Abstract

The double burden of malnutrition (DBM), defined as the simultaneous presence of undernutrition (underweight, wasting, stunting, and micronutrient deficiencies) and overnutrition (overweight and obesity), affects most low income and middle-income countries, particularly in South and Southeast Asia. This coexistence has emerged alongside rapid demographic and socioeconomic transitions reshaping dietary patterns and lifestyles, resulting in many households experiencing both forms of malnutrition simultaneously. Limited household resources, unequal food distribution, and poor diet quality, combined with reduced physical activity, create conditions in which children remain undernourished while adults gain excess weight.

This thesis addresses these gaps through four interconnected studies focused at the household level. A narrative review proposed standardised definitions at the individual, household, and population levels. Multi-country analyses using nationally representative data from Bangladesh, Cambodia, Nepal, and Timor-Leste documented substantial increases in household-level DBM. A systematic review and meta-analysis of 30 studies showed that urban residence, higher household wealth, older maternal age, and short maternal stature increase DBM likelihood, while breastfeeding and higher maternal education reduce it. A structured policy review in Bangladesh revealed no specific DBM indicators and no household-level monitoring. This thesis demonstrates that addressing DBM requires consistent measurement, integrated programme approaches, and effective governance. Ongoing policy developments in South and Southeast Asia create important opportunities for the required change.

Speaker

Ashis Talukder is a PhD researcher at the National Centre for Epidemiology and Population Health at The Australian National University and a public health nutrition researcher with a strong academic and professional background. He holds Honours and Master's degrees in Statistics from the University of Dhaka, Bangladesh, and serves as an Assistant Professor in the Statistics Discipline at Khulna University. He has extensive experience analysing large-scale cross-sectional datasets, particularly demographic and health surveys from low- and middle-income countries, and specialises in applying advanced statistical methods to address key public health challenges, including maternal and child health, nutrition, and the double burden of malnutrition. His work focuses on translating complex data into actionable insights for policy and practice, and he is actively involved in mentoring emerging researchers.