|Relationship between household wealth inequality and chronic childhood under-nutrition in Bangladesh|
||Rathavuth Hong, James E Banta and Jose A Betancourt
||International Journal for Equity in Health, 2006, 5:15 doi:10.1186/1475-9276-5-15
Background: 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.
Methods: Utilizing 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.
Results: The 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).
Conclusion: This 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.