埃塞俄比亚 6-23 个月龄儿童中富含维生素 A 的食物消费的与财富相关的不平等；2019 年微型 DHS 数据的 Wagstaff 分解。
Wealth-related inequality in vitamin A rich food consumption among children of age 6-23 months in Ethiopia; Wagstaff decomposition of the 2019 mini-DHS data.
机构信息
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Internal Medicine, University of Gondar College of Medicine and Health Science, Comprehensive Specialized Hospital, Gondar, Ethiopia.
出版信息
PLoS One. 2024 Oct 8;19(10):e0302368. doi: 10.1371/journal.pone.0302368. eCollection 2024.
INTRODUCTION
Vitamin A (VA) cannot be made in the human body and thus foods rich in VA are the only sources of vitamin A for the body. However, ensuring availability in adequate amount of foods rich in VA remains a challenge, mainly in low-income counties including Ethiopia. In addition, children from the poorest and less educated families of same country have disproportionately limited consumptions of foods rich in VA. Therefore, the present study aimed assessing the wealth related inequality in vitamin A consumption (VAC) and decompose it to the various contributing factors.
METHODS
This study was conducted using the 2019 Ethiopian demographic and health survey data on a weighted sample of 1,497 children of age 6-23 months in Ethiopia. The wealth related inequality in VAC was quantified using concentration index and plotted using concentration curve. The Wagstaff decomposition analysis was performed to assess the relative contributions of each explanatory variable to the inequalities in the overall concentration index of VAC.
RESULT
The overall Wagstaff normalized concentration index (C) analyses of the wealth-related inequality in consumption of foods rich in VA among children aged 6-23 months was [C = 0.25; 95% C: 0.15, 0.35]. Further decomposition of the C by the explanatory variables reported the following contributions; primary level of women's education (7.2%), secondary and above (17.8%), having ANC visit during pregnancy (62.1%), delivery at a health institution (26.53%), living in the metropolis (13.7%), central region (34.2%), child age 18-23 months (4.7%) contributed to the observed wealth related inequality in the consumption of foods rich in vitamin A in Ethiopia.
CONCLUSION
We found pro-rich wealth-related inequality in VAC among children of age 6-23 months in Ethiopia. Additionally, maternal education, region, ANC visit, and place of delivery were the significant contributors of wealth-related inequality of VAC. Nutritional related interventions should prioritise children from poorer households and less educated mothers. Moreover, enhancing access to ANC and health facilities delivery services through education, advocacy, and campaign programs is highly recommended in the study setting.
简介
维生素 A（VA）无法在人体内合成，因此富含 VA 的食物是人体获取维生素 A 的唯一来源。然而，确保富含 VA 的食物的供应量充足仍然是一个挑战，特别是在包括埃塞俄比亚在内的低收入国家。此外，来自同一国家最贫穷和受教育程度最低的家庭的儿童对富含 VA 的食物的消费也受到了不成比例的限制。因此，本研究旨在评估维生素 A 消费（VAC）的财富相关不平等，并将其分解为各种促成因素。
方法
本研究使用 2019 年埃塞俄比亚人口与健康调查数据，对埃塞俄比亚年龄在 6-23 个月的 1497 名儿童进行了加权样本分析。使用集中指数来量化 VAC 的财富相关不平等，并通过集中曲线进行绘制。采用 Wagstaff 分解分析来评估每个解释变量对 VAC 总体集中指数不平等的相对贡献。
结果
6-23 个月儿童摄入富含 VA 食物的财富相关不平等的总体 Wagstaff 标准化集中指数（C）分析结果为[C=0.25；95%置信区间：0.15，0.35]。通过解释变量对 C 的进一步分解报告了以下贡献：妇女小学教育水平（7.2%）、中学及以上（17.8%）、孕期接受 ANC 检查（62.1%）、在医疗机构分娩（26.53%）、居住在大都市（13.7%）、中部地区（34.2%）、儿童年龄为 18-23 个月（4.7%）对埃塞俄比亚富含维生素 A 的食物消费的财富相关不平等有影响。
结论
我们发现埃塞俄比亚 6-23 个月儿童的 VAC 存在有利于富人的财富相关不平等。此外，母亲教育、地区、ANC 检查和分娩地点是 VAC 财富相关不平等的重要促成因素。营养相关干预措施应优先考虑来自贫困家庭和受教育程度较低的母亲的儿童。此外，在研究环境中，强烈建议通过教育、宣传和运动方案，增加获得 ANC 和卫生设施分娩服务的机会。
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