster, UK Malawi Liverpool Wellcome (MLW) Programme, Blantyre, Malawi School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, MalawiCentre for Health Informatics, Statistics and Computing (CHICAS), Lancaster University, Lancaster, UK Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Population & Health Impact Surveillance Group, Kenya Medical Research Institute-Wellcome Trust Research programme, Nairobi, KenyaDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumCentre for Health Informatics, Statistics and Computing (CHICAS), Lancaster University, Lancaster, UKDepartment of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Abstract 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 2015–2016 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 twenty-eight districts in Malawi. Participants: Mother–child pairs with mothers aged 15–49 years and children aged below 60 months (n 4618 pairs) for DBM and between 6 and 59 months (n 4209 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 with 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. https://www.cambridge.org/core/product/identifier/S1368980024002064/type/journal_articleDouble burdenTriple burdenMalnutritionMalawiMother–child pairs
spellingShingle Jessie Jane Khaki
Peter M Macharia
Lenka Beňová
Emanuele Giorgi
Aline Semaan
Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling study
Public Health Nutrition
Double burden
Triple burden
Malnutrition
Malawi
Mother–child pairs
title Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling study
title_full Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling study
title_fullStr Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling study
title_full_unstemmed Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling study
title_short Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi: a mapping and multilevel modelling study
title_sort prevalence and determinants of double and triple burden of malnutrition among mother child pairs in malawi a mapping and multilevel modelling study
topic Double burden
Triple burden
Malnutrition
Malawi
Mother–child pairs
url https://www.cambridge.org/core/product/identifier/S1368980024002064/type/journal_article
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