Spatial Differences in Diet and Determinants of Diet Quality in Bangladesh: Results from the Household Income and Expenditure Survey 2016

Abstract

Objective: The study explored the spatial differences in diet and the association of sociodemographic characteristics with diet quality at the household level in Bangladesh based on the household income and expenditure survey (HIES) data of 2016. Methodology: It was a secondary data analysis of the cross-sectional survey data of HIES 2016. Both statistical and spatial analyses were applied to assess both diet quantity and quality while evaluating diet qualities in terms of the household dietary diversity score (HDDS), percentage of food energy from staples (PFES), and percentage of expenditure on food (PEF) as an indicator of the economic vulnerability to food insecurity (EVFI). The study was conducted using RStudio, STATA, and ArcGIS software. Results: The study showed the national per household food energy intake (median) was around 7959 kcal. Additionally, the micronutrient intake (median) per household per day was approximately 1710 mg of calcium, 97 mg of iron, 47 mg of zinc, and 1140 mcg of vitamin A. The mean consumption was highest in rural and lowest in the city 2016 Bangladesh, respectively, for food energy, iron, and zinc per household per day. The food energy inadequacy (FEI) was about 61% overall in Bangladesh in 2016, with the highest FEI at about 74% in the Barishal division. The FEI was the highest (78%) in the city area. Southeastern parts of the country were found to be more affected by inadequate food energy intake. Inadequate calcium and vitamin A intakes dominated throughout the country affecting about 80% of the households nationally. Calcium inadequacy was the highest in Sylhet division (87.8%) and vitamin A inadequacy was also highly prevalent in Sylhet (92%). Inadequate calcium intake is prevalent in more than 80% of iii the households in the subdistricts of the peripheral parts of the country, especially in the south-east, south-west and north-east sub-districts. Inadequate Vitamin A intake was highly prevalent (affecting >80% of the households) southern, north-east and northwestern parts of the country. The analyzed outcome of diet qualities showed that the average HDDS was about 6.3 in Bangladesh. The national average PFES per household per day was about 70% in the study period, with the highest intake in the Rangpur division at about 77% and the lowest at about 64% in the Chittagong division. The result of consumed PFES also showed that the households with inferior diet quality were highest in the rural areas (about 30%) and none in the city of Bangladesh. The spatial distribution of HDDS and PFES showed that rural regions in settlements and the north, northwest, and southeast regions had mostly low diet diversity. Besides, the average PEF per household per day was about 54%, with the highest in Mymensingh (57.4%) and the lowest in the Dhaka division (50.2%). The average PEF in the households illustrated was highest in rural (55.2%) and lowest in the city (45.7%). Overall, based on the PEF at the sub-district level, the medium level of vulnerability comprised the highest share (69%) in Bangladesh. The mean PEF in the households illustrated highest in rural and lowest in the city. Age, gender, literacy, educational qualification, and religion of the household's head, along with the number of earners, monthly income, area of settlements, and divisions, were significantly correlated with HDDS, PFES, and EVFI. Conclusion: The study findings suggest that targeted interventions, including access to education, women empowerment, and employment generation programs should be implemented in peripheral areas (north, northwest, and southeast) to increase diet quantity and quality and minimize economic vulnerability to achieve sustainable food and nutrition security in Bangladesh.