Background: Urbanization is rapidly reshaping the socio-economic and health landscapes of South and Southeast Asia, presenting both opportunities and significant public health challenges. Among the most pressing is the double burden of malnutrition (DBM), the co-existence of undernutrition and overnutrition within the same households or populations. This phenomenon underscores that urban growth, while associated with improved infrastructure and economic development, does not uniformly translate into better nutritional outcomes. This perspective aims to explore spatial patterns of DBM using night-time light (NTL) satellite data as a proxy for urbanization in Bangladesh, Cambodia, and Nepal.
Methods: We conducted a spatial analysis of DBM in relation to urbanization by integrating demographic and nutrition survey data with NTL satellite imagery. NTL intensity served as a proxy for urban growth and economic activity, allowing us to identify areas of high urbanization and assess their overlap with DBM prevalence at the population and household levels.
Results: DBM affects approximately 12–14% of households in Nepal, Bangladesh, and Cambodia. Areas with high NTL intensity are associated with higher rates of household-level DBM. Urban centers such as Dhaka in Bangladesh and Kathmandu in Nepal emerge as prominent DBM hotspots, demonstrating a clear spatial overlap between urbanization and malnutrition.
Conclusions: Integrating NTL data into public health planning can enhance the identification of high-risk areas and guide targeted, context-specific interventions. Addressing DBM in urbanizing regions requires cross-sectoral policies that combine nutrition-sensitive urban planning with inclusive food systems and social protection strategies.
