Department of Economics, COMSATS University, Islamabad, Pakistan.
Department of Economics, COMSATS University, Islamabad, Pakistan.
Public Health. 2022 Apr;205:133-138. doi: 10.1016/j.puhe.2022.01.041. Epub 2022 Mar 10.
Growing evidence has associated solid/polluted fuel (PF) burning with higher risks of acute respiratory infection (ARI) among under-five children. However, higher usage of PF contributed to upsurge communal air pollution, which may further aggravate ARI. Instead, women empowerment may mitigate the risk of ARI by shifting towards cleaner fuels. This study aimed to estimate the mitigating impact of community-level women empowerment on ARI among under-five children in Pakistan. In addition, the study also aimed to explore the mitigating impact pathway of empowered women community.
A cross-sectional study design was used to collect data under 2018 Pakistan Demographic and Health Survey.
Retrieved data used in the analysis comprised 12,295 surviving under-five children suffering from cough coinciding with short and rapid breathing and fever from 561 communities. Because of hierarchical structure of the data, two-level mixed-effects logistic regression was used to compute unbiased odds ratios.
Approximately 58% of total households used PF as a primary fuel, and PF usage by more than 50% of households led to 129 polluted communities. About 19% of children suffered from symptoms of ARI within 2 weeks preceding the survey. After adjusting for individual, household and communal attributes, the odds of suffering from ARI were 1.156 times higher among children from polluted households than their counterparts. The odds of ARI were aggravated to 1.333 for highly polluted communities. Women empowerment mitigated the risk of ARI by odds of 0.708 and 0.671 at individual level and communal levels, respectively. After shifting towards cleaner fuels, highly women empowered community-mitigated ARI risk by odds of 0.765.
Under-five children of highly polluted communities were at higher risk of ARI, while highly women empowered communities mitigated the risk by shifting towards cleaner fuels. We suggest interventional efforts towards empowering poor women in mitigating ARI.
越来越多的证据表明，固体/污染燃料（PF）的燃烧与五岁以下儿童急性呼吸道感染（ARI）的风险增加有关。然而，PF 的高使用率导致了公共空气污染的激增，这可能进一步加重 ARI。相反，妇女赋权可能通过转向更清洁的燃料来降低 ARI 的风险。本研究旨在估计巴基斯坦社区层面妇女赋权对五岁以下儿童 ARI 的缓解影响。此外，本研究还旨在探索增强妇女社区的缓解影响途径。
本研究采用横断面研究设计，于 2018 年收集巴基斯坦人口与健康调查的数据。
本研究使用的分析数据来自 561 个社区的 12295 名幸存的五岁以下儿童，这些儿童患有咳嗽、呼吸急促和发热等症状。由于数据的层次结构，本研究使用两级混合效应逻辑回归来计算无偏比值比。
大约 58%的家庭使用 PF 作为主要燃料，超过 50%的家庭使用 PF 导致了 129 个污染社区。大约 19%的儿童在调查前两周内出现 ARI 症状。在调整了个体、家庭和社区属性后，来自污染家庭的儿童患 ARI 的几率比对照组高 1.156 倍。高度污染社区的 ARI 几率增加到 1.333 倍。妇女赋权通过个体和社区层面分别将 ARI 风险降低了 0.708 和 0.671 倍。高度赋权的社区转向更清洁的燃料后，通过降低 0.765 倍的几率来缓解 ARI 风险。
高度污染社区的五岁以下儿童患 ARI 的风险较高，而高度赋权的社区通过转向更清洁的燃料来降低风险。我们建议采取干预措施，增强贫困妇女的能力，以降低 ARI 的风险。
