Prevalence and determinants of non-communicable diseases risk factors among reproductive-aged women: Findings from a nationwide survey in Bangladesh
Authors: Chowdhury Saifur Rahman , Islam Md. Nazrul , Sheekha Tasbeen Akhtar , Kader Shirmin Bintay , Hossain Ahmed 
Published: June 2023

Introduction
Knowing the risk factors like smoking status, overweight/obesity, and hypertension among women of reproductive age could allow the development of an effective strategy for reducing the burden of non-noncommunicable diseases. We sought to determine the prevalence and determinants of smoking status, overweight/obesity, hypertension, and cluster of these non-noncommunicable diseases risk factors among Bangladeshi women of reproductive age.

Methods
This study utilized the Bangladesh Demographic and Health Survey (BDHS) data from 2017–2018 and analyzed 5,624 women of reproductive age (age 18–49 years). This nationally representative cross-sectional survey utilized a stratified, two-stage sample of households. Poisson regression models with robust error variance were fitted to find the adjusted prevalence ratio (APR) for smoking, overweight/obesity, hypertension, and for the clustering of non-noncommunicable diseases risk factors across demographic variables.

Results
The average age of 5,624 participants was 31 years (SD = 9.1). The prevalence of smoking, overweight/obesity, and hypertension was 9.6%, 31.6%, and 20.3%, respectively. More than one-third of the participants (34.6%) had one non-noncommunicable diseases risk factor, and 12.5% of participants had two non-noncommunicable diseases risk factors. Age, education, wealth index, and geographic location were significantly associated with smoking status, overweight/obesity, and hypertension. Women between 40–49 years had more non-noncommunicable diseases risk factors than 18–29 years aged women (APR: 2.44; 95% CI: 2.22–2.68). Women with no education (APR: 1.15; 95% CI: 1.00–1.33), married (APR: 2.32; 95% CI: 1.78–3.04), and widowed/divorced (APR: 2.14; 95% CI: 1.59–2.89) were more likely to experience multiple non-noncommunicable diseases risk factors. Individuals in the Barishal division, a coastal region (APR: 1.44; 95% CI: 1.28–1.63) were living with a higher number of risk factors for non-noncommunicable diseases than those in the Dhaka division, the capital of the country. Women who belonged to the richest wealth quintile (APR: 1.82; 95% CI: 1.60–2.07) were more likely to have the risk factors of non-noncommunicable diseases.

Conclusions
The study showed that non-noncommunicable diseases risk factors are more prevalent among women from older age group, currently married and widowed/divorced group, and the wealthiest socio-economic group. Women with higher levels of education were more likely to engage in healthy behaviors and found to have less non-noncommunicable diseases risk factors. Overall, the prevalence and determinants of non-noncommunicable diseases risk factors among reproductive women in Bangladesh highlight the need for targeted public health interventions to increase opportunities for physical activity and reduce the use of tobacco, especially the need for immediate interventions in the coastal region.