DESIGN: We analysed women's data from the Bangladesh Demographic Health Surveys, conducted between 1996 and 2022. Sociodemographic characteristics, changes in BMI distribution and underweight and overweight prevalence were estimated at national and urban-rural levels. Associated factors were identified using multilevel mixed-effect logistic regression, with survey year as a random intercept. Multinomial regressions were used for the individual survey waves.
SETTING: Nationally representative cross-sectional survey.
PARTICIPANTS: 90 510 reproductive-aged women.
RESULTS: There is an epidemiological transition from underweight to overweight by approximately 5 kg/m2 over the period. The prevalence of underweight women declined by 41·34 %, while overweight/obesity increased by 33·62 %. For urban-rural disparities, the prevalence of underweight was consistently higher among rural women, whereas overweight was more common among urban women. Increased age and higher education had higher odds of being overweight/obese and relatively higher socio-economic status had higher odds of being overweight and lower odds of being underweight. Access to television had mostly higher odds of being overweight. Age, education, socio-economic status and watching television showed consistent risks over time, while other factors showed inconsistent risks at different survey times.
CONCLUSIONS: There was an epidemiological transition in BMI, with a declining trend in underweight and a substantial increase in overweight. Targeted interventions are needed to tackle the persistent undernutrition in rural areas and the rapidly escalating epidemic of overweight/obesity, particularly in urban settings.
METHODS: Data were derived from four waves of nationally representative Bangladesh Demographic and Health Survey (BDHS) conducted between 2004 and 2014. Rate of change analysis was used to calculate the average annual rate of increase in CS from 2004 to 2014, by socio-demographic categories. Multi-level logistic regression was used to identify the socio-demographic predictors of CS in a cross-sectional analysis of the 2014 BDHS data.
RESULT: CS rates increased from 3.5% in 2004 to 23% in 2014. The average annual rate of increase in CS was higher among women of advanced maternal age (≥35 years), urban areas, and relatively high socio-economic status; with higher education, and who regularly accessed antenatal services. The multi-level logistic regression model indicated that lower (≤19) and advanced maternal age (≥35), urban location, relatively high socio-economic status, higher education, birth of few children (≤2), antenatal healthcare visits, overweight or obese were the key factors associated with increased utilization of CS. Underweight was a protective factor for CS.
CONCLUSION: The use of CS has increased considerably in Bangladesh over the survey years. This rising trend and the risk of having CS vary significantly across regions and socio-economic status. Very high use of CS among women of relatively high socio-economic status and substantial urban-rural difference call for public awareness and practice guideline enforcement aimed at optimizing the use of CS.