Abstract
Background: Double burden of malnutrition (DBM) is a complex nutritional phenomenon, where an individual or a household simultaneously face two contradictory forms of nutritional adversities. Studies on assessing the prevalence, trends, and determinants of DBM at household in Pakistan are scarce, so this study measured the prevalence, trends, and determinants of DBM at household level using nationally representative datasets. Methods: Data of last two waves of Demographic and Health Surveys (DHS) of Pakistan conducted in 2012-2013 and 2017-2018 were used to assess the DBM prevalence, trends, and determinants at the household level. Data of mother-child dyads aged between 15 and 49 years and 0 and 59 months was included, while data with incomplete anthropometry or anthropometric outliers was excluded. Results: Across two survey periods, there has been a significant decrease in pediatrics stunting from 45% to 37.3%, while a rapid proliferation of maternal obesity from 45% to 52.3% was reported. Similarly, the prevalence of DBM at household level was 17.3% in 2012-2013, which increased to 18.9% in 2017-2018. Among different provinces of Pakistan, Baluchistan, Khyber Pakhtunkhwa (KPK) and Federally Administered Tribal Areas (FATA) have significantly higher prevalence of DBM at household than Islamabad Capital Territory (ICT). Factors such as child age, birth order, and socioeconomic status were significantly associated with DBM in Pakistani households. Conclusion: DBM in Pakistan is a complex and chronic challenge, which affects almost one-fifth of households. There is need to urgently address the issues of DBM and to improvise nutrition specific and nutrition sensitive interventions to curtail the issues pertaining to DBM at household.