Pooled prevalence and factors of overweight/obesity among women of reproductive age in low and middle-income countries with high maternal mortality: A multi-level analysis of recent demographic and health surveys

Background: Due to the increased magnitude of overweight/obesity in many countries, the World Health Organization (WHO) has identified it as a significant public health crisis, particularly affecting women of reproductive age in developing nations. Despite obesity/overweight among women of reproductive age being widely acknowledged as a pressing public health issue, there has been limited investigation into its pooled prevalence and various associated factors in low and middle-income countries (LMICs) with high maternal mortality. Thus, the objective of our study was to assess the pooled prevalence and associated factors of overweight/obesity among reproductive-age women in low and middle-income countries with high maternal mortality. Methods: We analyzed secondary data using recent Demographic and Health Survey datasets from 21 low and middle-income countries with high maternal mortality. A weighted sample of 64,076 women of reproductive age was included in the analysis. The variables were extracted from the IR file, and the data were cleaned, recoded, and analyzed using STATA version 14.2 software. A multilevel binary logistic regression model was applied, and adjusted odds ratios (AOR) with 95% confidence intervals and a p-value of ≤ 0.05 were used to identify statistically significant associated factors. Model fitness and comparison were assessed using the ICC, MOR, PCV, and deviance (−2LLR). Result: In this study, the pooled prevalence of overweight/obesity among women of reproductive age was 32% (95% CI: 27% − 37%), with a significant variation between countries, ranging from 10% in Burundi to 53% in Mauritania. Women of reproductive age with overweight/obesity showed a significant positive association with various factors compared to those with a normal BMI. Accordingly, women’s age, women’s educational status, women’s occupation, women’s marital status, households’ income levels, number of living children, frequency of watching television, using the internet, sex of household head, and sources of drinking water were identified as individual-level factors. On the other hand, residence, community poverty, and community-level media usage were found to be significantly associated with community-level variables. Conclusions and recommendations: More than three out of ten women of reproductive age were overweight/obese in low and middle-income countries with high maternal mortality. Individual-level and community-level factors were associated with overweight/obesity. Special attention is recommended to older women, those with formal education, non-working women, individuals who spend time watching television and using the internet, urban residents, and female household heads. Furthermore, since higher household income is associated with an increased likelihood of weight gain, it is important to provide appropriate health interventions for women from the wealthiest households.