International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
BMC Public Health. 2021 Mar 19;21(1):545. doi: 10.1186/s12889-021-10601-6.
Globally, about 25% of children suffer from subclinical vitamin A deficiency (VAD), and approximately 300 million children globally had anemia as per 2011 estimates. Micronutrient deficiencies are generally referred to as "hidden hunger" because these deficiencies developed gradually. The present study determines the socio-economic inequalities in vitamin A supplementation (VAS) and Iron supplementation (IS) among children aged 6-59 months in India and to estimate the change in the percent contribution of different socio-economic correlates for such inequality from 2005 to 06 to 2015-16.
Data from National Family Health Survey (NFHS) 2005-06 and 2015-16 was used for the analysis. Bivariate analysis and logistic regression analysis was used to carve out the results. Moreover, Wagstaff decomposition analysis was used to find the factors which contributed to explain socio-economic status-related inequality among children in India.
It was revealed that the percentage of children who do not receive vitamin A supplementation was reduced from 85.5% to 42.1%, whereas in the case of IS, the percentage reduced from 95.3% to 73.9% from 2005-06 to 2015-16 respectively. The child's age, mother's educational status, birth order, breastfeeding status, place of residence and empowered action group (EAG) status of states were the factors that were significantly associated with vitamin A supplementation and iron supplementation among children in India. Moreover, it was found the children who do not receive vitamin A supplementation and iron supplementation got more concentrated among lower socio-economic strata. A major contribution for explaining the gap for socio-economic status (SES) related inequality was explained by mother's educational status, household wealth status, and empowered action group status of states for both vitamin A supplementation and iron supplementation among children aged 6-59 months in India.
Schemes like the Integrated Child Development Scheme (ICDS) would play a significant role in reducing the socio-economic status-related gap for micro-nutrient supplementation among children in India. Proper implementation of ICDS will be enough for reducing the gap between rich and poor children regarding micro-nutrient supplementation.
全球约有 25%的儿童患有亚临床维生素 A 缺乏症（VAD），根据 2011 年的估计，全球约有 3 亿儿童患有贫血。微量营养素缺乏通常被称为“隐性饥饿”，因为这些缺乏是逐渐发展的。本研究旨在确定印度 6-59 个月儿童中维生素 A 补充（VAS）和铁补充（IS）的社会经济不平等，并估计从 2005-06 年到 2015-16 年，不同社会经济相关因素对这种不平等的贡献百分比变化。
本研究使用了 2005-06 年和 2015-16 年国家家庭健康调查（NFHS）的数据进行分析。采用双变量分析和逻辑回归分析得出结果。此外，还使用 Wagstaff 分解分析来找出导致印度儿童社会经济地位相关不平等的因素。
结果显示，未接受维生素 A 补充的儿童比例从 85.5%降至 42.1%，而接受 IS 的儿童比例从 95.3%降至 73.9%，分别从 2005-06 年到 2015-16 年。儿童年龄、母亲教育程度、出生顺序、母乳喂养状况、居住地点和州的赋权行动小组（EAG）地位是与印度儿童维生素 A 补充和铁补充显著相关的因素。此外，研究发现，未接受维生素 A 补充和铁补充的儿童更多地集中在较低的社会经济阶层。母亲教育程度、家庭财富状况和州的赋权行动小组地位是导致印度 6-59 个月儿童维生素 A 补充和铁补充社会经济地位（SES）相关不平等的主要因素。
综合儿童发展计划（ICDS）等计划将在减少印度儿童社会经济地位相关的微量营养素补充差距方面发挥重要作用。适当实施 ICDS 将足以缩小贫富儿童在微量营养素补充方面的差距。
