scholarly journals Socioeconomic inequalities in child growth failure in Ethiopia: findings from the 2000 and 2016 Demographic and Health Surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051304
Author(s):  
Tolesa Bekele ◽  
Patrick Rawstorne ◽  
Bayzidur Rahman
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Growth Failure ◽  
Wealth Quintile ◽  
Child Growth ◽  
Socioeconomic Inequalities ◽  
Geographical Region ◽  
Demographic And Health Surveys ◽  
Maternal Body Mass Index ◽  
Geographical Regions

ObjectiveSocioeconomic inequalities in child growth failure (CGF) remain one of the main challenges in Ethiopia. This study examined socioeconomic inequalities in CGF and determinants that contributed to these inequalities in Ethiopia.MethodsThe Ethiopia Demographic and Health Surveys 2000 and 2016 data were used in this study. A pooled unweighted sample of the two surveys yielded 21514 mother–child pairs (10873 in 2000 and 10641 in 2016). We assessed socioeconomic inequalities in CGF indicators using the concentration curve and concentration index (CI). We then decomposed the CI to identify percentage contribution of each determinant to inequalities.ResultsSocioeconomic inequalities in CGF have increased in Ethiopia between 2000 and 2016. The CI increased from −0.072 and −0.139 for stunting, −0.088 and −0.131 for underweight and −0.015 and −0.050 for wasting between 2000 and 2016, respectively. Factors that mainly contributed to inequalities in stunting included geographical region (49.43%), number of antenatal care visits (31.40%) and child age in months (22.20%) in 2000. While in 2016, inequality in stunting was contributed mainly by wealth quintile (46.16%) and geographical region (−13.70%). The main contributors to inequality in underweight were geographical regions (82.21%) and wealth quintile (27.21%) in 2000, while in 2016, wealth quintile (29.18%), handwashing (18.59%) and access to improved water facilities (−17.55%) were the main contributors. Inequality in wasting was mainly contributed to by maternal body mass index (−66.07%), wealth quintile (−45.68%), geographical region (36.88%) and paternal education (33.55%) in 2000, while in 2016, wealth quintile (52.87%) and urban areas of residence (-17.81%) were the main driving factors.ConclusionsThis study identified substantial socioeconomic inequalities in CGF, and factors that relatively contributed to the disparities. A plausible approach to tackling rising disparities may involve developing interventions on the identified predictors and prioritising actions for the most socioeconomically disadvantaged groups.

scholarly journals Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys

2014 ◽  
Vol 17 (11) ◽  
pp. 2407-2418 ◽  
Author(s):  
Helga Bjørnøy Urke ◽  
Maurice B Mittelmark ◽  
Martín Valdivia
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Maternal Education ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Sampling Weights ◽  
Cross Sectional ◽  
Growth Standards ◽  
Low Educated

AbstractObjectiveTo examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria.DesignTrend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991–2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban–rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights).SettingPeru.SubjectsChildren aged 0–59 months surveyed in 1991–92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007–08 (n 8232) and 2011 (n 8186).ResultsChild stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991–2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020).ConclusionsThe 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.

scholarly journals Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Emeline Rougeaux ◽  
J. Jaime Miranda ◽  
Mary Fewtrell ◽  
Jonathan C. K. Wells
Keyword(s):  
Internal Migration ◽  
Urban Areas ◽  
Health Surveys ◽  
Child Outcomes ◽  
Child Growth ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Nutritional Health ◽  
Double Burden Of Malnutrition ◽  
Overweight Prevalence

Abstract Background Peru has historically experienced high rural-to-urban migration. Despite large reductions in undernutrition, overweight is increasing. Elsewhere, internal migration has been associated with differences in children’s growth and nutritional health. We investigated how child growth and nutritional status in Peru varied over time and in association with maternal internal migration. Methods Using data from Demographic & Health Surveys from 1991 to 2017, we assessed trends in child growth (height-for-age [HAZ], weight-for-age [WAZ], weight-for-height [WHZ] z scores) and nutritional health (stunting, underweight, overweight) by maternal adult internal migration (urban [UNM] or rural non-migrant [RNM], or urban-urban [UUM], rural-urban [RUM], rural-rural [RRM], or urban-rural migrant [URM]). Using 2017 data, we ran regression analyses, adjusting for confounders, to investigate associations of maternal migration with child outcomes and the maternal and child double burden of malnutrition. We further stratified by timing of migration, child timing of birth and, for urban residents, type of area of residence. Results are given as adjusted predictive margins (mean z score or %) and associated regression p-values [p]. Results In 1991–2017, child growth improved, and undernutrition decreased, but large differences by maternal migration persisted. In 2017, within urban areas, being the child of a migrant woman was associated with lower WHZ (UUM = 0.6/RUM = 0.5 vs UNM = 0.7; p = 0.009 and p < 0.001 respectively) and overweight prevalence ((RUM 7% vs UNM = 11% [p = 0.002]). Results however varied both by child timing of birth (birth after migration meant greater overweight prevalence) and type of area of residence (better linear growth in children of migrants [vs non-migrants] in capital/large cities and towns but not small cities). In rural areas, compared to RNM, children of URM had higher HAZ (− 1.0 vs − 1.2; p < 0.001) and WAZ (− 0.3 vs − 0.4; p = 0.001) and lower stunting (14% vs 21%; [p < 0.001]). There were no differences by timing of birth in rural children, nor by time since migration across all children. The mother and child double burden of malnutrition was higher in rural than urban areas but no differences were found by maternal internal migration. Conclusions Migration creates a unique profile of child nutritional health that is not explained by maternal ethnic and early life factors, but which varies depending on the pathway of migration, the child timing of birth in relation to migration and, for urban dwellers, the size of the place of destination. Interventions to improve child nutritional health should take into consideration maternal health and migration history.

scholarly journals Urban–Rural Disparities in the Magnitude and Determinants of Stunting among Children under Five in Tanzania: Based on Tanzania Demographic and Health Surveys 1991–2016

2021 ◽  
Vol 18 (10) ◽  
pp. 5184
Author(s):  
Wenjun Zhu ◽  
Si Zhu ◽  
Bruno F. Sunguya ◽  
Jiayan Huang
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Household Level ◽  
Individual Level ◽  
Child Stunting ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural ◽  
The Individual

Our study aims to examine the disparity of under-5 child stunting prevalence between urban and rural areas of Tanzania in the past three decades, and to explore factors affecting the rural–urban disparity. Secondary analyses of Tanzania Demographic and Health Surveys (TDHS) data drawn from 1991–1992, 1996, 1999, 2004–2005, 2009–2010, and 2015–2016 surveys were conducted. Under-5 child stunting prevalence was calculated separately for rural and urban children and its decline trends were examined by chi-square tests. Descriptive analyses were used to present the individual-level, household-level, and societal-level characteristics of children, while multivariable logistic regression analyses were performed to examine determinants of stunting in rural and urban areas, respectively. Additive interaction effects were estimated between residence and other covariates. The results showed that total stunting prevalence was declining in Tanzania, but urban–rural disparity has widened since the decline was slower in the rural area. No interaction effect existed between residence and other determinants, and the urban–rural disparity was mainly caused by the discrepancy of the individual-level and household-level factors between rural and urban households. As various types of determinants exist, multisector nutritional intervention strategies are required to address the child stunting problem. Meanwhile, the intervention should focus on targeting vulnerable children, rather than implementing different policies in rural and urban areas.

scholarly journals Complementary feeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys

2013 ◽  
Vol 11 (4) ◽  
pp. 815-828 ◽  
Author(s):  
Rebecca A. Heidkamp ◽  
Mohamed Ag Ayoya ◽  
Ismael Ngnie Teta ◽  
Rebecca J. Stoltzfus ◽  
Joseline Pierre Marhone
Keyword(s):  
Health Surveys ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Child Growth ◽  
Demographic And Health Surveys ◽  
Growth Outcomes

scholarly journals Trends of caesarean section deliveries in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aaisha Amjad ◽  
Abeeha Imran ◽  
Nabeeha Shahram ◽  
Rubeena Zakar ◽  
Ahmed Usman ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Urban Areas ◽  
Health Surveys ◽  
Secondary Data ◽  
Demographic And Health Surveys ◽  
Independent Variables ◽  
Economic Class ◽  
The Past ◽  
Child Bearing ◽  
Socio Demographic Factors

Abstract Background Pakistan is among those countries where the number of caesarean section births has increased unusually in the past two decades. Therefore, the aim of the present study is to analyse the trend of caesarean section deliveries among child-bearing women (aged 15–49 years) in Pakistan and to identify maternal socio-demographic factors and pregnancy-related variables associated with the change in caesarean deliveries from 1990 to 2018. Methods Secondary data from Pakistan Demographic and Health Surveys (1990–2018) were analysed. The analysis of data was confined to child-bearing mothers. Sample sizes were 4029, 5721, 7461 and 8287 for the time periods of 1990–91, 2006–07, 2012–13 and 2017–18, respectively. Socio-demographic information of the mothers and pregnancy-related variables were taken as independent variables for the present study. The association between independent variables and caesarean deliveries was measured in terms of unadjusted odds ratios (OR) and adjusted OR (AOR). Results The percentages of the mothers who had at least one delivery during the 5 years prior to each survey who had caesarean deliveries increased continuously from 3.2% in 1990–91 to 19.6% in 2017–18. Results indicate that mothers over 24 years of age, located in Punjab, from the richest socio-economic class and living in urban areas were more likely to have delivered by caesarean section. Mothers with a first child in birth order and who had five and more children, as well as mothers who had more antenatal care visits and delivered babies in private hospitals showed a higher probability of caesarean section births. Conclusions The findings of the present study confirm the gradual upsurge in the percentage of mothers delivering by caesarean section during the past two decades in Pakistan. Against this backdrop, some measures need to be taken by health departments to regulate the number of caesarean deliveries. Awareness among women about pregnancy complications and elaborated details by gynaecologists about the medically indicated reasons for caesarean delivery are a few important steps in Pakistan that can help in reducing caesarean deliveries which are not medically indicated.

scholarly journals Association between intimate partner violence and poor child growth: results from 42 demographic and health surveys

2016 ◽  
Vol 94 (5) ◽  
pp. 331-339 ◽  
Author(s):  
Jeanne Chai ◽  
Günther Fink ◽  
Sylvia Kaaya ◽  
Goodarz Danaei ◽  
Wafaie Fawzi ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Health Surveys ◽  
Intimate Partner ◽  
Child Growth ◽  
Demographic And Health Surveys ◽  
Poor Child

scholarly journals Socio-economic differentials in minimum dietary diversity among young children in South-East Asia: evidence from Demographic and Health Surveys

2018 ◽  
Vol 21 (16) ◽  
pp. 3048-3057 ◽  
Author(s):  
Chloe M Harvey ◽  
Marie-Louise Newell ◽  
Sabu S Padmadas
Keyword(s):  
Young Children ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Surveys ◽  
Dietary Diversity ◽  
East Asian ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Minimum Dietary Diversity

AbstractObjectiveTo investigate the socio-economic differentials underlying minimum dietary diversity (MDD) among children aged 6–23 months in three economically diverse South-East Asian countries.DesignThe outcome variable MDD was defined as the proportion of children aged 6–23 months who received foods from four of the seven recommended food groups within the 24 h prior to interview. The association between socio-economic factors and MDD, adjusting for relevant characteristics, was examined using logistic regression.SettingWe used cross-sectional population data from recent Demographic and Health Surveys from Cambodia (2014), Myanmar (2015–16) and Indonesia (2012).SubjectsTotal of 8364 children aged 6–23 months.ResultsApproximately half of all children met the MDD, varying from 47·7 % in Cambodia (n1023) to 58·2 % in Indonesia (n2907) and 24·6 % in Myanmar (n301). The likelihood (adjusted OR; 95 % CI) of meeting MDD increased for children in the richest households (Cambodia: 2·4; 1·7, 3·4; Myanmar: 1·8; 1·1, 3·0; Indonesia: 2·0; 1·6, 2·5) and those residing in urban areas (Cambodia: 1·4; 1·1, 1·9; Myanmar: 1·7; 1·2, 2·4; Indonesia: 1·7; 1·5, 1·9). MDD deprivation was most severe among children from the poorest households in rural areas. The association between mother’s labour force participation and MDD was positive in all three countries but reached significance only in Indonesia (1·3; 1·1, 1·5).ConclusionsMDD deprivation among young children was significantly high in socio-economically disadvantaged families in all three study settings. MDD requirements are not being met for approximately half of young children in these three South-East Asian countries.

scholarly journals Trends in child growth failure among children under five years of age in Ethiopia: Evidence from the 2000 to 2016 Demographic and Health Surveys

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254768
Author(s):  
Tolesa Bekele ◽  
Patrick Rawstorne ◽  
Bayzidur Rahman
Keyword(s):  
Growth Failure ◽  
Total Sample ◽  
Child Growth ◽  
World Health ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Z Score ◽  
Middle Income ◽  
The Government ◽  
Health Organization

Introduction In a majority of low- and middle-income countries (LMICs), levels of child growth failure (CGF) have steadily declined since 2000. However, some countries show a different trend. Despite continued investment from the government of Ethiopia as well as donors, CGF levels are still high in Ethiopia. This study aimed to assess trends in CGF and associated sociodemographic, economic and water, sanitation, and hygiene (WASH) factors from 2000 to 2016 in Ethiopia. Methods Data were taken from four rounds of the Ethiopia Demographic and Health Survey (EDHS). Children aged between 0 to 59 months were included. CGF indicators were categorised based on height-for-age z-score (HAZ) < -2 Standard deviation (SD), weight-for-age z-score (WAZ) < -2 SD and weight-for-height z-score (WHZ) < -2 SD. CGF trends were estimated for predicted probabilities and odds ratios (ORs) between 2000 and 2016. Results A total sample size of 31978 for HAZ, 32045 for WAZ and 32246 for WHZ were included in the current study. Stunting decreased from an adjusted odds ratio (AOR) = 0.77 (95% CI: 0.67 to 0.88) in 2005 to an AOR = 0.45 (95% CI: 0.39 to 0.53) in 2016 compared with the year 2000. Compared with data in 2000, underweight decreased from an AOR of 0.70 (95% CI: 0.61 to 0.80) in 2005 to an AOR of 0.43 (95% CI: 0.36 to 0.50) in 2016. Wasting declined from an AOR of 0.91 (95% CI: 0.75 to 1.10) in 2005 to an AOR of 0.76 (95% CI: 0.61 to 0.94) in 2016, compared with data in 2000. Conclusions Between 2000 to 2016, there was a decline in CGF levels albeit the levels are still relatively high compared with the World Health Organization (WHO) cut-off levels for public health concern. Observed rates of change varied across sociodemographic, economic and WASH factors which suggest that interventions tailored towards addressing the imbalances across those factors are required.

scholarly journals Decomposition of socioeconomic inequalities in child vaccination in Ethiopia: results from the 2011 and 2016 demographic and health surveys

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039617
Author(s):  
Firew Tekle Bobo ◽  
Andrew Hayen
Keyword(s):  
Maternal Health ◽  
Vaccination Coverage ◽  
Health Surveys ◽  
Socioeconomic Inequalities ◽  
Childhood Vaccination ◽  
Maternal Health Service ◽  
Demographic And Health Surveys ◽  
Measles Vaccine ◽  
Concentration Indices ◽  
Child Vaccination

ObjectivesMonitoring and addressing unnecessary and avoidable differences in child vaccination is a critical global concern. This study aimed to assess socioeconomic inequalities in basic vaccination coverage among children aged 12–23 months in Ethiopia.Design, setting and participantsSecondary analyses of cross-sectional data from the two most recent (2011 and 2016) Ethiopia Demographic and Health Surveys were performed. This analysis included 1930 mother–child pairs in 2011 and 2004 mother–child pairs in 2016.Outcome measuresCompletion of basic vaccinations was defined based on whether a child received a single dose of Bacille Calmette-Guerin (BCG), three doses of diphtheria, tetanus toxoids and pertussis (DTP), three doses of oral polio vaccine and one dose of measles vaccine.MethodsThe concentration Curve and Concentration Indices (CCIs) were used to estimate wealth related to inequalities. The concentration indices were also decomposed to examine the contributing factors to socioeconomic inequalities in childhood vaccination.ResultsFrom 2011 to 2016, the proportion of children who received basic vaccination increased from 24.6% (95% CI 21.4% to 28.0%) to 38.6% (95% CI 34.6% to 42.9%). While coverage of BCG, DTP and polio immunisation increased during the study period, the uptake of measles vaccine decreased. The positive concentration index shows that basic vaccination coverage was pro-rich (CCI=0.212 in 2011 and CCI=0.172 in 2016). The decomposition analysis shows that use of maternal health services such as family planning and antenatal care, socioeconomic status, exposure to media, urban–rural residence and maternal education explain inequalities in basic vaccination coverage in Ethiopia.ConclusionsChildhood vaccination coverage was low in Ethiopia. Vaccination was less likely in poorer than in richer households. Addressing wealth inequalities, enhancing education and improving maternal health service coverage will reduce socioeconomic inequalities in basic vaccination uptake in Ethiopia.

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