印度儿童的维生素A补充：他们的社会经济地位及其居住邦的经济和社会发展状况会产生影响吗？
Vitamin A supplementation among children in India: Does their socioeconomic status and the economic and social development status of their State of residence make a difference?
作者信息
Agrawal Sutapa, Agrawal Praween
机构信息
South Asia Network for Chronic Disease, Public Health Foundation of India, C-1/52, First Floor, Safdurjung Development Area, New Delhi, India.
Population Council, 42, Golf Links, First Floor, New Delhi, India.
出版信息
Int J Med Public Health. 2013 Mar 31;3(1):48-54. doi: 10.4103/2230-8598.109322.
BACKGROUND
India has the largest percentage/number of vitamin A deficient children in the world. However, the effectiveness of a program of vitamin A supplementation at the population level has been rarely examined. We aim to examine the status of vitamin A supplementation among preschool children in India and its association with their socioeconomic and demographic characteristics and the social and economic development level of the State in which they reside.
MATERIALS AND METHODS
Data are from a cross-sectional study of 20,802 children aged 12-35 months whose mothers participated in the National Family Health Survey 3 (NFHS-3) conducted during 2005-2006. The association between the socioeconomic and demographic characteristics of the children, the social and economic development status of the State in which they reside and vitamin A supplementation status was examined by means of unadjusted and adjusted logistic regression models.
RESULTS
Only 25% of the children in India received vitamin A supplementation, indicating a poor coverage, and the differences between the States were wide (<10% to >45%). Rural children (OR: 1.20; 95% CI: 1.10-1.30; < 0.0001) and children of educated mothers (OR: 2.40; 95% CI: 2.04-2.83; < 0.0001) were more likely to receive vitamin A supplementation than others. Children born in a higher birth order (6+) (OR: 0.54; 95% CI: 0.46-0.63; < 0.0001) and those residing in states with low levels of social and economic development (OR: 0.51; 95% CI: 0.46-0.57; < 0.0001) were only about half as likely to receive vitamin A supplementation as their counterparts.
CONCLUSION
The national vitamin A supplementation program in India did not reach a majority of preschool children in 2005. Greater maternal formal education, higher household wealth status and high social development status of their State of residence appears to be an important determinant for receipt of a vitamin A supplementation by preschool children in India.
背景
印度是世界上维生素A缺乏儿童比例/数量最高的国家。然而，在人群层面维生素A补充计划的有效性很少得到检验。我们旨在研究印度学龄前儿童维生素A补充状况及其与社会经济、人口特征以及他们所居住邦的社会经济发展水平之间的关联。
材料与方法
数据来自一项横断面研究，研究对象为20802名年龄在12至35个月的儿童，其母亲参与了2005 - 2006年期间开展的第三次全国家庭健康调查（NFHS - 3）。通过未调整和调整后的逻辑回归模型，研究了儿童的社会经济和人口特征、他们所居住邦的社会经济发展状况与维生素A补充状况之间的关联。
结果
印度仅有25%的儿童接受了维生素A补充，表明覆盖率较低，各邦之间的差异很大（<10%至>45%）。农村儿童（比值比：1.20；95%置信区间：1.10 - 1.30；<0.0001）以及母亲受过教育的儿童（比值比：2.40；95%置信区间：2.04 - 2.83；<0.0001）比其他儿童更有可能接受维生素A补充。出生顺序较高（6胎及以上）的儿童（比值比：0.54；95%置信区间：0.46 - 0.63；<0.0001）以及居住在社会经济发展水平较低邦的儿童（比值比：0.51；95%置信区间：0.46 - 0.57；<0.0001）接受维生素A补充的可能性仅为其他儿童的一半左右。
结论
2005年印度的全国维生素A补充计划未能覆盖大多数学龄前儿童。母亲接受更多正规教育、家庭财富状况较高以及所居住邦的社会发展水平较高，似乎是印度学龄前儿童接受维生素A补充的重要决定因素。
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