Peer-reviewed article

Prevalence and Determinants of the Composite Index of Anthropometric Failure in Children Under Five Years in Bangladesh: Insights From a National Survey.

Rafid Hassan, Shahadoth Hossain, Md Mahbub Alam, Sanjib Saha, Tanjina Akter et al. · 22 Jun 2025

Abstract

Child undernutrition remains a significant public health issue in Bangladesh, with high rates of stunting, wasting, and underweight. The Composite Index of Anthropometric Failure (CIAF) offers a comprehensive tool for assessing overall undernutrition. Although previous studies in Bangladesh have utilized CIAF, they have relied on older datasets. Estimating the current status is essential for designing and implementing targeted interventions due to the dynamic nature of undernutrition. This study aimed to provide updated insights by analyzing the CIAF and its determinants among children under 5 years, using the most recent 2022 Bangladesh Demographic and Health Survey (BDHS) data. A total of 3950 under-5-year-old children were included. The modified Poisson regression was employed to identify the associated factors. The overall prevalence of CIAF was 33.7%, with subgroups of wasted and underweight (4.7%), stunted and underweight (10.8%), wasting, stunting, and underweight (3.4%), only wasted (3%), only stunted (8.8%), and only underweight (3%). Factors associated with higher risk of CIAF included older aged child, higher birth order (ARR: 1.30, 95% CI: 1.08-1.58), smaller birth size (ARR: 1.45, 95% CI: 1.24-1.70), uneducated mothers (ARR: 1.49, 95% CI: 1.16-1.93), maternal underweight (ARR: 1.28, 95% CI: 1.13-1.46), short stature (ARR: 1.54, 95% CI: 1.40-1.70). Children from the poorest households (ARR: 1.25, 95% CI: 1.02-1.53) and Sylhet (ARR: 1.22, 95% CI: 1.02-1.47) also had a higher risk. This study suggests strengthening community-based nutrition-specific programs along with improving access to healthcare, family planning, food assistance, and income opportunities to reduce child undernutrition in Bangladesh.