Factors affecting social determinants of female adolescent malnutrition in Bangladesh

Tazkia Tarannum

(She/Her)

Faculty of Medical & Life Sciences

Queen Mary, University of London

I am a medical doctor and I have served in national, international and UN organisations in varying capacity e.g district trainer and monitoring specialist in a national nutrtion programme in Bangladesh funded by unicef and national consultant for COVID-19 vaccination with WHO Bangladesh.
Bangladeshi

Overview

Understanding and emphasising on social determinants of healths and inequality is as important as focusing on biological or clinical causes of female adolescent malnutrition especially in lower middle income countries like Bangladesh which can have both undernutrition and overnutrition. Tackling malnutrition should be

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Key Findings

    How to apply research

    • Investigate the local contexts of the population that malnutrition programs aim to affect. The differences in the contexts, local religions, family dynamics, income etc. all impact malnutrition.In order to tackle malnutrition, poverty and gender inequality will also have to be tackled as these factors can individually or collectively cause malnutrition.
    • Bangladesh seems to have fairly good policies to tackle adolescent malnutrition. Much of it have been updated after this paper has been written.However the implementation of the policies and their monitoring should be the priority for Bangladesh Government.Also improving coordination among different partners/ministries is crucial to approach social determinants of female adolescent malnutrition in Bangladesh. Collective efforts from all sector can tackle malnutrition more efficiently
    • There should be more research conducted on adolescent malnutrition in Bangladesh and worldwide.There are currently large gaps in research which make it difficult to understand the larger context and information regarding malnutrition.Investigating impact of seasonal variation, dietary diversification on malnutrition, variation in factors affecting adolescent malnutrition in remote area, rural, urban area etc will give more insight in solving malnutrition and related complications
    • Do not just focus on female malnutrition as male malnutrition is also an issue.

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    About this research

      This research was independently conducted and did not receive funding from outside of the university.

      Recommended for

      About this research

        This research was independently conducted and did not receive funding from outside of the university.

        Recommended for

        What findings means

        This paper proved female adolescent malnutrition in Bangladesh requires further exploration from a social determinants point of view. Treating social determinants of female adolescent malnutrition as a fundamental cause requires more importance.

        To find out the factors affecting female adolescent malnutrition in Bangladesh, contextualizing the situation of female adolescents is imperative. Individual risk factors cannot be addressed if they are embedded into the context of a specific set of social norm. A literature review proved existent inequality in the social determinants is capable of killing the affected ones just like their biological counterparts.

        One of the most relevant findings of the paper was that among the 10 most important factors that contribute to adolescent malnutrition- being female and being poor subject female adolescents to the worst outcome of malnutrition. Other factors like literacy of parents, age of marriage etc were capable of causing malnutrition individually as well as by influencing other factors.

        Understanding how these factors affect adolescent malnutrition requires their positioning within the various cultural and societal contexts of Bangladesh. Thus, any programs to promote better nutrition should consider these contexts.

        Also Bangladesh needs to focus on including all adolescents in their nationally representative database.This paper showed Bangladesh’s national demographic surveys did not completely include nutritional status of adolescents.No data on Rohingya adolescents, marginalised tribal adolescents were included in the national surveys.

        Methodology

        Qualitative study using quasi systematic review. This method can be employed when the research question was broad. The sample size was 15 academic papers out of 1259 papers which were initially chosen based on Boolean search, inclusion and exclusion criteria. Out of the 15 papers 7 papers were from 4 academic databases and 8 papers from google scholar. Among the four academic databases Pubmed, Web of Science focuses on clinical and biomedical literature while JSTOR and Scopus include academic papers on social science.

        Due to the lack of research in Bangladesh on the topic of adolescent malnutrition, the scoping of the literature could be a major limitation.

        Glossary

        ConceptDefinition
        PovertyThis was a common theme found in all of the seven studies. Adolescents belonging to low socio-economic status and victims of poverty had higher percentages of stunting, wasting, thinness and micro-nutrient deficiencies. Studies proved, these affected the older, ever married or pregnant adolescents and subjected them to anaemia. Being poor but living in urban city also caused malnutrition though a number of studies showed urban adolescents are less prone to malnutrition. Literature has shown adolescents belonging to disadvantaged social position were more prone to be stunted. Stunting and underweight was caused by poverty in tribal adolescents in Bangladesh as demonstrated by others work too. Lower social position is a risk factor for being underweight in rural women which is a similar finding in many literature as well as this
        Female adolescent malnutrition owing to patriarchal societySocially, culturally and religiously Bangladesh is a male dominated society. Studies proved it’s a hugely patriarchal society.Thus, sometimes fails to give equal attention to growing adolescents where both the boys and the girls have increased requirement for nutrition due to growth spurt. Especially when girls are married off many families expect them to become pregnant right away not considering the risks and their increased nutritional demand. Cultural and social causes, affect the female adolescents in a worse way than adolescent males. Furthermore, limited autonomy of female adolescents put them higher risk of malnutrition
        Maternal educationMaternal education protected against malnutrition especially as educated mothers have more decision making power.This finding was consistent with findings from literature review, however, impact of paternal education was not seen very rarely, hence it is difficult to say whether it may aid in preventing malnutrition

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        Want to read the full paper? It is available open access

        Tarannum, T. (2019). Factors affecting social determinants of female adolescent malnutrition in bangladesh.