Trends and determinants of inequities in childhood stunting in Bangladesh from 1996/7 to 2014

International Journal for Equity in Health

Research

Atonu Rabbani¹  Sifat Yusuf²  Alayne Adams²  Akib Khan³ 

[1] Department of Economics, University of Dhaka, Dhaka, Bangladesh;Health Systems and Population Sciences Division, International Center for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh;James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh;

关键词: Stunting;    Severe stunting;    Socioeconomic inequities;    Bangladesh;    Bangladesh Demographic and Health Survey;    Concentration index;    Decomposition;   

DOI  :  10.1186/s12939-016-0477-7

 received in 2016-06-02, accepted in 2016-11-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWe explore long-term trends and determinants of socioeconomic inequities in chronic childhood undernutrition measured by stunting among under-five children in Bangladesh. Given that one in three children remain stunted in Bangladesh, the socioeconomic mapping of stunting prevalence may be critical in designing public policies and interventions to eradicate childhood undernutrition.MethodsSix rounds of Bangladesh Demographic and Health Survey data are utilized, spanning the period 1996/97 to 2014. Using recognized measures of absolute and relative inequality (namely, absolute and relative difference, concentration curve and index), we quantify trends, and decompose changes in the concentration index to identify factors that best explain observed dynamics.ResultsDespite remarkable improvements in average nutritional status over the last two decades, socio-economic inequalities have persisted, and according to some measures, even worsened. For example, expressed as rate-ratios, the relative inequality in under-five stunting increased by 56% and the concentration index more than doubled between 1996/97 and 2014. Decomposition analyses find that wealth and maternal factors such as mothers’ schooling and short stature are major contributors to observed socio-economic inequalities in child undernutrition and their changes over time.ConclusionsReflecting on recent success around socioeconomic and gender equity in child mortality, and the weak legacy of nutrition policy in Bangladesh, we suggest that nutrition programming energies be focused specifically on the most disadvantaged and applied at scale to close socioeconomic gaps in stunting prevalence.

【 授权许可】

CC BY   
© The Author(s). 2016