Abstract
BackgroundHousehold food insecurity and under-nutrition remain critically important in developing countries struggling to emerge from the scourge of poverty, where historically, improvements in economic conditions have benefited only certain privileged groups, causing growing inequality in health and healthcare among the population.MethodsUtilizing information from 5,977 children aged 0-59 months included in the 2004 Bangladesh Demographic and Health Survey , this study examined the relationship between household wealth inequality and chronic childhood under-nutrition. A child is defined as being chronically undernourished or whose growth rate is adversely stunted, if his or her z-score of height-for-age is more than two standard deviations below the median of international reference. Household wealth status is measured by an established index based on household ownership of durable assets. This study utilized multivariate logistic regressions to estimate the effect of household wealth status on adverse childhood growth rate.ResultsThe results indicate that children in the poorest 20% of households are more than three time as likely to suffer from adverse growth rate stunting as children from the wealthiest 20% of households (OR=3.6; 95% CI: 3.0, 4.3). The effect of household wealth status remain significantly large when the analysis was adjusted for a child's multiple birth status, age, gender, antenatal care, delivery assistance, birth order, and duration that the child was breastfed; mother's age at childbirth, nutritional status, education; household access to safe drinking water, arsenic in drinking water, access to a hygienic toilet facility, cooking fuel cleanliness, residence, and geographic location (OR=2.4; 95% CI: 1.8, 3.2).ConclusionThis study concludes that household wealth inequality is strongly associated with childhood adverse growth rate stunting. Reducing poverty and making services more available and accessible to the poor are essential to improving overall childhood health and nutritional status in Bangladesh.
Highlights
Household food insecurity and under-nutrition remain critically important in developing countries struggling to emerge from the scourge of poverty, where historically, improvements in economic conditions have benefited only certain privileged groups, causing growing inequality in health and healthcare among the population
The country's substantial agricultural sector contributes to 19% of the overall gross domestic product (GDP) and to the significant increase of all exported agriculture products
The primary objective of this study is to investigate the association between household wealth inequality and childhood under-nutrition in Bangladesh
Summary
Household food insecurity and under-nutrition remain critically important in developing countries struggling to emerge from the scourge of poverty, where historically, improvements in economic conditions have benefited only certain privileged groups, causing growing inequality in health and healthcare among the population. In spite of remarkable advances in public health during recent decades, many people throughout the developing world remain vulnerable to food insecurity, under-nutrition, and ill health [1] These problems tend to be severe in developing countries struggling to emerge from the scourge of extreme poverty [2]. The industrial sector is rapidly becoming one of the more important components of the Bangladesh economy, contributing 34% to GDP, while the service sector contributing to 47% of GDP Despite these economic improvements, the country still struggles to emerge from the clutches of poverty. A recent comparative risk assessment by the World Health Organization estimates under-nutrition is by far the largest contributor to the global burden of disease [15]
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