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孟加拉国妇女营养不良的区域性教育和财富相关不平等。

Regional education and wealth-related inequalities in malnutrition among women in Bangladesh.

机构信息

Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh.

Department of Economics, Fogelman College of Business and Economics, The University of Memphis, 3675 Central Ave, Memphis, TN38152, USA.

出版信息

Public Health Nutr. 2022 Jun;25(6):1639-1657. doi: 10.1017/S1368980021003840. Epub 2021 Sep 6.

Abstract

OBJECTIVES

This paper examines the associations of socio-economic and demographic correlates with malnutrition among women and investigates education and wealth-related inequalities in malnutrition among women by region.

DESIGN

We utilise a two-level mixed-effects logistic regression model to evaluate the associations and employ the concentration, Wagstaff and Erreygers's correction indices to measure socio-economic inequalities in malnutrition among women.

SETTING

Bangladesh Demographic and Health Survey data.

PARTICIPANTS

Non-pregnant women aged 15-49 years.

RESULTS

We find evidence of a significant cluster effect in the data. Women's age, marital status, total children ever born, education level, husband's/partner's education level, residence and wealth index appear to be significantly associated with women underweight and overweight/obesity status. Underweight status is higher among less-educated women and women from poor households, whereas overweight/obesity is more concentrated among higher educated women and women from wealthy households. The southwestern region of the country demonstrates lower education and wealth-related inequalities in malnutrition among women. In contrast, the central and the northeastern areas apparently experience the highest education and wealth-related inequalities in malnutrition among women. The regional differences in predicted probabilities of being underweight shrink at higher education level and the richest quintile, whereas the differences in overweight/obese diminish at the primary education level and lower quintile households.

CONCLUSIONS

Our findings strengthen the evidence base for effective regional policy interventions to mitigate education and wealth-related inequalities in malnutrition among women. There is a need for developing regional awareness programmes and establishing regional monitoring cells to ensure proper health and nutrition facilities in underprivileged regions.

摘要

目的

本文考察了社会经济和人口统计学因素与妇女营养不良之间的关联,并研究了按地区划分的妇女营养不良与教育和财富相关的不平等现象。

设计

我们使用两级混合效应逻辑回归模型来评估关联,并采用集中指数、Wagstaff 和 Erreygers 校正指数来衡量妇女营养不良中的社会经济不平等。

设置

孟加拉国人口与健康调查数据。

参与者

年龄在 15-49 岁之间的非孕妇。

结果

我们发现数据中存在显著的聚类效应。妇女的年龄、婚姻状况、总生育子女数、教育水平、丈夫/伴侣的教育水平、居住地点和财富指数似乎与妇女体重过轻和超重/肥胖状况显著相关。受教育程度较低的妇女和贫困家庭的妇女体重过轻的比例较高,而超重/肥胖的比例则较高的妇女和富裕家庭的妇女。该国西南部地区在妇女营养不良方面的教育和财富相关不平等现象较低。相比之下,中部和东北部地区显然在妇女营养不良方面经历了最高的教育和财富相关不平等现象。随着教育水平和最富裕五分位数的提高,预测体重过轻的概率差异会缩小,而在小学教育水平和较低五分位数家庭中,超重/肥胖的差异会减少。

结论

我们的发现为有效实施区域性政策干预提供了依据,以减轻妇女营养不良方面的教育和财富相关不平等现象。需要制定区域性宣传计划并设立区域性监测小组,以确保贫困地区获得适当的卫生和营养设施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4231/9991694/932a01cb5382/S1368980021003840_fig1.jpg

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