Socioeconomic Status and Childhood Morbidity in Rural Bangladesh: A Case Study Using Health and Demographic Data

Abstract

Rationale: The relationship between socioeconomic status (SES) and childhood morbidity is less well studied. Moreover, most of the previous studies were cross sectional and weakly demonstrated that a relationship exists between SES and childhood diseases. Therefore, to grasp the impact of SES on morbidity, it was necessary to analyze the data over a period of years. Objectives: The study aimed at determining the extent of, trends in and variations in major childhood morbidity and service utilization by socioeconomic status. Methodology: This empirical study was based on secondary data from a field research station of International Center for Diarrhoeal Diseases Research in Bangladesh (ICDDR,B) Matlab Health and Demographic Surveillance System (HDSS). Two sets of data were used; child morbidity data of 1996 and 1999 -2002, and socioeconomic data of 1996. A total of 31,052 children below five years of age were included in the sample. Findings: The findings reveal that child morbidity does not considerably vary among different socioeconomic groups. However, children of the richest group are slightly less likely to suffer from diseases. Incidence of diarrhea appears to be same in all income groups, but the richest group children are less likely to have higher number of episodes of diarrhea. Over the study years there was an increasing possibility to have recurrent pneumonia episodes -only 0.5% in 1996 increased to 2.9% children in 2002. Incidence and recurrence of pneumonia differ slightly among the three socioeconomic status (SES) groups. Children of the poorest and the middle group are more likely to have more number of pneumonia episodes than children in the richest group. Female children are more likely to suffer from diarrhea, recurrent diarrhea and recurrent pneumonia. Regarding the equity issue, neither SES nor parent's education have an influence on diarrhea episodes, duration or choice of providers. Conclusion: Total morbidity status of children does not differ much among different SE groups. However, Children of the richest group are slightly less likely to have any type of morbidity. Children of the poorest and the middle group are more likely to have more number of pneumonia episodes than children of the richest group. To improve performance of the health sector, targeting by socioeconomic groups may not be essential for reducing childhood morbidity. It may give better output if overall child health services can be improved in terms of availability and quality in primary care level.