Mind the gap: What explains the poor-non-poor inequalities in severe wasting among under-five children in low- and middle-income countries? Compositional and structural characteristics.
Mind the gap: What explains the poor-non-poor inequalities in severe wasting among under-five children in low- and middle-income countries? Compositional and structural characteristics.
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DOI：
10.1371/journal.pone.0241416
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Uthman OA
中科院分区：
文献类型：
--
作者：
Fagbamigbe AF;Kandala NB;Uthman OA
充分了解儿童严重消瘦（SW）发展中的贫困-非贫困差距是应对低收入和中等收入国家（LMICs）弱势儿童健康结果长期严峻挑战的必要条件。关于解释低收入国家社会财富分配不平等的因素，缺乏资料。本研究旨在量化人口、环境和邻近因素在解释中低收入国家贫穷-非贫穷社会工作差距方面的贡献。我们汇总了2010年至2018年在中低收入国家进行的人口与健康调查的连续二级数据。最终数据包括51个LMICs的55，823个社区内的532，680名五岁以下儿童。我们的结果变量是5岁以下儿童是否患有SW。Oaxaca-Blinder分解被用来解读贫困-非贫困差距的SW的决定因素。贫困家庭的儿童从埃及的37.5%到缅甸的52.1%不等。来自贫困家庭的儿童中SW的总体患病率为5.3%，而来自非贫困家庭的儿童中SW的总体患病率为4.2%。有21个国家存在统计上显著的有利于穷人的不平等现象（即工作机会集中在贫困家庭的儿童中），只有3个国家存在统计上显著的有利于非穷人的不平等现象。造成各国财富不平等的重要因素各不相同。SW财富不平等的主要因素包括社区社会经济地位，媒体访问，以及母亲的年龄和教育。社会经济因素创造了最大的差距，在发展SW的贫困和非贫困家庭的儿童之间的不平等。一个潜在的战略，以减轻SW的负担是减少财富的不平等之间的母亲在低收入和中等收入国家通过多部门和国家具体的干预措施，考虑到本研究中确定的因素。
A good understanding of the poor-non-poor gap in childhood development of severe wasting (SW) is a must in tackling the age-long critical challenge to health outcomes of vulnerable children in low- and middle-income countries (LMICs). There is a dearth of information about the factors explaining differentials in wealth inequalities in the distribution of SW in LMICs. This study is aimed at quantifying the contributions of demographic, contextual and proximate factors in explaining the poor-non-poor gap in SW in LMICs. We pooled successive secondary data from the Demographic and Health Survey conducted between 2010 and 2018 in LMICs. The final data consist of 532,680 under-five children nested within 55,823 neighbourhoods from 51 LMICs. Our outcome variable is having SW or not among under-five children. Oaxaca-Blinder decomposition was used to decipher poor-non-poor gap in the determinants of SW. Children from poor households ranged from 37.5% in Egypt to 52.1% in Myanmar. The overall prevalence of SW among children from poor households was 5.3% compared with 4.2% among those from non-poor households. Twenty-one countries had statistically significant pro-poor inequality (i.e. SW concentrated among children from poor households) while only three countries showed statistically significant pro-non-poor inequality. There were variations in the important factors responsible for the wealth inequalities across the countries. The major contributors to wealth inequalities in SW include neighbourhood socioeconomic status, media access, as well as maternal age and education. Socio-economic factors created the widest gaps in the inequalities between the children from poor and non-poor households in developing SW. A potential strategy to alleviate the burden of SW is to reduce wealth inequalities among mothers in the low- and middle-income countries through multi-sectoral and country-specific interventions with considerations for the factors identified in this study.
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影响因子：
1.2
作者：
Eshete, Hiwot;Abebe, Yewelsew;Tesheme, Tesfalem
通讯作者：
Tesheme, Tesfalem
DOI：
10.3760/cma.j.issn.1001-0939.2020.0020
发表时间：
2020-02-20
期刊：
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影响因子：
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作者：
通讯作者：
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影响因子：
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作者：
Fagbamigbe, A. F.;Kandala, N. B.;Uthman, A. O.
通讯作者：
Uthman, A. O.
影响因子：
4.5
作者：
Fagbamigbe, A. F.;Kandala, N. B.;Uthman, O. A.
通讯作者：
Uthman, O. A.
影响因子：
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作者：
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