Population Studies Division, Bangladesh Institute of Development Studies, Dhaka, Bangladesh.
International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.
Int J Health Plann Manage. 2020 Mar;35(2):441-468. doi: 10.1002/hpm.2918. Epub 2019 Nov 8.
BACKGROUND: Undernutrition is one of the major public health concerns in Bangladesh. This study examined the trends and patterns of childhood undernutrition, inequality, and its socioeconomic contributors in Bangladesh. METHODS: Data were extracted from the last four rounds of the Bangladesh Demographic Health Survey (BDHS). A regression-based decomposition method was applied to assess the socioeconomic contributors of inequality. RESULTS: Although the prevalence of childhood undernutrition has declined during the period 2004 to 2014, the rate of undernutrition is higher among the children of mothers who had lower education, live in rural areas, and are from the poorest wealth quintile. Socioeconomic status accounted for almost half of the total inequality in the prevalence of both stunting and underweight among children, whereas maternal education was ranked second among the contributors. CONCLUSIONS: Findings of the study indicate that undernutrition inequalities in terms of socioeconomic aspects appear to have widened over time. Improving economic activity and maternal education will improve the nutritional status of children and as a consequence reduce inequality. Therefore, investments in education, creation of working opportunities, and empowerment of vulnerable and disadvantaged people along with nutrition-specific interventions will be important measures to eliminate this inequality at the population level.
背景:营养不良是孟加拉国主要的公共卫生问题之一。本研究旨在探讨孟加拉国儿童营养不良的趋势和模式、不平等现象及其社会经济决定因素。
方法:数据来自孟加拉国人口与健康调查(BDHS)的前四轮调查。采用回归分解方法评估不平等现象的社会经济决定因素。
结果:尽管 2004 年至 2014 年期间儿童营养不良的患病率有所下降,但受教育程度较低、居住在农村地区和来自最贫困五分之一的家庭的母亲所生子女的营养不良率更高。社会经济地位几乎占儿童发育迟缓症和消瘦症患病率总不平等的一半,而母亲教育则是导致不平等的第二大因素。
结论:研究结果表明,儿童营养不良的不平等现象在社会经济方面似乎随着时间的推移而扩大。改善经济活动和母亲教育将改善儿童的营养状况,从而减少不平等。因此,在教育、创造就业机会、赋权弱势群体和劣势人群方面进行投资以及采取营养专项干预措施,将是在人口层面消除这种不平等的重要措施。
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