Predicting nutritional status for women of childbearing age from their economic, health, and demographic features: A supervised machine learning approach

Abstract

Background Malnutrition imposes enormous costs resulting from lost investments in human capital and increased healthcare expenditures. There is a dearth of research focusing on the prediction of women’s body mass index (BMI), and the malnutrition outcomes (underweight, overweight and obesity) in developing countries. This paper attempts to fill out this knowledge gap by predicting the BMI and the risks of malnutrition outcomes for Bangladeshi women of childbearing age from their economic, health, and demographic features. Methods Data from the 2017-18 Bangladesh Demographic and Health Survey and a series of supervised machine learning (SML) techniques are used. Additionally, this study circumvents the imbalanced distribution problem in obesity classification by utilizing an oversampling approach. Results Study findings demonstrate that support vector machine and k-nearest neighbor are the two best-performing methods in BMI prediction based on coefficient of determination (R2), root mean square error (RMSE), and mean absolute error (MAE). The combined predictor algorithms consistently yield top specificity, Cohen’s kappa, F1-score, and AUC in classifying the malnutrition status, and their performance is robust to alternative standards. The feature importance ranking based on several nonparametric and combined predictors indicates that socioeconomic status, women’s age, and breastfeeding status are the most important features in predicting women’s nutritional outcomes. Furthermore, the conditional inference trees corroborate that those three features along with the partner’s educational attainment and employment significantly predict malnutrition risks. Conclusion To the best of our knowledge, this is the first study that predicts BMI and one of the pioneer studies to classify all three malnutrition outcomes for women of childbearing age in Bangladesh, let alone in any lower-middle income country, using SML techniques. Moreover, in the context of Bangladesh, this paper is the first to identify and rank features that are critical in predicting nutritional outcomes using several feature selection algorithms. The estimators from this study predict the outcomes of interest most accurately and efficiently compared to other existing studies in the relevant literature. Therefore, study findings can aid policymakers in designing policy and programmatic approaches to address the double burden of malnutrition among Bangladeshi women, thereby reducing the country’s economic burden.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

he author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Demographic and Health Survey Data collection procedures for the 2017-18 BDHS were approved by the Institutional Review Boards of the ICF International, Rockville, MD, USA and Bangladesh Medical Research Council, Dhaka, Bangladesh. Informed consent was obtained from all respondents in the survey before asking questions, and separately before obtaining biomarker and anthropometric measurements.

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