Determinants of Nutritional Status among School-Going Children in Rural Bangladesh

ABSTRACT Background Malnutrition in childhood is a significant global health crisis that has a serious impact on children, families, society, and has negative effects on development. Therefore, this study aimed to evaluate the prevalence as well as the associated factors of nutritional status among school-going children in the rural Bangladesh. Methods A cross-sectional study was conducted among 370 schoolchildren (6–12 years) in Burichang Upazila, Cumilla from May to June 2025. Nutritional status was assessed using body mass index (BMI)-for-age z-scores according to WHO 2007 reference standards. Associations between factors were evaluated using chi-square tests Fisher’s exact test. Independent predictors were identified through ordinal logistic regression (proportional odds model). Results The prevalence of underweight, normal weight, and overweight was 20.8%, 62.2%, and 17%, respectively. Consumption of fruits and vegetables, sugary drink intake, access to sanitation facilities, hand-washing with soap, and child awareness were significantly associated with nutritional status. Children from families with a monthly income between 10,000 and 20,000 BDT were 1.73 times more likely to be underweight compared to those from families earning more than 30,000 BDT (OR = 1.739; 95% CI: 1.057–2.861; p = 0.029). Children whose fathers had secondary/higher secondary education had 54.2% lower odds of being underweight compared to those whose fathers had no formal education (OR = 0.458; 95% CI: 0.254–0.826; p = 0.009). Similarly, children whose mothers had graduate/postgraduate education (OR = 0.244; 95% CI: 0.073–0.812; p = 0.022) and secondary/higher secondary education (OR = 0.280; 95% CI: 0.093–0.850; p = 0.025) had significantly lower odds of being underweight compared to children whose mothers had no formal education. Children who were not aware of healthy eating habits had 2.04 times higher odds of being underweight compared to those who were aware (OR = 2.035; 95% CI: 1.310–3.160; p = 0.002). Conclusions Malnutrition is prevalent among rural school-going children in Bangladesh, with parental income and education as key determinants, along with dietary diversity, hygiene practices, and nutrition awareness. The findings highlight the need to improve household socioeconomic conditions, particularly parental education and income, alongside strengthening nutrition and hygiene education to reduce malnutrition.