title: The role of maternal education in the 15-year trajectory of malnutrition in children under 5 years of age in Bangladesh.
abstract: Malnutrition in children under 5 years of age (U5s) is a serious public health problem in low- and middle-income countries including Bangladesh. Improved maternal education can contribute effectively to reduce child malnutrition. We examined the long-term impact of maternal education on the risk of malnutrition in U5s and quantified the level of education required for the mothers to reduce the risk. We used pooled data from five nationwide demographic and health surveys conducted in 1996-1997, 1999-2000, 2004, 2007 and 2011 in Bangladesh involving 28 941 U5s. A log-binomial regression model was used to examine the association between maternal education (no education, primary, secondary or more) and malnutrition in children, measured by stunting, underweight and wasting controlling for survey time, maternal age, maternal body mass index, maternal working status, parity, paternal education and wealth quintile. An overall improvement in maternal educational attainment was observed between 1996 and 2011. The prevalence of malnutrition although decreasing was consistently high among children of mothers with lower education compared with those of mothers with higher education. In adjusted models incorporating time effects, children of mothers with secondary or higher education were at lower risk of childhood stunting [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.81, 0.89], underweight (RR: 0.83, 95% CI: 0.78, 0.88) and wasting (RR: 0.82, 95% CI: 0.74, 0.91) compared with children of mothers with no education. We demonstrated the importance of promoting women's education at least up to the secondary level as a means to tackle malnutrition in Bangladesh.
authors.affiliation: School of Population Health, University of Queensland, Herston, Queensland, Australia. m.hasan1@uq.edu.au.
authors.forename: Md Tanvir
authors.initials: MT
authors.lastname: Hasan
authors.affiliation: School of Veterinary Science, Gatton Campus, University of Queensland, Gatton, Queensland, Australia.|WHO Collaborating Centre for Children's Health and Environment, Queensland Children's Medical Research Institute, University of Queensland, Herston, Queensland, Australia.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Soares Magalhaes
authors.affiliation: School of Population Health, University of Queensland, Herston, Queensland, Australia.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.affiliation: School of Population Health, University of Queensland, Herston, Queensland, Australia.
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Mamun
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000517:prevention & control; D009035:Mothers / Q000193:education; D009752:Nutritional Status; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome
keywords: Bangladesh; children under 5 years of age; malnutrition; maternal education