Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Centre for Environment and Development, College of Development Studies, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia.
Int J Environ Res Public Health. 2022 May 30;19(11):6684. doi: 10.3390/ijerph19116684.
Young children in low- and middle-income countries (LMICs) are vulnerable to adverse effects of household microenvironments. The UN Sustainable Development Goals (SDGs)-specifically SDG 3 through 7-urge for a comprehensive multi-sector approach to achieve the 2030 goals. This study addresses gaps in understanding the health effects of household microenvironments in resource-poor settings. It studies associations of household microenvironment variables with episodes of acute respiratory infection (ARI) and diarrhoea as well as with stunting among under-fives using logistic regression. Comprehensive data from a nationally representative, cross-sectional demographic and health survey (DHS) in Uganda were analysed. We constructed and applied the multidimensional energy poverty index (MEPI) and the three-dimensional women empowerment index in multi-variate regressions. The multidimensional energy poverty was associated with higher risk of ARI (OR = 1.32, 95% CI 1.10 to 1.58). Social independence of women was associated with lower risk of ARI (OR= 0.91, 95% CI 0.84 to 0.98), diarrhoea (OR = 0.93, 95% CI 0.88 to 0.99), and stunting (OR = 0.83, 95% CI 0.75 to 0.92). Women's attitude against domestic violence was also significantly associated with episodes of ARI (OR = 0.88, 95% CI 0.82 to 0.93) and diarrhoea (OR = 0.89, 95% CI 0.84 to 0.93) in children. Access to sanitation facilities was associated with lower risk of ARI (OR = 0.55, 95% CI 0.45 to 0.68), diarrhoea (OR = 0.83, 95% CI 0.71 to 0.96), and stunting (OR = 0.64, 95% CI 0.49 to 0.86). Investments targeting synergies in integrated energy and water, sanitation and hygiene, and women empowerment programmes are likely to contribute to the reduction of the burden from early childhood illnesses. Research and development actions in LMICs should address and include multi-sector synergies.
生活在中低收入国家（LMICs）的幼儿容易受到家庭微观环境的不利影响。联合国可持续发展目标（SDGs）——特别是 SDG3 至 7——敦促采取全面的多部门方法来实现 2030 年的目标。本研究旨在解决对资源匮乏环境中家庭微观环境健康影响认识不足的问题。本研究使用逻辑回归分析了家庭微观环境变量与五岁以下儿童急性呼吸道感染（ARI）和腹泻发作以及发育迟缓之间的关联。对乌干达全国代表性的横断面人口与健康调查（DHS）的综合数据进行了分析。我们构建并应用多维能源贫困指数（MEPI）和三维妇女赋权指数进行多变量回归。多维能源贫困与 ARI 风险增加相关（OR=1.32，95%CI 1.10 至 1.58）。妇女的社会独立性与 ARI 风险降低相关（OR=0.91，95%CI 0.84 至 0.98）、腹泻（OR=0.93，95%CI 0.88 至 0.99）和发育迟缓（OR=0.83，95%CI 0.75 至 0.92）。妇女反对家庭暴力的态度也与儿童 ARI（OR=0.88，95%CI 0.82 至 0.93）和腹泻（OR=0.89，95%CI 0.84 至 0.93）发作显著相关。获得卫生设施与 ARI 风险降低相关（OR=0.55，95%CI 0.45 至 0.68）、腹泻（OR=0.83，95%CI 0.71 至 0.96）和发育迟缓（OR=0.64，95%CI 0.49 至 0.86）。针对综合能源和水、卫生和个人卫生以及妇女赋权方案协同作用的投资，可能有助于减轻儿童早期疾病的负担。中低收入国家的研究和开发行动应解决并包括多部门协同作用。
