Khatun Masuma, Stenlund Hans, Hörnell Agneta
Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, SE-901 85 Umeå, Sweden.
Public Health Nutr. 2004 Dec;7(8):1071-9. doi: 10.1079/PHN2004652.
To explore the effect of BRAC (formerly Bangladesh Rural Advancement Committee) initiatives towards promoting gender and social equity in health among children of poor mothers who are BRAC members.
A cohort of 576 children from the prospective study of a BRAC- International Centre for Diarrhoeal Disease Research, Bangladesh joint research project was analysed. Data were collected three times during 1995-1996 with approximately 4-month intervals. Stunting, defined as height-for-age below minus two standard deviations from the reference median, was the outcome health measure. The study children were stratified into three groups according to their mother's social and BRAC membership status: poor and BRAC member (BM), poor non-member (TG) and non-poor non-member (NTG).
Matlab, rural area of Bangladesh.
Children aged 6-72 months.
The overall prevalence of stunting was 76%; the highest prevalence was found among TG (84.6%) children and no significant difference was observed between BM and NTG children (67.3% and 69.4%, respectively). In all groups, a significantly larger proportion of girls was stunted compared with boys in the first round. Group-level analysis showed that stunting decreased among all children except BM boys at the end of third round, with the largest decline among BM girls. In contrast, stunting prevalence increased among BM boys. A similar trend was found in the individual-level analysis, where a larger proportion of BM girls recovered from stunting compared with other groups and no recovery was observed among BM boys. At the end of the third round, the nutritional status of BM girls was almost equal to that of the BM boys, while gender inequity remained large among TG and NTG children.
The BRAC initiative appeared to contribute to a significant equity gain in health for girls, as well as to decreased differences in ill health between the poor and the non-poor.
探讨孟加拉农村发展委员会（BRAC，前身为孟加拉农村进步委员会）的举措对促进BRAC成员中贫困母亲的子女在健康方面的性别平等和社会公平的影响。
对来自BRAC-孟加拉国国际腹泻病研究中心联合研究项目前瞻性研究的576名儿童队列进行了分析。在1995年至1996年期间分三次收集数据，间隔约4个月。发育迟缓定义为年龄别身高低于参考中位数减两个标准差，是健康状况的衡量指标。研究儿童根据其母亲的社会和BRAC成员身份分为三组：贫困且为BRAC成员（BM）、贫困非成员（TG）和非贫困非成员（NTG）。
孟加拉国农村地区马特莱布。
6至72个月大的儿童。
发育迟缓的总体患病率为76%；TG组（84.6%）儿童的患病率最高，BM组和NTG组儿童之间未观察到显著差异（分别为67.3%和69.4%）。在所有组中，第一轮时发育迟缓的女孩比例显著高于男孩。组水平分析显示，除BM组男孩外，所有儿童在第三轮结束时发育迟缓情况均有所下降，BM组女孩下降幅度最大。相比之下，BM组男孩的发育迟缓患病率有所上升。个体水平分析也发现了类似趋势，即与其他组相比，BM组中有更大比例的女孩从发育迟缓中恢复，而BM组男孩未观察到恢复情况。在第三轮结束时，BM组女孩的营养状况几乎与BM组男孩相同，而TG组和NTG组儿童中的性别不平等仍然很大。
BRAC的举措似乎有助于显著提高女孩在健康方面的公平性，同时减少贫困和非贫困人群之间健康不良的差异。
