Knowledge Leadership, Global Alliance for Improved Nutrition (GAIN), Washington, District of Columbia.
Department of Environmental Science and Policy, University of California, Davis, California.
Matern Child Nutr. 2019 Oct;15(4):e12826. doi: 10.1111/mcn.12826. Epub 2019 May 2.
Child stunting in Vietnam has reduced substantially since the turn of the century but has remained relatively high for several years. We analysed data on children 6-59 months (n = 85,932) from the Vietnam Nutritional Surveillance System, a nationally representative cross-sectional survey. Multivariable Poisson regression models were used to estimate relative risk (RR) of stunting, stratified by child age and ecological region. Covariates at the child, maternal, household, and environmental levels were included based on available data and the World Health Organization conceptual framework on child stunting. Among children 6-23 months, the strongest associations with child stunting were child age in years (RR: 2.49; 95% CI [2.26, 2.73]), maternal height < 145 cm compared with ≥150 cm (RR: 2.04; 95% CI [1.85, 2.26]), living in the Northeast compared with the Southeast (RR: 2.01; 95% CI [1.69, 2.39]), no maternal education compared with a graduate education (RR: 1.77; 95% CI, [1.44, 2.16]), and birthweight < 2,500 g (RR: 1.75; 95% CI [1.55, 1.98]). For children 24-59 months, the strongest associations with child stunting were no maternal education compared with a graduate education (RR: 2.07; 95% CI [1.79, 2.40]), living in the Northeast compared with the Southeast (RR: 1.94; 95% CI [1.74, 2.16]), and maternal height < 145 cm compared with ≥150 cm (RR: 1.81; 95% CI [1.69, 1.94]). Targeted approaches that address the strongest stunting determinants among vulnerable populations are needed and discussed. Multifaceted approaches outside the health sector are also needed to reduce inequalities in socioeconomic status.
自本世纪初以来,越南儿童发育迟缓的情况已大幅减少,但多年来仍居高不下。我们分析了越南营养监测系统中 6-59 个月儿童(n=85932)的数据,这是一项具有全国代表性的横断面调查。使用多变量泊松回归模型,按儿童年龄和生态区对发育迟缓的相对风险(RR)进行分层分析。根据现有数据和世卫组织儿童发育迟缓概念框架,将儿童、产妇、家庭和环境层面的协变量纳入其中。在 6-23 个月的儿童中,与儿童发育迟缓最强相关的因素是年龄(RR:2.49;95%CI [2.26,2.73])、母亲身高<145cm 与≥150cm 相比(RR:2.04;95%CI [1.85,2.26])、与东南部相比东北部(RR:2.01;95%CI [1.69,2.39])、与产妇未受过教育相比,受过高等教育(RR:1.77;95%CI,[1.44,2.16])和出生体重<2500g(RR:1.75;95%CI [1.55,1.98])。对于 24-59 个月的儿童,与儿童发育迟缓最强相关的因素是与产妇受过高等教育相比,未受过教育(RR:2.07;95%CI [1.79,2.40])、与东南部相比东北部(RR:1.94;95%CI [1.74,2.16])和母亲身高<145cm 与≥150cm 相比(RR:1.81;95%CI [1.69,1.94])。需要针对弱势人群中最严重的发育迟缓决定因素采取有针对性的方法,并对此进行讨论。还需要在卫生部门以外采取多方面的方法,以减少社会经济地位不平等。