Assessing risk factors for malnutrition among women in Bangladesh and forecasting malnutrition using machine learning approaches

Abstract

Background: This paper presents an in-depth examination of malnutrition in women in Bangladesh. Malnutrition in women is a major public health issue related to different diseases and has negative repercussions for children, such as premature birth, decreased infection resistance, and an increased risk of death. Moreover, malnutrition is a severe problem in Bangladesh. Data from the Bangladesh Demographic Health Survey (BDHS) conducted in 2017-18 was used to identify risk factors for malnourished women and to create a machine learning-based strategy to detect their nutritional status. Methods: A total of 17022 women participants are taken to conduct the research. All the participants are from different regions and different ages. A chi-square test with a five percent significance level is used to identify possible risk variables for malnutrition in women and six machine learning-based classifiers (Naïve Bayes, two types of Decision Tree, Logistic Regression, Random Forest, and Gradient Boosting Machine) were used to predict the malnutrition of women. The models are being evaluated using different parameters like accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1 score, and area under the curve (AUC). Results: Descriptive data showed that 45% of the population studied were malnourished women, and the chi-square test illustrated that all fourteen variables are significantly associated with malnutrition in women and among them, age and wealth index had the most influence on their nutritional status, while water source had the least impact. Random Forest had an accuracy of 60% and 60.2% for training and test data sets, respectively. CART and Gradient Boosting Machine also had close accuracy like Random Forest but based on other performance metrics such as kappa and F1 scores Random Forest got the highest rank among others. Also, it had the highest accuracy and F1 scores in k-fold validation along with the highest AUC (0.604). Conclusion: The Random Forest (RF) approach is a reasonably superior machine learning-based algorithm for forecasting women’s nutritional status in Bangladesh in comparison to other ML algorithms investigated in this work. The suggested approach will aid in forecasting which women are at high susceptibility to malnutrition, hence decreasing the strain on the healthcare system.