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Gendered Effects of Siblings on Child Malnutrition in South Asia: Cross-sectional Analysis of Demographic and Health Surveys from Bangladesh, India, and Nepal

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Abstract

This study examines the effects of number and sex of siblings on malnutrition of boys and girls under-5 in South Asia. Cross-sectional analyses were conducted on Demographic and Health Surveys data on children under-5 in Bangladesh (N = 7,861), India (N = 46,655) and Nepal (N = 2,475). Data were pooled across countries, and multinomial logistic regression was used to assess the relationship between number and sex of siblings and malnutrition outcomes (wasting, stunting, underweight; based on anthropometric data), adjusting for country and key social and maternal-child health indicators in sex stratified analyses. Number of brothers increased the odds for severe wasting [1 vs. 0 brothers adjusted odds ratio (AOR) = 1.31, 95 % CI = 1.11, 1.55; 2 vs. 0 brothers AOR = 1.36, 95 % CI = 1.07, 1.73] for girls but not boys. Having more male siblings and more female siblings increased the odds of stunting for boys and girls, but effect of 3+ sisters on severe stunting was significantly stronger for girls than boys (girls- 3+ vs. 0 sisters AOR = 2.25, 95 % CI = 1.88, 2.70; boys- 3+ vs. 0 sisters AOR = 1.37, 95 % CI = 1.13, 1.67). For underweight, three or more sisters increased the odds for severe underweight for girls (AOR = 1.27, 95 % CI = 1.04, 1.57) but not boys. Having brothers heightens girl risk for acute malnutrition (wasting), where having multiple sisters increases girl risk for chronic malnutrition (stunting/underweight). Boy malnutrition is less affected by siblings. Findings suggest that issues of son preference/daughter aversion may affect child malnutrition in South Asia.

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Authors and Affiliations

  1. Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA, USA

    Anita Raj, Lotus P. McDougal & Jay G. Silverman

  2. Center on Gender Equity and Health, University of California, San Diego, CA, USA

    Anita Raj, Lotus P. McDougal & Jay G. Silverman

  3. Clinical Addiction Research and Education, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA

    Anita Raj

  4. Joint Doctoral Program in Public Health (Global Health), San Diego State University/University of California, San Diego, San Diego, CA, USA

    Lotus P. McDougal

  5. Institute of the Americas, 10111 N. Torrey Pines Rd., MC0507, La Jolla, CA, 92093-0507, USA

    Anita Raj

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  1. Anita Raj
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  3. Jay G. Silverman
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Correspondence to Anita Raj.

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Raj, A., McDougal, L.P. & Silverman, J.G. Gendered Effects of Siblings on Child Malnutrition in South Asia: Cross-sectional Analysis of Demographic and Health Surveys from Bangladesh, India, and Nepal. Matern Child Health J 19, 217–226 (2015). https://doi.org/10.1007/s10995-014-1513-0

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  • DOI: https://doi.org/10.1007/s10995-014-1513-0

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