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Open Access Research article

Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

Mohammad Mafijul Islam12, Morshed Alam1, Md Tariquzaman3, Mohammad Alamgir Kabir14, Rokhsona Pervin5, Munni Begum6 and Md Mobarak Hossain Khan7*

Author Affiliations

1 Department of Statistics, Jahangirnagar University, Savar, Dhaka, -1342, Bangladesh

2 Department of Mathematics & Statistics, Bowling Green State University, Bowling Green, OH, 43402, USA

3 Probationary Senior Officer, Pubali Bank Ltd, Dhaka, Bangladesh

4 Department of Applied Statistics, University of Malaya, Kuala Lumpur, Malaysia

5 Department of Agricultural Statistics, Sher-e Bangla Nagar Agricultural University, Sher-e Bangla Nagar, Dhaka, -1207, Bangladesh

6 Department of Mathematical Sciences, Ball State University, Muncie, IN, 47306, USA

7 Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany

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BMC Public Health 2013, 13:11  doi:10.1186/1471-2458-13-11

Published: 8 January 2013

Abstract

Background

Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable.

Methods

The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model.

Results

The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother’s education, father’s education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman.

Conclusions

Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh.

Keywords:
Malnutrition; Under-five children; Predictors; Generalized Poisson regression model; Bangladesh