Medical Research Council (MRC) Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada.
Int Health. 2021 Sep 3;13(5):436-445. doi: 10.1093/inthealth/ihaa093.
Global obesity estimates show a steadily increasing pattern across socioeconomic and geographical divides, especially among women. Our analysis tracked and described obesity trends across multiple equity dimensions among women of reproductive age (15-49 y) in 11 sub-Saharan African (SSA) countries during 1994-2015.
This study consisted of a cross-sectional series analysis using nationally representative demographic and health surveys (DHS) data. The countries included were Cameroon, Comoros, Congo, Cote d'Ivoire, Ghana, Kenya, Lesotho, Nigeria, Senegal, Zambia and Zimbabwe. The data reported are from a reanalysis conducted using the WHO Health Equity Assessment Toolkit that assesses inter- and intra-country health inequalities across socioeconomic and geographical dimensions. We generated equiplots to display intra- and inter-country equity gaps.
There was an increasing trend in obesity among women of reproductive age across all 11 SSA countries. Obesity increased unequally across wealth categories, place of residence and educational measures of inequality. The wealthiest, most educated and urban dwellers in most countries had a higher prevalence of obesity. However, in Comoros, obesity did not increase consistently with increasing wealth or education compared with other countries. The most educated and wealthiest women in Comoros had lower obesity rates compared with their less wealthy and less well-educated counterparts.
A window of opportunity is presented to governments to act structurally and at policy level to reduce obesity generally and prevent a greater burden on disadvantaged subpopulation groups in sub-Saharan Africa.
全球肥胖估计显示，社会经济和地理差异，尤其是在女性中，肥胖趋势呈稳步上升趋势。我们的分析跟踪并描述了 1994 年至 2015 年期间 11 个撒哈拉以南非洲（SSA）国家生育年龄（15-49 岁）的女性在多个公平维度的肥胖趋势。
本研究采用了使用全国代表性人口和健康调查（DHS）数据的横截面系列分析。包括的国家有喀麦隆、科摩罗、刚果、科特迪瓦、加纳、肯尼亚、莱索托、尼日利亚、塞内加尔、赞比亚和津巴布韦。报告的数据来自使用世卫组织健康公平评估工具包进行的重新分析，该工具包评估了社会经济和地理维度的国家内部和国家之间的健康不平等。我们生成了等距图来显示国家内部和国家之间的公平差距。
在所有 11 个 SSA 国家，生育年龄的女性肥胖率呈上升趋势。在所有财富类别、居住地和教育不平等衡量标准中，肥胖的不平等程度都在增加。大多数国家最富有、最受教育和居住在城市的人肥胖率更高。然而，在科摩罗，与其他国家相比，肥胖率并没有随着财富或教育的增加而持续增加。与较不富裕和教育程度较低的同龄人相比，科摩罗最受教育和最富有的女性肥胖率较低。
政府有机会在结构上和政策层面采取行动，以减少普遍肥胖，并防止撒哈拉以南非洲弱势人群负担加重。
