SEARCHCROSS-SECTIONALpublic health, epidemiology

cross-sectional·public health, epidemiology, nutrition, clinical nutrition, pediatrics·PMC10625300

Nutrition transition, double burden of malnutrition, and urbanization patterns in secondary cities of Bangladesh, Kenya and Rwanda

BMC Nutrition · 13 authors, 8 centres

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TL;DR

A cross-sectional survey of approximately 1200 households in six secondary cities across Bangladesh, Kenya, and Rwanda assessed food insecurity, dietary diversity, and nutritional status. The study found a high double burden of malnutrition, with high stunting and overweight rates, which was worsened by the COVID-19 pandemic.

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812 CHARS

This cross-sectional study collected data from about 1200 urban and peri-urban households in six secondary cities across Bangladesh, Kenya, and Rwanda in 2021. The study used household questionnaires, dietary recalls for women of reproductive age, anthropometric measurements, and health record reviews to assess food insecurity, dietary diversity, and nutritional status. The central result was a high double burden of malnutrition. Stunting in children under 5 ranged from 7.8% to 46.6%, while overweight was present in 42.1% to 55.8% of adult women. Food insecurity increased significantly during the COVID-19 pandemic, affecting over 99% of households in Rwandan cities. The study is limited by its cross-sectional design, which cannot establish causation, and potential recall bias for pre-COVID conditions.

STUDY TYPE

cross-sectional

SPECIALTY

public health

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AI pipeline

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ORIGINAL PAPER

PMC10625300

Nutrition transition, double burden of malnutrition, and urbanization patterns in secondary cities of Bangladesh, Kenya and Rwanda

BMC Nutrition

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ABSTRACT

Background By 2050, approximately 68% of the global population will live in cities, but nutrition data on urban populations of low- and middle-income countries are scarce. Fast growing secondary cities, combining characteristics and hurdles of urban and rural settings, are hotspots for the double burden of malnutrition. The Nutrition in City Ecosystems (NICE) project focuses on 6 secondary cities in Bangladesh, Kenya and Rwanda, to improve health and nutrition, and reduce poverty. To assess the baseline situation and guide future interventions, food insecurity, dietary diversity, nutrition status, and food production and purchasing patterns were explored. Methods In a cross-sectional study design, data were collected from urban and peri-urban households of Dinajpur and Rangpur in Bangladesh, Bungoma and Busia in Kenya, and Rubavu and Rusizi in Rwanda. Approximately 1200 households, in neighborhoods prone to malnutrition, were involved from April to June 2021. We assessed Household Food Insecurity Access Score (HFIAS), both current and before COVID-19, Household Dietary Diversity Score (HDDS), Minimum Dietary Diversity for Women (MDD-W), anthropometric measurements, household and socioeconomic information, and questions related to food production and consumer behavior. Further we collected secondary data on low birthweight and anemia during pregnancy. Results All cities experienced a substantial increase in food insecurity during the COVID-19 pandemic. Stunting rates in children under 5 years varied among the cities and ranged from 7.8% in Busia to 46.6% in Rubavu, while half of adult women were overweight (between 42.1% in Rusizi and 55.8% in Bungoma). Furthermore, many women did not consume an adequately diverse diet (MDD-W < 5 for 29.3% in Bangladesh, 47.5% in Kenya, and 67.0% in Rwanda), however many of the urban and peri-urban households were engaged in farming (58–78%). Conclusions The double burden of malnutrition is high in secondary cities and the COVID-19 pandemic has exacerbated levels of food insecurity. Demand for, and access to, an affordable healthy diverse diet that comprises local, nutritious, and agroecologically produced foods present a pathway for overcoming the complex challenges of malnutrition.

CITATION EXPORT

Tanja Barth-Jaeggi, Cornelia Speich, Cassien Havugimana et al.. Nutrition transition, double burden of malnutrition, and urbanization patterns in secondary cities of Bangladesh, Kenya and Rwanda. BMC Nutrition. (2023). https://doi.org/10.1186/s40795-023-00782-1

AUTHORS

13 · 8 CENTRES

Tanja Barth-Jaeggi, Cornelia Speich, Cassien Havugimana, Francine Bayisenge, Simon Kimenju, Wilfred Omondi, S. Fuad Pasha, Shahidul Islam, Kesso Gabrielle van Zutphen-Küffer, Sophie van den Berg, Dominique Barjolle, Marnie Pannatier, Helen Prytherch

1https://ror.org/03adhka07grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Allschwil, Switzerland
2https://ror.org/02s6k3f65grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
3Swiss TPH, Kigali Office, Kigali, Rwanda
4Kula Vyema Centre of Food Economics, Nairobi, Kenya
5Mitra and Associates, Dhaka, Bangladesh
6https://ror.org/01htfbe02grid.491408.0Sight and Life, Kaiseraugst, Switzerland
7https://ror.org/05a28rw58grid.5801.c0000 0001 2156 2780ETH Zurich, Zurich, Switzerland
8https://ror.org/046ec5t14grid.481455.90000 0001 2203 6926Syngenta Foundation for Sustainable Agriculture, Basel, Switzerland