Ethnicity and child health in northern Tanzania: Maasai pastoralists are disadvantaged compared to neighbouring ethnic groups.
Ethnicity and child health in northern Tanzania: Maasai pastoralists are disadvantaged compared to neighbouring ethnic groups.
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DOI：
10.1371/journal.pone.0110447
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
James S
中科院分区：
文献类型：
--
作者：
Lawson DW;Borgerhoff Mulder M;Ghiselli ME;Ngadaya E;Ngowi B;Mfinanga SG;Hartwig K;James S
坦桑尼亚北方的马赛人是一个主要依赖畜牧业的半游牧民族，他们面临着一些预计会对儿童健康产生负面影响的挑战，包括边缘化、易受干旱影响、服务提供不达标和持续的土地争夺冲突。然而，由于缺乏适当的全国调查数据，没有对马赛儿童健康进行大规模的比较研究。2009年至2011年，坦桑尼亚“永远的草原”组织调查了来自坦桑尼亚北方56个村庄的3500多名儿童的健康状况。抽样调查的主要族裔群体是马赛人、苏库马人、朗吉人和梅鲁人。使用多层次回归，我们比较每个族裔群体的基础上（一）儿童健康的测量，包括人体测量指标的营养状况和自我报告的发病率;和（二）重要的儿童健康的直接决定因素，包括粮食不安全，饮食，母乳喂养行为和疫苗接种率。然后，我们（三）对比家庭之间的马赛人的程度，生计是依赖于牲畜放牧。对儿童营养状况和疾病的衡量证实，与邻近的族裔群体相比，马赛人处于相当不利的地位，梅鲁人相对较弱，而朗吉人和苏库马人在大多数比较中处于中间地位。然而，马赛儿童报告疟疾和蠕虫感染的可能性较小。整个研究地点的粮食不安全程度很高，但马赛人尤为严重，这反映在富含碳水化合物的主食、水果和蔬菜的饮食摄入量较低。尽管据报道，马赛人对牛奶（一种潜在的断奶食品）的消费量较高，但母乳喂养在马赛人中得到了推广。马赛和苏库马的疫苗接种覆盖率最低。与主要依靠农业的马赛人相比，主要依靠畜牧业的马赛人表现出进一步不利的迹象。我们讨论了潜在的生态，社会经济，人口和文化因素负责这些差异和人口健康研究和政策的影响。
The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow's milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy.
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