Prevalence and determinants of underweight among children in the Myanmar-China border region: A cross-sectional study
DOI:
https://doi.org/10.62992/6zmxj826Keywords:
Kachin state, GLMM, Under-5 children, UnderweightAbstract
Background: Underweight in children remains a significant nutritional problem in low- and middle-income countries, affecting growth and development. It is linked to higher risks of infections, developmental delays and long-term cognitive impairments.
Objectives: This study aimed to identify the prevalence and determinants of underweight along the Myanmar-China border of Kachin state, Myanmar where socio-political instability and limited resources exacerbate the problem.
Methods: This cross-sectional analytical study was conducted from April 2024 to March 2025 in the Myanmar-China border region of Kachin State, focusing on children aged 6-59 months. A multistage random sampling method was used to enrol the study population. Data collection took place after getting ethical approval. A Generalized Linear Mixed Model (GLMM) was utilized to investigate factors associated with underweight.
Results: Among the 518 children studied, the prevalence of underweight was 17.8% (95% CI: 14.70-21.30). Several significant factors were associated to children being underweight including birth weight, vaccination completion by 18 months, household size (specifically, having ≥2 children under five years old), the father's level of education, birth interval and waste management practices. Multivariable analysis revealed that children in households with ≥2 children under five (AOR: 1.99, 95% CI: 1.07-3.70), mothers engaged in farming (AOR: 2.67; 95% CI: 1.33–5.37), a shorter birth interval of <2 years (AOR: 2.08, 95% CI: 1.19-3.65) and inadequate waste disposal (AOR: 2.07, 95% CI: 1.17-3.64) were at greater risk of being underweight.
Conclusion: Almost one-fifth of children in the Myanmar-China border region were underweight with higher risks associated to households with ≥2 children under five, mother who were farmers and shorter birth intervals. Inadequate garbage disposal was also strongly associated with increased odds of being underweight. This highlights the need to address household dynamics and sanitation practices to reduce the prevalence of underweight children in the region.
References
WHO. Malnutrition 2024 [Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition.
WHO. Nutrition 2024 [Available from: https://www.who.int/health-topics/nutrition#tab=tab_2.
Govender I, Rangiah S, Kaswa R, Nzaumvila D. Malnutrition in children under the age of 5 years in a primary health care setting. South African family practice : official journal of the South African Academy of Family Practice/Primary Care. 2021;63(1):e1-e6.
Alemayehu GM, Cherie KT, Chernet AG. Severity of malnutrition among underweight children and family-related factors: A cross-sectional analysis of data from the 2019 Ethiopian Demographic and Health Survey (EDHS). Health Sci Rep. 2022;5(6):e860.
Cuntz U, Quadflieg N, Voderholzer U. Health Risk and Underweight. Nutrients. 2023;15(14).
De P, Chattopadhyay N. Effects of malnutrition on child development: Evidence from a backward district of India. Clinical Epidemiology and Global Health. 2019;7(3):439-45.
Tamir TT, Zegeye AF, Workneh BS, Mekonen EG. Underweight and associated factors among children under age of five in low and lower-middle income African countries: hierarchical analysis of demographic and health survey data. Frontiers in Public Health. 2024;12.
Adhikari D, Khatri RB, Paudel YR, Poudyal AK. Factors Associated with Underweight among Under-Five Children in Eastern Nepal: Community-Based Cross-sectional Study. Front Public Health. 2017;5:350.
Islam SMD-U, Mondal PK, Ojong N, Bodrud-Doza M, Siddique MAB, Hossain M, et al. Water, sanitation, hygiene and waste disposal practices as COVID-19 response strategy: insights from Bangladesh. Environment, Development and Sustainability. 2021;23(8):11953-74.
Chowdhury TR, Chakrabarty S, Rakib M, Saltmarsh S, Davis KA. Socio-economic risk factors for early childhood underweight in Bangladesh. Globalization and Health. 2018;14(1):54.
Mon TS, Payakkaraung S, Rungamornrat S. Factors Predicting Chronic Malnutrition Among Young Children in Myanmar. Journal of Population and Social Studies [JPSS]. 2023;31:637-51.
MIMU. Kachin state information 2024 [Available from: https://themimu.info/states_regions/kachin.
Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Statistics in medicine. 1998;17(14):1623-34.
Hein AK, Hong SA, Puckpinyo A, Tejativaddhana P. Dietary diversity, social support and stunting among children aged 6–59 months in an internally displaced persons camp in Kayin state, Myanmar. Clinical nutrition research 2019;8(4):307-17.
Dereń K, Nyankovskyy S, Nyankovska O, Łuszczki E, Wyszyńska J, Sobolewski M, et al. The prevalence of underweight, overweight and obesity in children and adolescents from Ukraine. Scientific reports. 2018;8(1):3625.
Li H, Yuan S, Fang H, Huang G, Huang Q, Wang H, et al. Prevalence and associated factors for stunting, underweight and wasting among children under 6 years of age in rural Hunan Province, China: a community-based cross-sectional study. BMC Public Health. 2022;22(1):483.
Nigatu G, Assefa Woreta S, Akalu TY, Yenit MK. Prevalence and associated factors of underweight among children 6–59 months of age in Takusa district, Northwest Ethiopia. International journal for equity in health. 2018;17:1-8.
John JM, John JS. Prevalence and risk factors associated with underweight among under-five children in a rural area of Puducherry. Muller Journal of Medical Sciences and Research. 2018;9(1):7-11.
Kumar R, Abbas F, Mahmood T, Somrongthong R. Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan. BMJ open. 2019;9(7):e028972.
Koetaan D, Smith A, Liebenberg A, Brits M, Halkas C, Van Lill M, et al. The prevalence of underweight in children aged 5 years and younger attending primary health care clinics in the Mangaung area, Free State. African Journal of Primary Health Care and Family Medicine. 2018;10(1):1-5.
Wakeyo MM, Kebira JY, Assefa N, Dheresa M. Short birth interval and its associated factors among multiparous women in Mieso agro-pastoralist district, Eastern Ethiopia: A community-based cross-sectional study. Front Glob Womens Health. 2022;3:801394.
Rana MJ, Gautam A, Goli S, Uttamacharya, Reja T, Nanda P, et al. Planning of births and maternal, child health, and nutritional outcomes: recent evidence from India. Public Health. 2019;169:14-25.
Ahmmed F, Hasan MN, Hossain MF, Khan MTF, Rahman MM, Hussain MP, et al. Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach. BMJ Paediatr Open. 2024;8(1).
Tiwari R, Ausman LM, Agho KE. Determinants of stunting and severe stunting among under-fives: evidence from the 2011 Nepal Demographic and Health Survey. BMC Pediatrics. 2014;14(1):239.
Ifad U. The state of food security and nutrition in the world 2017: FAO;; 2017.
Essilfie G, Kofinti RE, Asmah EE. Reducing stunting and underweight through mother’s birth spacing: evidence from Ghana. BMC Pregnancy and Childbirth. 2024;24(1):624.
Seidu AA, Hagan Jnr JE, Budu E, Aboagye RG, Okyere J, Sakyi B, et al. High-risk fertility behaviour and undernutrition among children under-five in sub-Saharan Africa: a cross-sectional study. BMJ Open. 2023;13(6):e066543.
Akombi BJ, Agho KE, Hall JJ, Wali N, Renzaho AMN, Merom D. Stunting, Wasting and Underweight in Sub-Saharan Africa: A Systematic Review. Int J Environ Res Public Health. 2017;14(8).
WHO. Birth spacing — report from a WHO technical consultation. 2006.
Patlán-Hernández AR, Stobaugh HC, Cumming O, Angioletti A, Pantchova D, Lapègue J, et al. Water, sanitation and hygiene interventions and the prevention and treatment of childhood acute malnutrition: A systematic review. Matern Child Nutr. 2022;18(1):e13257.
Sukoco NEW, Usman Y, Putro G, Hidayangsih PS. The Association of Household Garbage Management and Socioeconomic with Underweight in Children Under Five in Lebak District and Tangerang City, Banten, Indonesia. Global Journal of Health Science. 2021;13(9):1-90.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
International Journal of Public Health Asia Pacific (IJPHAP) is licensed under a Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 international (CC BY-NC-ND 4.0) license, unless otherwise stated. Please read our Policies page for more information on Open Access, copyright, and permissions.
