Trends and Inequality of Childhood Stunting in Bangladesh: A Household Level Analysis

Although Bangladesh has achieved remarkable economic growth and improved various health indicators, childhood stunting remains one of the major public health concerns. This paper examines the trends and patterns of childhood stunting and inequality and its socio-economic contributors in Bangladesh. Data have been extracted from the Bangladesh Demographic and Health Survey (BDHS), a nationally representative cross-sectional survey. The most recent five rounds (2004, 2007, 2011, 2014, and 2017-18) of the BDHS data are used. In addition, a regression-based decomposition method is applied to assess the socio-economic contributors to the inequality of childhood stunting. Findings show that the overall change in stunting prevalence from 2004 to 2017-18 accounts for about 39 per cent, while the prevalence of stunting declines at a rate of 3.26 per cent per annum— from 51 per cent in 2004 to 31 per cent in 2017-18, indicating that the inequality of childhood stunting has not improved much yet. The value of the concentration index accounts for -0.365 in 2004 and -0.352 in 2017-18. Evidence from the most recent five rounds of BDHS indicates that the household wealth index contributes the highest (about 50 per cent) to the inequality of childhood stunting in Bangladesh, followed by wealth status. The paper suggests that investing in economic status and community-based educational programs can improve childhood malnutrition situations and, at the same time, reduce inequality. Nutrition-specific interventions such as micronutrient supplemen-tation, improved food and nutrient intake during pregnancy for low-income households, and strengthening infant and young child feeding practices might also be prioritised to tackle childhood stunting. Further, investment in health and education, employment opportunities, and empowerment of poor and disadvantageous women will be essential measures to eradicate childhood stunting and its inequality at the population level.