Skip to main content

Advertisement

Log in

Analysis of the spatial patterns of malnutrition among women in Nigeria with a Bayesian structured additive model

  • Published:
GeoJournal Aims and scope Submit manuscript

Abstract

Malnutrition among women has severe consequences on their health, households and national development. The different forms of malnutrition among adult individuals are severe thinness, underweight, overweight and obesity which are usually assessed using height and weight indices calculated as body mass index (BMI). In this study, the spatial distributions of the various forms of malnutrition measured at the upper and lower tails of the BMI were accessed among women of reproductive age in Nigeria after accounting for the influence of socio-economic factors. Bayesian quantile regression that permits for inference on conditional quantiles, yielding a complete description of the functional changes among covariates at different quantiles of the response variable was adopted. Markov random field and Bayesian P-splines were used as prior distributions for the spatial and nonlinear effects respectively, while computation was based on MCMC approach. Data were derived from the 2013 Nigeria Demographic and Health Survey. Findings indicate the existence of spatial structure in the various forms of malnutrition with neighbouring states sharing similar patterns and that the socio-economic variables exact dissimilar influence on the various forms of malnutrition. The study provides valuable insights for policy makers in the quest for halting all forms of malnutrition among Nigerian women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Ahmed, T., Hossain, M., & Sanin, K. I. (2011). Maternal obesity: Implications for pregnancy outcome and long-term risks-a link to maternal nutrition. International Journal of Gynecology and Obstetrics, 115(Suppl 1), S6–S10.

    Google Scholar 

  • Ahmed, T., Hossain, M., & Sanin, K. I. (2012). Global burden of maternal and child undernutrition and micronutrient deficiencies. Annals of Nutrition and Metabolism, 61(Suppl 1), 8–17.

    Article  Google Scholar 

  • Akseer, N., Bhatti, Z., Mashal, T., Soofi, S., Moineddin, R., & Black, R. E. (2018). Geospatial inequalities and determinants of nutritional status among women and children in Afghanistan: An observational study. The Lancet Global Health, 6(4), PE447–E459.

    Article  Google Scholar 

  • Babalola, S., & Fatusi, A. (2009). Determinants of use of maternal health services in Nigeria-looking beyond individual and household factors. BMC Pregnancy and Childbirth, 9, 43.

    Article  Google Scholar 

  • Belitz, C., Brezger, A., Klein, N., Kneib, T., Lang, S., Umlauf, N. (2015). Bayesx—software for Bayesian inference in structured additive regression models, version 3.0.2. http://www.bayesx.org

  • Bharati, S., Pal, M., Bhattacharya, B. N., & Bharati, P. (2007). Prevalence and causes of chronic energy deficiency and obesity in Indian women. Human Biology, 79(4), 395–412.

    Article  Google Scholar 

  • Brezger, A., & Lang, S. (2006). Generalized structured additive regression based on Bayesian P-splines. Computational Statistics and Data Analysis, 50(4), 967–991.

    Article  Google Scholar 

  • Cesare, M. D., Bhatti, Z., Soofi, S. B., Fortunato, L., Ezzati, M., & Bhutta, Z. A. (2015). Geographical and socioeconomic inequalities in women and children’s nutritional status in Pakistan. The Lancet Global Health, 3(4), PE229–E239.

    Article  Google Scholar 

  • Denison, F. C., Roberts, K. A., Barr, S. M., & Norman, J. E. (2010). Obesity, pregnancy, inflammation, and vascular function. Reproduction, 140(3), 373–385.

    Article  Google Scholar 

  • Duda, R. B., Darko, R., Saffah, J., Adanu, R. M., Anarfi, J. K., & Hill, A. G. (2007). Prevalence of obsesity among women in Accra, Ghana. African Journal of Health Sciences, 14(3), 154–159.

    Google Scholar 

  • Fahrmeir, L., & Kneib, T. (2011). Bayesian smoothing and regression for longitudinal, spatial and event history data. Oxford statistical science series. Oxford: Oxford University Press.

    Google Scholar 

  • Gayawan, E. (2014). Spatial analysis of choice of place of delivery in Nigeria. Sexual and Reproductive Healthcare, 5(2), 59–67.

    Article  Google Scholar 

  • Gayawan, E., Adebayo, S. B., Komolafe, A. A., & Akomolafe, A. A. (2017). Spatial distribution of malnutrition among children under five in Nigeria: A Bayesian quantile regression approach. Applied Spatial Analysis and Policy. https://doi.org/10.1007/s12061-017-9240-8.

    Article  Google Scholar 

  • Gewa, C. A., Leslie, T. F., & Pawloski, L. R. (2013). Geographic distribution and socio-economic determinants of women’s nutritional status in Mali households. Public Health Nutrition, 16(9), 1575–1585.

    Article  Google Scholar 

  • Griffiths, P., & Bentley, M. (2005). Women of higher socio-economic status are more likely to be overweight in Karnataka, India. European Journal of Clinical Nutrition, 59(10), 1217–1220.

    Article  Google Scholar 

  • Haile, D., Azage, M., Mola, T., & Rainey, R. (2016). Exploring spatial variations and factors associated with childhood stunting in Ethiopia: Spatial and multilevel analysis. BMC Pediatrics, 16, 49.

    Article  Google Scholar 

  • Hong, X., & Ye, X. (2018). Exploring the influence of land cover on weight loss awareness. GeoJournal, 83(5), 935–947.

    Article  Google Scholar 

  • Kamal, M., & Islam, M. A. (2010). Socio-economic correlates of malnutrition among married women in Bangladesh. Malasia Journal of Nutrition, 16(3), 349–359.

    Google Scholar 

  • Kandala, N. B., Fahrmeir, L., Klasen, S., & Priebe, J. (2009). Geo-additive models of childhood undernutrition in three sub-Saharan African countries. Population, Space and Place, 15(5), 461–473.

    Article  Google Scholar 

  • Kandala, N. B., & Stranges, S. (2014). Geographic variation of overweight and obesity among women in Nigeria: A case for nutritional transition in sub-Saharan Africa. PLoS ONE, 9(e101), 103.

    Google Scholar 

  • Kitsantas, P., & Pawloski, L. R. (2010). Maternal obesity, health status during pregnancy, and breastfeeding initiation and duration. The Journal of Maternal-Fetal and Neonatal Medicine, 23(2), 135–141.

    Article  Google Scholar 

  • Koenker, R., & Bassett, J. G. (1978). Regression quantiles. Econometrica, 46(1), 33–50.

    Article  Google Scholar 

  • Lang, S., & Brezger, A. (2004). Baysian P-splines. Journal of Computational and Graphical Statistics, 13(1), 183–212.

    Article  Google Scholar 

  • Letamo, G., & Navaneetham, K. (2014). Prevalence and determinants of adult under-nutrition in Botswana. PLoS ONE, 9(e102), 675.

    Google Scholar 

  • Liu, J., Smith, M. A., & Ferguson, J. E. (2010). Maternal obesity and breast-feeding practices among white and black women. Obesity: A Research Journal, 18(1), 175–182.

    Article  Google Scholar 

  • Monda, K. L., Adair, L., Zhai, F. G., & Popkin, B. (2008). Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China. European Journal of Clinical Nutrition, 62(11), 1318–1325.

    Article  Google Scholar 

  • Mtambo, O. P. L., Masangwi, S. J., & Kazembe, L. M. (2015). Spatial quantile regression using INLA with applications to childhood overweight in Malawi. Spatial and Spatio-temporal Epidemiology, 13, 7–14.

    Article  Google Scholar 

  • Muller, O., & Krawinkel, M. (2005). Malnutrition and health in developing countries. Canadian Medical Association Journal, 173(3), 279–286.

    Article  Google Scholar 

  • Normal, J. E., & Reynolds, R. (2011). The consequences of obesity and excess weight gain in pregnancy. Proceedings of the Nutrition Society, 70(4), 450–456.

    Article  Google Scholar 

  • NPC, & ICF International. (2014). Nigeria demographic and health survey 2013. National Population Commission [Nigeria] and ICF International, Abuja, Nigeria and Rockville, Maryland, USA.

  • Popkin, B. M. (1993). Nutrition patterns and transition. Population and Development Review, 19(1), 138–157.

    Article  Google Scholar 

  • Popkin, B. M. (1998). The nutrition transition and its health implications in lower-income countries. Public Health Nutrition, 1(1), 5–21.

    Article  Google Scholar 

  • Rossington, C. E. (1981). Environmental aspects of child growth and nutrition: A case study from Ibadan, Nigeria. GeoJournal, 5(4), 347–356.

    Article  Google Scholar 

  • Samouda, H., Ruiz-Castell, M., Bocquet, V., Kuemmerle, A., Chioti, A., Dadoun, F., et al. (2018). Geographical variation of overweight, obesity and related risk factors: Findings from the European health examination survey in Luxembourg. PLoS ONE, 13(e0197), 021.

    Google Scholar 

  • Sobal, J., & Stunkard, A. J. (1989). Socioeconomic status and obesity: A review of the literature. Psychological Bulletin, 105(2), 260–275.

    Article  Google Scholar 

  • Tchicaya, A., & Lorentz, N. (2012). Socioeconomic inequality and obesity prevalence trends in Luxembourg, 1995–2007. BMC Research Notes, 5, 467.

    Article  Google Scholar 

  • Tebekaw, Y., Teller, C., & Colon-Ramos, U. (2014). The burden of underweight and overweight among women in Addis Ababa, Ethiopia. BMC Public Health, 14, 1126.

    Article  Google Scholar 

  • Tomkins, A. (2001). Nutrition and maternal morbidity and mortality. British Journal of Nutrition, 85(Suppl 2), S93–S99.

    Article  Google Scholar 

  • UNICEF. (2009). Tracking progress on child and maternal nutrition: A survival and development priority. New York: United Nations Children Fund.

    Google Scholar 

  • Uyanga, J. (1981). The regional correlates of child nutrition in rural Southeastern Nigeria. GeoJournal, 5(4), 331–338.

    Article  Google Scholar 

  • Waldmann, E., Kneib, T., Yue, Y. R., Lang, S., & Flexeder, C. (2013). Bayesian semiparametric additive quantile regression. Statistical Modelling, 13, 223–252. https://doi.org/10.1177/1471082X13480650.

    Article  Google Scholar 

  • WHO. (2017). Malnutrition: Fact sheet. Geneva: World Health Organization.

    Google Scholar 

  • Yadav, A., Ladusingh, L., & Gayawan, E. (2015). Does a geographical context explain regional variation in child malnutrition in India? Journal of Public Health, 23(5), 277–287.

    Article  Google Scholar 

  • Yu, K., & Moyeed, R. A. (2001). Bayesian quantile regression. Statistics and Probability Letters, 54(4), 437–447.

    Article  Google Scholar 

  • Yue, Y., & Rue, H. (2011). Bayesian inference for additive mixed quantile regression models. Computational Statistics and Data Analysis, 55(1), 84–96.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported with a grant from UNICEF’s Nigeria Country office but the design, analysis and interpretation of results were carried out by the authors without any role by UNICEF. We appreciate Measure DHS for granting access to the data and useful comments from Elisabeth Waldmann on Bayesian quantile regression.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ezra Gayawan.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to declare.

Ethical Standard

The data used in this study was obtained from The DHS Program (https://dhsprogram.com), who was the main partner that conducted the survey, after approval was given to our request.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Akeresola, R.A., Gayawan, E. Analysis of the spatial patterns of malnutrition among women in Nigeria with a Bayesian structured additive model. GeoJournal 85, 81–92 (2020). https://doi.org/10.1007/s10708-018-9958-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10708-018-9958-0

Keywords

Navigation