The Effect of Women’s Individual Level Fertility on Their Children’s stunting in Bangladesh

Women’s individual level fertility is a major public health concern and is recognized as a serious problem of women’s human in our country. The nutritional status of children is a sensitive indicator of a country’s socioeconomic characteristics as well as demographic characteristics. The research work used Bangladesh Demographic and Health Survey 2011 (BDHS 2011) data. Therefore, using secondary data from 2011 BDHS surveys, this study attempted to reveal the effect of individual level fertility on children’s stunting in Bangladesh. In this study, some socioeconomic and demographic variables like mother’s education level, father’s education level, father’s occupation, wealth status, sex of child, age of child, mother age, mothers currently pregnant, preceding birth interval, place of residence and region were used. In this study, ANOVA F-test shows that there exists strong positive association with stunting between two continuous variables number of siblings and child age (in months). For this study purpose univariate analysis was used for frequency distribution of individual variables. Then bivariate and multivariate analyses were performed to identify the determinants of child nutritional status. The analyses reveal that a large proportion of women experienced individual level fertility and a major proportion of child are found to be stunted. Women’s individual level fertility has strong significant association on stunting of their children at 1% level of significance. Although, nutritional status (stunting) of children is strongly affected by type of place of residence, region, mother’s educational level, father’s educational level, wealth status, age of child (in months), preceding birth interval (in months) and mother age. Women’s individual level fertility also provides strong significant relationship with child nutritional status in unadjusted model. Although, adjustment for all socioeconomic and demographic variables, the strength of the association between women’s individual fertility and their child’s nutritional status remain strong. Sex of child, mother’s currently pregnant and father’s occupation are found to be insignificant with stunting (height-for-age). The results from this study provide evidence for a relation between women’s individual level fertility and nutritional status (stunting) of children in Bangladesh. These findings persisted, even after adjusting for socioeconomic and demographic related characteristics. The findings may help policy makers, project planners and government in designing and implementing the nutritional programs in Bangladesh.
Under-nutrition of children is unfortunately still very common in many parts of the world. For example, 45% o

f the children in Bangladesh are stunted (i.e., have a low height for their age) - an indicator of chronic under-nutrition (UNICEF 2010). In addition to the serious implications for child mortality, there are long-term effects of childhood under-nutrition on health, well-being, and productivity (Black, Morris, and Bryce 2003; Chang et al. 2002; Glewwe, Jacoby, and King 2001; Graff et al. 2010; Grantham-McGregor et al. 2007; Mendez and Adair 1999; Weinreb et al. 2002).

A child who lives in an area where the adults have many children may be at a disadvantage because of a generally low income level. When other people have low income a consequence may be that their children are sick relatively often, and these diseases can be transmitted to the child under study and thus enhance the stunting risk. Further, a higher income in the community may – at least in the somewhat longer run – stimulate, for example, the establishment of health care institutions that any child may benefit from (Kravdal 2003).

The mechanism possibly linking high aggregate-level fertility and an individual child’s stunting is an aggregate version of the household-level pathway referred to earlier as the sibling effect and also bears some resemblance to one of the income related mechanisms just described. The argument runs as follows: when another family has many children, that family may itself experience a high prevalence of diseases (because of the dilution of resources and possible more intense disease transmission within the household), which increases the disease risk for the child under study and ultimately its chance of being stunted(Rutstein and Johnson 2004).

The number of children a child interacts with outside the household might also affect the chance of being infected. A possible indicator of that could be the number of children within a surrounding area of a certain size, which is determined by the number of households within this area multiplied by the number of children in each household. However, the former probably varies much more than the latter (even given any rural/urban control variable that might be included) and the two are inversely linked to each other, so we hesitate to consider aggregate fertility as affecting an individual child’s chance of being stunted through this mechanism(Fotso and Giroux 2007).