Double Burden of Malnutrition and Its Associated Factors at Household Level among Indigenous Communities in Sarawak

Yolanda Anak, Salleh (2024) Double Burden of Malnutrition and Its Associated Factors at Household Level among Indigenous Communities in Sarawak. Masters thesis, UNIMAS.

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Abstract

The increasing trend obesity in adults and persisting stunting in children remains a public health concern in Malaysia. However, information on the coexistence of this contrasting form of malnutrition called the double burden of malnutrition (DBM) among the indigenous communities in Sarawak is scarce. To not neglect the health of indigenous people, this cross-sectional study aims to determine the household-level DBM and its associated factors among the indigenous communities in Sarawak. Total of 286 mother-child pairs were recruited via multistage random sampling from six divisions in Sarawak. Using interviewer-administered questionnaires, demographic, socioeconomic, and food security status were collected. Two days 24-hour dietary recall for both mother and child were obtained to determine dietary intake, and to compute for Malaysian Healthy Eating Index (M-HEI) to assess dietary quality. Height and weight were measured following standard guidelines. Household with an overweight or obese mother with an undernourished child, who is either underweight, stunting or wasting is classified as DBM. Simple and multiple binary logistic regression analysis were performed to determine associated factors to DBM. In this study, 25.2% of the households had DBM, of which 12.9% were overweight/obese mother with a stunting child, 11.9% were overweight/obese mother with a wasting child, and 9.4% were overweight/obese mother with an underweight child. Younger maternal age, larger household size and higher household income per capita were associated with higher odds of DBM. In contrast, higher monthly non-food expenses and higher child M-HEI fish and seafood score were associated with lower odds of DBM. Further research is warranted to better understand the determinants associated with DBM among the indigenous communities in Sarawak.

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