塞拉利昂儿童发育迟缓的程度和趋势不平等：来自人口与健康调查和多指标类集调查的证据。
Extent of and trends in inequalities in child stunting in Sierra-Leone from 2005 to 2013: evidence from demographic and health surveys and multiple indicator cluster surveys.
机构信息
Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Birehan for mothers and children morbidity and mortality surveillance project, Debre Brehan, Ethiopia.
出版信息
Int J Equity Health. 2020 Jun 5;19(1):88. doi: 10.1186/s12939-020-01212-5.
BACKGROUND
Comprehensive assessment of stunting disparity in Sierra-Leone has not been done so far. We aimed to document extent and over time dynamics of inequality in stunting in Sierra-Leone using approaches that facilitate implementation of interventions aim to eliminate non-justified stunting disparity in the country.
METHODS
The data for the study were derived from two rounds of the Sierra Leone Demographic and Health Survey conducted in 2008 and 2013, and two rounds of the Sierra Leone Multiple Indicator Cluster Survey done in 2005 and 2010. We used the 2019 update WHO Health Equity Assessment Toolkit (HEAT) to do the analysis. The toolkit makes use of data stored in the WHO Health Equity Monitor database. We analyzed stunting inequality using summary measures: Population Attributable Risk, Population Attributable Fraction, Difference and Ratio. The summary measures were computed for five equity stratifers: wealth, education, child's sex, place of residence and subnational region. We computed 95% Confidence Interval (CI) for each point estimate to show whether or not observed stunting inequalities are statistically significant, and whether or not the disparity changed over time statistically significantly.
RESULTS
The findings demonstrated stark inequalities in stunting in all the studied dimensions of inequality. While residence and subnational regional related inequalities remain unchanged over time, wealth and educational inequality had seen slight improvement during the same time period. Large sex related stunting inequality remained during the first three surveys time points, but it disappeared in 2013.
CONCLUSIONS
Huge stunting disparities occurred in Sierra Leone, and the disparity disproportionately affects disadvantaged subpopulations and male children. Nutrition interventions that specifically target the subgroups which suffer more from the burden of stunting are required.
背景
目前为止，塞拉利昂尚未对发育迟缓的整体差异进行全面评估。我们旨在采用便于实施旨在消除该国不合理发育迟缓差异的干预措施的方法，记录塞拉利昂发育迟缓不平等的程度和随时间的动态变化。
方法
本研究的数据来自于 2008 年和 2013 年进行的两轮塞拉利昂人口与健康调查以及 2005 年和 2010 年进行的两轮塞拉利昂多指标类集调查。我们使用 2019 年更新的世卫组织卫生公平评估工具包（HEAT）进行分析。该工具包利用存储在世卫组织卫生公平监测数据库中的数据。我们使用综合指标：人群归因风险、人群归因分数、差异和比值，来分析发育迟缓的不平等。综合指标是针对五个公平分层因素进行计算的：财富、教育、儿童性别、居住地和国家以下地区。我们计算了每个点估计的 95%置信区间（CI），以显示观察到的发育迟缓不平等是否具有统计学意义，以及不平等是否随时间发生统计学意义上的变化。
结果
研究结果表明，在所有研究的不平等维度中，发育迟缓存在明显的不平等。虽然居住地和国家以下地区相关的不平等在整个研究期间保持不变，但财富和教育不平等在同一时期略有改善。在前三轮调查中，性别相关的发育迟缓不平等一直存在，但在 2013 年消失了。
结论
塞拉利昂存在巨大的发育迟缓差距，这种差距不成比例地影响了弱势群体和男童。需要针对受发育迟缓负担影响更大的亚人群开展营养干预措施。
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