Epidemiol Health.  2019;41:e2019039. 10.4178/epih.e2019039.

Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015–2016)

• Mndala L
• Kudale A

• KMID: 2469441
• DOI: http://doi.org/10.4178/epih.e2019039

Abstract

OBJECTIVES
Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi.
METHODS
A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m² , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds.
RESULTS
In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43).
CONCLUSIONS
Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.

Keyword

Overweight; Obesity; Malawian non-pregnant adult women; Body mass index; Social and demographic determinants; Cross-sectional studies

MeSH Terms

Adult*
Body Mass Index
Cross-Sectional Studies*
Demography
Developing Countries
Female
Health Surveys*
Humans
Life Style
Logistic Models
Malawi*
Obesity*
Odds Ratio
Overweight*
Prevalence
Public Health
Social Class
Surveys and Questionnaires