Changing Determinants of Child Wasting: Insights from the Prevalence of Stunting, Wasting, and Malnutrition and Their Determinants — An Analysis of BDHS 2022 Data

Background: Malnutrition remains a critical public health challenge in Bangladesh, particularly among children under five years. This study examines the prevalence and determinants of stunting, wasting, and underweight using nationally representative data from the 2022 Bangladesh Demographic and Health Survey (BDHS), with an emphasis on post-pandemic trends and socioeconomic disparities. Methods: We conducted a cross-sectional analysis of 4,118 children aged 0–59 months with valid anthropometric data. Multivariable logistic regression was performed on a complete-case subsample of 1,216 children to identify associations between malnutrition outcomes and socioeconomic, maternal and child health, and environmental factors. Outcomes were defined using WHO 2006 Child Growth Standards. Results: Among 4,118 children under five, the prevalence of stunting, wasting, and underweight was 23.5%, 11.7%, and 22.8%, respectively. Stunting and underweight showed strong associations with wealth and maternal education, while wasting was less influenced by long-term socioeconomic factors. Higher wealth (AOR for Richest vs. Poorest: 0.38) and maternal education (AOR for Higher vs. None: 0.33) significantly reduced the odds of stunting. Low birth weight, fewer ANC visits, and lower maternal BMI increased the risk of malnutrition—particularly for wasting and underweight. Wasting appeared more sensitive to acute shocks, likely reflecting the impact of the COVID-19 pandemic. Environmental factors like unimproved sanitation and older child age also increased the odds of stunting and underweight. Other factors, including child sex and delivery characteristics, were not significant in adjusted models. Conclusion: Child malnutrition in Bangladesh is strongly influenced by socioeconomic and maternal health factors, but wasting may reflect more immediate shocks. Targeted interventions focusing on poverty reduction, maternal health, and prenatal care are critical to addressing persistent and emerging forms of malnutrition.