Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)

Abstract Background Despite significant progress in reducing child undernutrition, Bangladesh remains among the top six countries globally with the largest burden of child stunting and has disproportionately high stunting prevalence among the urban poor. We use population representative data to iden...

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Autores principales:	Hayman Win, Jordyn Wallenborn, Nicole Probst-Hensch, Günther Fink
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Urban health Health equity Child nutrition Stunting Linear growth Bangladesh Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/7c2fe61a86b94e8f9b420fb0469d4625
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spelling	oai:doaj.org-article:7c2fe61a86b94e8f9b420fb0469d46252021-12-05T12:09:37ZUnderstanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)10.1186/s12889-021-12181-x1471-2458https://doaj.org/article/7c2fe61a86b94e8f9b420fb0469d46252021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12181-xhttps://doaj.org/toc/1471-2458Abstract Background Despite significant progress in reducing child undernutrition, Bangladesh remains among the top six countries globally with the largest burden of child stunting and has disproportionately high stunting prevalence among the urban poor. We use population representative data to identify key predictors of child stunting in Bangladesh and assess their contributions to linear growth differences observed between urban poor and non-poor children. Methods We combined six rounds of Demographic and Health Survey data spanning 2000-2018 and used official poverty rates to classify the urban population into poor and non-poor households. We identified key stunting determinants using stepwise selection method. Regression-decomposition was used to quantify contributions of these key determinants to poverty-based intra-urban differences in child linear growth status. Results Key stunting determinants identified in our study predicted 84% of the linear growth difference between urban poor and non-poor children. Child’s place of birth (27%), household wealth (22%), maternal education (18%), and maternal body mass index (11%) were the largest contributors to the intra-urban child linear growth gap. Difference in average height-for-age z score between urban poor and non-poor children declined by 0.31 standard deviations between 2000 and 2018. About one quarter of this observed decrease was explained by reduced differentials between urban poor and non-poor in levels of maternal education and maternal underweight status. Conclusions Although the intra-urban disparity in child linear growth status declined over the 2000-2018 period, socioeconomic gaps remain significant. Increased nutrition-sensitive programs and investments targeting the urban poor to improve girls’ education, household food security, and maternal and child health services could aid in further narrowing the remaining linear growth gap.Hayman WinJordyn WallenbornNicole Probst-HenschGünther FinkBMCarticleUrban healthHealth equityChild nutritionStuntingLinear growthBangladeshPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Urban health Health equity Child nutrition Stunting Linear growth Bangladesh Public aspects of medicine RA1-1270
spellingShingle	Urban health Health equity Child nutrition Stunting Linear growth Bangladesh Public aspects of medicine RA1-1270 Hayman Win Jordyn Wallenborn Nicole Probst-Hensch Günther Fink Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
description	Abstract Background Despite significant progress in reducing child undernutrition, Bangladesh remains among the top six countries globally with the largest burden of child stunting and has disproportionately high stunting prevalence among the urban poor. We use population representative data to identify key predictors of child stunting in Bangladesh and assess their contributions to linear growth differences observed between urban poor and non-poor children. Methods We combined six rounds of Demographic and Health Survey data spanning 2000-2018 and used official poverty rates to classify the urban population into poor and non-poor households. We identified key stunting determinants using stepwise selection method. Regression-decomposition was used to quantify contributions of these key determinants to poverty-based intra-urban differences in child linear growth status. Results Key stunting determinants identified in our study predicted 84% of the linear growth difference between urban poor and non-poor children. Child’s place of birth (27%), household wealth (22%), maternal education (18%), and maternal body mass index (11%) were the largest contributors to the intra-urban child linear growth gap. Difference in average height-for-age z score between urban poor and non-poor children declined by 0.31 standard deviations between 2000 and 2018. About one quarter of this observed decrease was explained by reduced differentials between urban poor and non-poor in levels of maternal education and maternal underweight status. Conclusions Although the intra-urban disparity in child linear growth status declined over the 2000-2018 period, socioeconomic gaps remain significant. Increased nutrition-sensitive programs and investments targeting the urban poor to improve girls’ education, household food security, and maternal and child health services could aid in further narrowing the remaining linear growth gap.
format	article
author	Hayman Win Jordyn Wallenborn Nicole Probst-Hensch Günther Fink
author_facet	Hayman Win Jordyn Wallenborn Nicole Probst-Hensch Günther Fink
author_sort	Hayman Win
title	Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
title_short	Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
title_full	Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
title_fullStr	Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
title_full_unstemmed	Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)
title_sort	understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in bangladesh (2000-2018)
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7c2fe61a86b94e8f9b420fb0469d4625
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_version_	1718372201232596992

Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)

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