Fertility is a key predictor of the double burden of malnutrition among women of child-bearing age in sub-Saharan Africa
Research snapshot1
Globally, countries are undergoing a nutrition transition, shifting from high rates of underweight towards growing rates of overweight and obesity. In sub-Saharan Africa (SSA), this transition has occurred relatively rapidly over the last 40 years. No study to date has specifically examined the double burden of malnutrition (DBM) in women of child-bearing age within the region. This study aimed to address this gap by classifying countries according to malnutrition prevalence of women of child-bearing age and determining key country-level and individual-level risk indicators associated with underweight, overweight and obesity within this group. Data from 34 SSA countries were acquired from Demographic and Health Surveys, the World Bank and the Swiss Federal Institute of Technology. National malnutrition prevalence rates were determined and random forest analysis and multinomial logistic regression models used to examine associated risk indicators.
Of the 34 countries studied, five continue to face significant undernutrition (greater than 10% prevalence of underweight), 11 countries face DBM (with a greater than 10% prevalence of both underweight and overweight/obesity) and 18 countries face significant overnutrition (greater than 10% prevalence of overweight (seven countries) and obesity (11 countries)). Across countries, fertility rate was the strongest predictor of undernutrition, overweight and obesity prevalence; fertility rates were highest in countries with high underweight prevalence and lowest in countries with high overweight/obesity prevalence. Economic and equality indicators (measured via Gross Domestic Product and Gini coefficient indicators) were also noted to be strong predictors of nutrition outcomes. Within countries, parity was a risk factor for underweight in countries with a high burden of underweight and a risk factor for overweight/obesity in overweight/obesity burdened countries. Age and wealth were noted to be protective factors for underweight but risk factors for overweight/obesity.
This study highlights the important role of fertility and parity in nutrition outcomes for women of child-bearing age and urges health professionals to consider integrating reproductive services and nutrition programmes in SSA.
Subscribe freely to receive Field Exchange content to your mailbox or front door.
Endnotes
1 Were, J. M., Stranges, S., & Creed, I. F. (2020). Fertility is a key predictor of the double burden of malnutrition among women of child-bearing age in sub-Saharan Africa. Journal of global health, 10(2), 020423. https://doi.org/10.7189/jogh.10.020423
More like this
FEX: Tackling the double burden of malnutrition in low and middle-income countries: response of the international community
Research By Alexandra Rutishauser-Perera Alexandra Rutishauser-Perera is a Humanitarian Nutrition Adviser with Save the Children. She has ten years of experience of public...
FEX: Effect of Asian population-specific BMI cut-off values on malnutrition double burden estimates
Summary of research1 Location: India What we know: India is a rapid developing economy with huge socio-economic and demographic heterogeneity and co-existence of under- and...
FEX: The Lancet series on the double burden of malnutrition
View this article as a pdf Research snapshot1 The double burden of malnutrition (DBM) is the coexistence of overnutrition (overweight and obesity) alongside undernutrition...
FEX: Anthropometric assessment of nutritional status in school-aged children and adolescents
View this article as a pdf Lisez cet article en français ici By Natasha Lelijveld Natasha Lelijveld is a senior nutritionist at ENN. She has previously worked in...
FEX: Use of anthropometry in school-aged children and adolescents
This is a summary of a Field Exchange research summary that was included in issue 66. The original article was authored by Natasha Lelijveld Natasha Lelijveld is a Senior...
NEX: Regional nutrition strategies to address the double burden in the Eastern Mediterranean
Dr Ayoub Al Jawaldeh has been the Regional Adviser for Nutrition in the WHO Regional Office for Eastern Mediterranean Region since 2009, leading the Regional Nutrition...
FEX: Double Burden of obesity and malnutrition in Western Sahara refugees
Summary of published research1 There is growing recognition of a ‘double burden’ of malnutrition among populations in both affluent and less-affluent countries, i.e. the...
FEX: Review of food security and nutrition amongst urban poor
Summary of review1 Location: Kenya, Niger, Bangladesh What we know: A significant and increasing proportion of the world population resides in urban slums. Achieving food...
FEX: Impact of maternal mental health on recovery from severe acute malnutrition in Malawi
View this article as a pdf MSc summer project1 By Mphatso Nancy Chisala Mphatso Chisala is a medic by profession with an interest in the prevention and treatment of child...
FEX: Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect
Summary of research1 Location: Global What we know: The decision not to breastfeed a child impacts on the health, nutrition and development of a child and on women's...
FEX: Diet and nutrition status among school-age children and adolescents in Tanzania
View this article as a pdf By Sauli John, Geofrey Mchau, Heavenlight Ayubu, Stanslaus Mafung'a, Samafilan Ainan, Wiggins Kyatikila, Elizabeth Lyimo, Frank Chacky, Fatoumata...
Resource: Women's nutrition: A summary of evidence, policy and practice including adolescent and maternal life stages
Please scroll down for links to download the Executive Summary (also available in French) and full report Lisez cet document d'information technique en français ici...
Resource: The Double Burden of Obesity and Malnutrition in a Protracted Emergency Setting: A Cross-Sectional Study of Western Sahara Refugees
Abstract Background Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it...
FEX: Review of nutrition and mortality indicators for Integrated Phase Classification
Summary of technical review1 The Integrated Phase Classification (IPC) Technical Working Group and the Standing Committee on Nutrition (SCN) Task Force on Assessment,...
FEX: Burden of child and maternal malnutrition and trends in states of India 1990-2017
View this article as a pdf Research snapshot1 India has a large and persistent burden of malnutrition. However, with a population of 1.4 billion people residing across states...
FEX: Development of a maternal service package for mothers of children with severe acute malnutrition admitted to nutrition rehabilitation centres in India
View this article as a pdf Lisez cet article en français ici By Vani Sethi, Praveen Kumar and Arjan De Wagt Vani Sethi PhD is a public health nutritionist in the...
FEX: Relationships between wasting and stunting and their concurrent occurrence in Ghanaian pre-school children
Summary of research* Location: Ghana. What we know: Wasting is a short-term health issue, but repeated episodes may lead to stunting (long-term or chronic malnutrition). This...
NEX: Nourishing the Sustainable Development Goals: Global Nutrition Report 2017
In this fourth Global Nutrition Report (GNR), significant burdens of three key forms of malnutrition (child stunting, anaemia in women of reproductive age and overweight in...
NEX: El Salvador: the road from national nutrition strategy to local implementation
View this article as a pdf Lisez cet article en français ici Dáysi de Marquez is Executive Director of the National Council for Food Security and Nutrition...
Delivering care to address a double burden of maternal malnutrition in Sri Lanka
View this article as a pdf Dr Irosha Nilaweera is a Consultant Community Physician for the National Programme for Maternal Care, Family Health Bureau, Ministry of Health, Sri...
Reference this page
Fertility is a key predictor of the double burden of malnutrition among women of child-bearing age in sub-Saharan Africa. Field Exchange 64, January 2021. p74. www.ennonline.net/fex/64/fertilitydoubleburdenafrica
(ENN_6899)