Food and Agriculture Organization of the United Nations (FAO), House-37, Road-8, Dhaka 1205, Bangladesh.
Department of Epidemiology, University of Alabama at Birmingham, USA, Birmingham, AL 35233, USA.
Int J Environ Res Public Health. 2020 Feb 8;17(3):1079. doi: 10.3390/ijerph17031079.
Socioeconomic inequality in child malnutrition is well-evident in Bangladesh. However, little is known about whether this inequality differs by regional contexts. We used pooled data from the 2011 and 2014 Bangladesh Demographic and Health Survey to examine regional differences in socioeconomic inequalities in stunting and underweight among children under five. The analysis included 14,602 children aged 0-59 months. We used logistic regression models and the Concentration index to assess and quantify wealth- and education-related inequalities in child malnutrition. We found stunting and underweight to be more concentrated among children from poorer households and born to less-educated mothers. Although the poverty level was low in the eastern regions, socioeconomic inequalities were greater in these regions compared to the western regions. The extent of socioeconomic inequality was the highest in Sylhet and Chittagong for stunting and underweight, respectively, while it was the lowest in Khulna. Regression results demonstrated the protective effects of socioeconomic status (SES) on child malnutrition. The regional differences in the effects of SES tend to diverge at the lower levels of SES, while they converge or attenuate at the highest levels. Our findings have policy implications for developing programs and interventions targeted to reduce socioeconomic inequalities in child malnutrition in subnational regions of Bangladesh.
孟加拉国儿童营养不良的社会经济不平等现象十分明显。然而,人们对于这种不平等是否因地区背景而异知之甚少。我们利用 2011 年和 2014 年孟加拉国人口与健康调查的数据,研究了五个月以下儿童发育迟缓症和体重不足的社会经济不平等在地区间的差异。分析包括了 14602 名 0-59 个月大的儿童。我们使用逻辑回归模型和集中指数来评估和量化儿童营养不良与财富和教育相关的不平等。我们发现,贫困家庭的儿童和受教育程度较低的母亲所生的儿童更容易出现发育迟缓症和体重不足。尽管东部地区的贫困水平较低,但与西部地区相比,这些地区的社会经济不平等程度更大。在 Sylhet 和 Chittagong,社会经济不平等对发育迟缓症和体重不足的影响程度最高,而在 Khulna 则最低。回归结果表明,社会经济地位(SES)对儿童营养不良具有保护作用。SES 效应的地区差异在 SES 较低的水平上趋于发散,而在最高水平上则趋于收敛或减弱。我们的研究结果为制定针对孟加拉国次国家地区儿童营养不良社会经济不平等问题的方案和干预措施提供了政策依据。