Kien Vu Duy, Lee Hwa-Young, Nam You-Seon, Oh Juhwan, Giang Kim Bao, Van Minh Hoang
Center for Population Health Sciences, Hanoi School of Public Health, Hanoi, Vietnam.
Center for Health System Research, Hanoi Medical University, Hanoi, Vietnam.
Glob Health Action. 2016 Feb 29;9:29263. doi: 10.3402/gha.v9.29263. eCollection 2016.
Child malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention.
This study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011.
Data were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities.
Inequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting.
Although the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition.
儿童营养不良不仅是导致儿童死亡率和发病率居高不下的主要因素，还会决定其成年后的社会经济地位。越南五岁以下儿童营养不良率已显著下降，但相关的不平等问题仍需关注。
本研究旨在探讨2000年至2011年间越南五岁以下儿童营养不良的趋势、影响因素及不平等状况的变化。
数据来源于2000年和2011年的越南多指标类集调查。研究使用的因变量为五岁以下儿童的发育迟缓、体重不足和消瘦情况。计算集中指数以了解儿童营养不良的程度，并对不平等状况进行分解，以了解决定因素对儿童营养不良的影响。采用全微分分解法来识别和探讨导致儿童营养不良不平等状况变化的因素。
尽管总体比率有所下降，但2000年至2011年间儿童营养不良的不平等状况有所加剧。营养不良方面的不平等大多归因于种族和社会经济地位。全微分分解显示，体重不足不平等状况变化的最大和第二大影响因素分别是年龄和社会经济地位。社会经济地位是发育迟缓不平等状况的最大影响因素。
尽管越南儿童营养不良的总体水平有所改善，但五岁以下儿童营养不良情况仍存在显著差异，社会经济条件较好的儿童情况更优。儿童营养不良方面社会经济不平等的影响随时间推移有所增加。可能需要采取多方面措施，联合多个相关部委和部门，以减少儿童营养不良方面的不平等。
