These findings were highlighted in a study titled “Geographical and socioeconomic inequalities in the double burden of malnutrition among women in Southeast Asia: A population-based study” published in the journal The Lancet Regional Health – Southeast Asia.
“DBM is of particular concern among women of reproductive age because it imparts multiple long-term adverse health consequences to individuals, societies, and health care systems.
“Undernutrition in women is associated with adverse pregnancy outcomes, including maternal mortality, delivery complications, preterm birth and intrauterine growth retardation. Conversely, maternal obesity leads to several maternal and foetal complications during pregnancy, delivery and postpartum. Nutrition in women is obviously important for women’s health and that for the future generation.
“An understanding of the country-specific DBM geographical and socioeconomic distribution in South and Southeast Asian countries will enable targeting of DBM interventions towards high-risk populations in the region,” said the researchers.
To conduct their investigation, the team utilised a population-representative cross-sectional data from the Demographic and Health Surveys conducted between 2000 and 2017 for seven South and South East Asian countries – Bangladesh, Cambodia, India, Myanmar, Nepal, Pakistan, and Timor-Leste – and the estimated national and subnational prevalence of women who were underweight and overweight.
This was followed by measuring the relative and absolute inequality across the underweight and overweight women in urban and rural areas. Data from 933,836 women were collected for the study.
For most countries, the underweight disproportionately affected the poorest in society. In contrast, the overweight disproportionately affected the richest.
The pooled prevalence of women underweight and overweight in the surveyed regions was 22% and 29%, respectively, with the variation found by country and year. For instance, the highest prevalence of underweight was observed in Bangladesh in 2000 at 44% and being overweight or obese was observed in Pakistan in 2017 at 67%.
However, being underweight was found to have reduced, and the increasing frequency of being overweight was detected in countries with comprehensive data, including Bangladesh, India, Nepal, Timor-Leste, and Cambodia.
Next, the absolute measure of inequality was found to have decreased over time for most countries. Prevalence measures also demonstrated that underweight was more prevalent and overweight was less prevalent amongst individuals in the poorer quintiles than those in the more affluent quintiles.
The results could provide evidence of the female nutritional status at the national and subnational levels, besides its relation to socioeconomic factors.
Overall, the study indicated that South and South East Asian women became more overweight over time and exceeded the prevalence of being underweight in almost all countries.
“Our study also recommends nutrition-specific programs for the poorest groups. In terms of programme coverage, there is an urgent need to cover vulnerable subnational areas, such as mass population coverage, a broad strengthening of the whole system, either alone or combined with targeting, is required.
“In this respect, monitoring the distribution of DBM at a subnational level across different socioeconomic groups and regions can provide a useful tool for health policy-makers,” said the researchers.
This research is partially funded by the Australian Government through the Australian Research Council's Centre of Excellence for Children and Families over the Life Course.
Source: The Lancet Regional Health – Southeast Asia
“Geographical and socioeconomic inequalities in the double burden of malnutrition among women in Southeast Asia: A population-based study”
Authors: Tuhin Biswas, et al.