Demystifying the factors associated with rural-urban gaps in severe acute malnutrition among under-five children in low- and middle-income countries: a decomposition analysis
Demystifying the factors associated with rural-urban gaps in severe acute malnutrition among under-five children in low- and middle-income countries: a decomposition analysis
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DOI：
10.1038/s41598-020-67570-w
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发表时间：
2020-07-07
影响因子：
4.6
通讯作者：
Uthman, A. O.
中科院分区：
文献类型：
--
作者：
Fagbamigbe, A. F.;Kandala, N. B.;Uthman, A. O.
在中低收入国家，对造成5岁以下儿童严重急性营养不良城乡差异的根本原因的探讨、操作、研究和理解都很差。我们使用2010年至2018年在51个LMIC中进行的连续人口和健康调查的数据集，在控制个人，家庭和邻里因素的同时，分解了SAM相关因素中的城乡不平等。这些数据包括51个国家55，823个社区内的532，680名五岁以下儿童。我们应用Blinder-Oaxaca分解技术来量化各种相关因素对SAM中观察到的城乡差异的贡献。总的来说，69%的儿童生活在农村地区，从加蓬的16%到乍得的81%不等。农村儿童SAM的总体患病率为4.8%，而城市儿童为4.2%。东帝汶农村地区的SAM流行率最高（11.1%），洪都拉斯城市地区的SAM流行率最高（8.5%）。9个国家存在统计上显著的亲农村（农村地区SAM的可能性明显较高）不平等，而只有塔吉克斯坦和马拉维存在统计上显著的亲城市不平等（p
What explains the underlying causes of rural-urban differentials in severe acute malnutrition (SAM) among under-five children is poorly exploited, operationalized, studied and understood in low- and middle-income countries (LMIC). We decomposed the rural-urban inequalities in the associated factors of SAM while controlling for individual, household, and neighbourhood factors using datasets from successive demographic and health survey conducted between 2010 and 2018 in 51 LMIC. The data consisted of 532,680 under-five children nested within 55,823 neighbourhoods across the 51 countries. We applied the Blinder-Oaxaca decomposition technique to quantify the contribution of various associated factors to the observed rural-urban disparities in SAM. In all, 69% of the children lived in rural areas, ranging from 16% in Gabon to 81% in Chad. The overall prevalence of SAM among rural children was 4.8% compared with 4.2% among urban children. SAM prevalence in rural areas was highest in Timor-Leste (11.1%) while the highest urban prevalence was in Honduras (8.5%). Nine countries had statistically significant pro-rural (significantly higher odds of SAM in rural areas) inequality while only Tajikistan and Malawi showed statistically significant pro-urban inequality (p