title: Predictors of maternal and child double burden of malnutrition in rural Indonesia and Bangladesh.
abstract: BACKGROUND
  Many developing countries now face the double burden of malnutrition, defined as the coexistence of a stunted child and overweight mother within the same household.
  
  
  OBJECTIVE
  This study sought to estimate the prevalence of the double burden of malnutrition and to identify associated maternal, child, and household characteristics in rural Indonesia and Bangladesh.
  
  
  METHODS
  A total of 247,126 rural households that participated in the Indonesia Nutrition Surveillance System (2000-2003) and 168,317 rural households in the Bangladesh Nutritional Surveillance Project (2003-2006) were included in the analysis. Maternal and child double burden (MCDB) and its association with individual and household characteristics were determined by using logistic regression models.
  
  
  RESULTS
  MCDB was observed in 11% and 4% of the households in rural Indonesia and Bangladesh, respectively. Maternal short stature [Indonesia (OR: 2.32; 95% CI: 2.25, 2.40); Bangladesh (OR: 2.11; 95% CI: 1.96, 2.26)], and older age were strong predictors of MCDB. Child characteristics such as older age and being female were associated with an increased odds of MCDB, whereas currently being breastfed was protective against MCDB [Indonesia (OR: 0.84; 95% CI: 0.81, 0.84); Bangladesh (OR: 0.55; 95% CI: 0.52, 0.58)]. A large family size and higher weekly per capita household expenditure predicted MCDB [Indonesia (OR: 1.34; 95% CI: 1.28, 1.40); Bangladesh (OR: 1.94; 95% CI: 1.77, 2.12)].
  
  
  CONCLUSIONS
  Double burden is not exclusive to urban areas. Future policies and interventions should address under- and overweight simultaneously in both rural and urban developing country settings.
authors.affiliation: Mathematica Policy Research Inc, Cambridge, MA 02139, USA. voddo@mathematica-mpr.com
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Oddo
authors.forename: Jee H
authors.initials: JH
authors.lastname: Rah
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Nasima
authors.initials: N
authors.lastname: Akhter
authors.forename: Mayang
authors.initials: M
authors.lastname: Sari
authors.forename: Saskia
authors.initials: S
authors.lastname: de Pee
authors.forename: Regina
authors.initials: R
authors.lastname: Moench-Pfanner
authors.forename: Martin
authors.initials: M
authors.lastname: Bloem
authors.forename: Klaus
authors.initials: K
authors.lastname: Kraemer
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D015992:Body Mass Index; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009035:Mothers; D044343:Overnutrition / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D014504:Urban Health