Estimation of child under-nutrition at disaggregated administrative tiers of Sunamganj District in Bangladesh: An application of small area estimation method

Children of Sunamganj district located in the north-eastern part of Bangladesh are highly vulnerable to undernutrition and chronic food insecurity due to its geographic location, long-time waterlog, frequent flash floods, and underdeveloped infrastructure. In this study, child undernutrition indicators stunting and underweight are estimated at district, sub-district (Upzila) and union level administrative tiers of Sunamganj district employing the World Bank small area estimation (SAE) method to a Sunamganj household level survey data collected in 2018 and the census 2011 data of Sunamganj. District level prevalence of stunting and underweight are estimated as about 48.5% (95% CI: 45.3–51.7%) and 37.0% (95% CI: 34.6–39.8%) based on the SAE method. At upzila level, stunting varied from 41.0% to 54.9% and underweight varied from 24.0% to 53.4%; while the indicators varied over 19.5–59.7% and 20.2–56.8% respectively at union level. A significant number of unions are found as hotspots of higher underweight and stunting over the north, north-eastern and north-western parts of Sunamganj. Though the southern part of Sunamganj was homogeneous in the upzila level maps of stunting and underweight; significant number of heterogeneous unions are found in the union-level maps. The upzilas belong to the northern part particularly closer to the Indian border and haor areas are mostly vulnerable to stunting and underweight. The study findings on disaggregate level prevalence of stunting and underweight might help the concerned government and non-government organizations to prepare and implement aid-related programs on public health and nutrition.