Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996-2018

Objective:To examine the height-for-age z-score (HAZ) of 0-35 months' children along with stunting prevalence to identify trends, changes and available nutrition-sensitive and specific determinants that could help explain the long-term variation in child linear growth using successive Bangladesh Demographic and Health Surveys (BDHS) data from 1996 to 2018.Design:The BDHS pooled data are used for determining the key outcome variables HAZ, stunting and severe stunting. Trends, kernel-weighted local polynomial smoothing illustrations, pooled multivariable linear probability model (LPM), ordinary least squares method (OLS) and regression decomposition were used.Participants:Mothers having 0-35 months' children, the most critical age range for growth faltering.Results:The mean HAZ increased by 0 center dot 91(+/- 1 center dot 53) with 0 center dot 041 annual average change, while the percentages of stunting (-26 center dot 63 +/- 0 center dot 54) and severe stunting (-21 center dot 12 +/- 0 center dot 48) showed a reduction with 1 center dot 21 and 0 center dot 96 average annual changes, respectively. The average HAZ improvement (0 center dot 42 +/- 1 center dot 56) in urban areas was less than the rural areas (1 center dot 16 +/- 1 center dot 44). Similar patterns followed for stunting and severe stunting. The prenatal doctor visits (3064 center dot 65 %), birth in a medical facility (1054 center dot 32 %), breastfeeding initiation (153 center dot 18 %) and asset index (144 center dot 73 %) demonstrated a huge change. The findings of OLS, LPM and regression decomposition identified asset index, birth order, paternal and maternal education, bottle-fed, prenatal doctor visit, birth in a medical facility, vaccination, maternal BMI and ever-breastfed as influencing factors to predict the long-term changes of stunting and severe stunting.Conclusion:The nutrition-sensitive and specific factors identified through regression decomposition describing long-term variation in child linear growth should be focused further to attain the sustainable development goals.