An analysis of the dual burden of childhood stunting and wasting in Myanmar: a copula geoadditive modelling approach

Abstract

Abstract Objective: To analyse the spatial variation and risk factors of the dual burden of childhood stunting and wasting in Myanmar. Design: Analysis was carried out on nationally representative data obtained from the Myanmar Demographic and Health Survey conducted during 2015–2016. Childhood stunting and wasting are used as proxies of chronic and acute childhood undernutrition. A child with standardised height-for-age Z score (HAZ) below –2 is categorised as stunted while that with a weight-for-height Z score (WHZ) below –2 as wasted. Setting: A nationally representative sample of households from the fifteen states and regions of Myanmar. Participants: Children under the age of five ( $n$ 4162). Results: Overall marginal prevalence of childhood stunting and wasting was 28·9 % (95 % CI 27·5, 30·2) and 7·3 % (95 % CI 6·5, 8·0) while their concurrent prevalence was 1·6 % (95 % CI 1·2, 2·0). The study revealed mild positive association between stunting and wasting across Myanmar. Both stunting and wasting had significant spatial variation across the country with eastern regions having higher burden of stunting while southern regions having higher prevalence of wasting. Child age and maternal WHZ score had significant non-linear association with both stunting and wasting while child gender, ethnicity and household wealth quintile had significant association with stunting. Conclusion: The study provides data-driven evidence about the association between stunting and wasting and their spatial variation across Myanmar. The resulting insights can aid in the formulation and implementation of targeted, region-specific interventions towards improving the state of childhood undernutrition in Myanmar.