毛里塔尼亚儿童发育迟缓的社会经济、性别和地区不平等：来自毛里塔尼亚多指标类集调查（2007-2015 年）的数据。

Socioeconomic, sex and area related inequalities in childhood stunting in Mauritania: Evidence from the Mauritania Multiple Indicator Cluster Surveys (2007-2015).

机构信息

Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia.

出版信息

PLoS One. 2021 Oct 18;16(10):e0258461. doi: 10.1371/journal.pone.0258461. eCollection 2021.

DOI:10.1371/journal.pone.0258461

PMID:34662888

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8523214/

Abstract

INTRODUCTION

The prevalence of stunting in under five children is high in Mauritania. However, there is a paucity of evidence on the extent and the overtime alteration of inequality in stunting. To this end, we did this study to investigate stunting inequality and the change with time using three rounds of Mauritania Multiple Indicator Cluster Surveys. The evidence is important to inform implementation of equitable nutrition interventions to help narrow inequality in stunting between population groups.

METHODS

World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) was used in the analysis of stunting inequality. Following standard equity analysis methods recommended by the WHO, we performed disaggregated analysis of stunting across five equity stratfiers: Wealth, education, residence, sex and sub-national regions. Then, we summarized stunting inequality through four measures of inequality: Difference, Ratio, Population Attributable Fraction and Population Attributable Risk. The point estimates of stunting were accompanied by 95% confidence intervals to measure the statistical significance of the findings.

RESULTS

The national average of childhood stunting in 2007, 2011 and 2015 was 31.3%, 29.7% and 28.2%, respectively. Glaring inequalities in stunting around the five equity stratifiers were observed in all the studied periods. In the most recent survey included in our study (2015), for instance, we recorded substantial wealth (PAF = -33.60; 95% CI: -39.79, -27.42) and education (PAF = -5.60; 95% CI: -9.68, -1.52) related stunting inequalities. Overall, no substantial improvement was documented in wealth and sex related inequality in stunting between 2007 and 2011 while region-based inequality worsened during the same time periods.

CONCLUSIONS

The burden of stunting appeared to be heavily concentrated among children born to socioeconomically worse-off women, women who live in rural settings and certain subnational regions. Targeted nutrition interventions are required to address drivers of stunting embedded within geographic and socioeconomic contexts.

摘要

简介

毛里塔尼亚五岁以下儿童发育迟缓的患病率很高。然而，关于发育迟缓不平等的程度和随时间变化的证据很少。为此，我们进行了这项研究，使用三轮毛里塔尼亚多指标类集调查来调查发育迟缓的不平等情况及其随时间的变化。这些证据对于为公平营养干预措施提供信息，帮助缩小人群组之间发育迟缓的不平等至关重要。

方法

本研究使用世界卫生组织（WHO）的健康公平评估工具包（HEAT）分析发育迟缓的不平等情况。根据世卫组织推荐的标准公平分析方法，我们对五个公平分层变量（财富、教育、居住地、性别和国家以下地区）进行了发育迟缓的分类分析。然后，我们通过不平等的四个衡量标准（差异、比率、人口归因分数和人口归因风险）来总结发育迟缓的不平等情况。发育迟缓的点估计值附有 95%置信区间，以衡量结果的统计显著性。

结果

2007 年、2011 年和 2015 年全国儿童发育迟缓的平均水平分别为 31.3%、29.7%和 28.2%。在所有研究期间，五个公平分层变量周围的发育迟缓存在明显的不平等。例如，在我们研究中包含的最近一次调查（2015 年）中，我们记录了大量的财富（PAF = -33.60；95%置信区间：-39.79，-27.42）和教育（PAF = -5.60；95%置信区间：-9.68，-1.52）相关的发育迟缓不平等。总体而言，2007 年至 2011 年间，财富和性别相关发育迟缓不平等没有实质性改善，而同期基于地区的不平等则恶化。