Association between household food production diversity and minimum dietary diversity of women in rural Bangladesh: A secondary analysis from BIHS 2018-19

Abstract

Background: Despite advances in food production in the last decade, rural Bangladeshi women of reproductive age (15-49 years) still suffer from micronutrient deficiency due to inadequate dietary diversity. A growing number of literatures suggest a positive association between production diversity and dietary diversity of women in rural Bangladesh. However, evidence from Bangladesh remains limited on the association between production diversity and dietary diversity indicators, particularly at a national scale. This knowledge gap has important implications for national nutrition and agriculture policies and programmes. Objectives: To investigate the association between household food production diversity and the dietary diversity among women of reproductive age 15-49 years in rural Bangladesh. Methods: A quantitative, cross-sectional study was done using the data from the third round of Bangladesh Integrated Household Survey (BIHS, 2018-19). Non-pregnant, non-lactating rural women of reproductive age 15-49 years were included for the analyses (n=3687) with complete dietary, production and household level data. Women’s dietary diversity was measured by Minimum Dietary Diversity of women (MDD-W) and dietary diversity score (WDDS). Production diversity was measured by Minimum Food Group Production Diversity (MFGPD) and Food Group Production Diversity Score (FGPDS) based on the same 10 food group as MDD-W. The survey weighted descriptive, bivariate and multivariate regression analyses were done to assess the association between dichotomous minimum food group production diversity with Minimum Dietary Diversity, whereas a secondary analysis using their continuous counterparts was done to assess robustness. Results: The dietary diversity was low among the women in rural Bangladesh, with only 37% women achieving minimum dietary diversity with a mean score of 4.24. However, household food group-based production diversity was positively associated with dietary diversity, though the strength of the association was modest. Factors such as gender of the household head, household size, and wealth index were significant predictors of dietary diversity in both models, with land type and women’s education emerging as additional significant predictors in secondary analysis. Conclusions: Food consumption diversity among women in rural Bangladesh is low, suggesting persistent inadequate micronutrient intake. The relationship between dietary diversity of women and household food-group production diversity was positive but modest. This suggests that household food production diversification is not enough to enhance women's nutritional status. An integrated approach is required, and nutrition-sensitive agriculture programmes should combine production diversification with efforts to improve other associated factors, including women's access to nutritious foods, household consumption of produced foods, market access, financial affordability and women's involvement in food decision making.