Ghosh Pritam
Department of Geography, Hijli College, Kharagpur, West Bengal, India.
Am J Hum Biol. 2024 Sep;36(9):e24092. doi: 10.1002/ajhb.24092. Epub 2024 May 22.
BACKGROUNDS & OBJECTIVES: The privileging of boys in immunization coverage, breastfeeding, and other child care practices in Indian patriarchal society raises questions about whether there are sex differences in the prevalence of undernutrition among children. This study evaluates the sex gap in the prevalence of Composite Index of Anthropometric Failure (CIAF) among Indian children from 2015-16 to 2019-21. Additionally, it seeks to identify the sex-specific determinants and persistent sex gap at national and subnational levels (social, economic, religious, and geopolitical regions) in anthropometric failure among the children from 2015-16 to 2019-21.
The study utilizes the 4th (2015-16) and 5th (2019-21) rounds of the National Family Health Survey data. Logistic regression models and the Fairlie decomposition technique were employed to explore the persistent and significant sex gap in the prevalence of CIAF, as well as the sex-specific determinants of CIAF among children in 2015-16 and 2019-21.
The study reveals a significant sex gap (approximately 4%-points), with boy's disadvantage in the prevalence of CIAF from 2015-16 to 2019-21 at both the national and subnational levels (social, religious, socioeconomic groups, and geopolitical regions). The gap is more pronounced in the first year of life and decreases in later stages. A comparatively faster CIAF decline among girls from 2016 to 2021 has widened the sex gap in final year than the previous. Child, mother, household, community, and geographic backgrounds explains about 5%-6% of the sex gap in the prevalence of CIAF from 2015-16 to 2019-21. The remaining 94%-95% of the unexplained sex gap may be attributed to biological factors or other factors. Currently, a heightened boy's disadvantage in CIAF risk is observed in ST community, wealthiest families, and the northern India.
The findings suggest a special attention for boys under 3 years to offset biological disadvantages like greater disease sensitivity and fragility compared to girls early on.
在印度父权社会中，男孩在免疫接种覆盖率、母乳喂养及其他儿童护理实践方面享有特权，这引发了关于儿童营养不良患病率是否存在性别差异的问题。本研究评估了2015 - 16年至2019 - 21年印度儿童中人体测量失败综合指数（CIAF）患病率的性别差距。此外，它旨在确定2015 - 16年至2019 - 21年期间全国和次国家层面（社会、经济、宗教和地缘政治区域）儿童人体测量失败中性别特异性决定因素和持续存在的性别差距。
本研究利用了第四轮（2015 - 16年）和第五轮（2019 - 21年）的全国家庭健康调查数据。采用逻辑回归模型和费尔利分解技术来探究CIAF患病率中持续存在且显著的性别差距，以及2015 - 16年和2019 - 21年儿童中CIAF的性别特异性决定因素。
该研究揭示了一个显著的性别差距（约4个百分点），在2015 - 16年至2019 - 21年期间，全国和次国家层面（社会、宗教、社会经济群体和地缘政治区域）男孩在CIAF患病率方面处于劣势。这种差距在出生后的第一年更为明显，在后期有所减小。2016年至2021年期间女孩的CIAF下降速度相对较快，使得最后一年的性别差距比之前有所扩大。儿童、母亲、家庭、社区和地理背景解释了2015 - 16年至2019 - 21年CIAF患病率中约5% - 6%的性别差距。其余94% - 95%无法解释的性别差距可能归因于生物学因素或其他因素。目前，在部落社区、最富裕家庭和印度北部地区，男孩在CIAF风险方面的劣势更为明显。
研究结果表明，需特别关注3岁以下男孩，以弥补其在早期相比女孩更大的疾病易感性和脆弱性等生物学劣势。
