Association between socio-economic status and childhood undernutrition in Bangladesh; a comparison of possession score and poverty index

Abstract

Objective: To determine how much of the variation in nutritional status of Bangladeshi children under 5 years old can be attributed to the socio-economic status of the family. Design: Nutritional status used reference Z-scores of weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ). A 'possession score' was generated based on ownership of a radio, television, bicycle, motorcycle and telephone, and the availability of electricity, with categories of 0 to 41 possessions. A five-point (quintile) 'poverty index' was created using principal component analysis. Setting: The Bangladesh Demographic and Health Survey 2004 was the source of data. Subjects: A sample of 4891 children aged ,5 years was obtained. Results: Some 57?8 % of the sample was either stunted, wasted or underweight (7?7 % were stunted, wasted and underweight). Of those stunted (48?4 %), 25?7 % were also underweight. Underweight and wasting prevalences were 40?7 % and 14?3 %, respectively. Mean WAZ, HAZ and WHZ did not differ by sex. Children of mothers with no education or no possessions were, on average, about 1 SD more underweight and stunted than those with higher educated mothers or with 41 possessions. The possession score provided much greater discrimination of undernutrition than the poverty index. Nearly 50 % of children from households with no possessions were stunted, wasted or underweight (only 27 % in the poorest quintile), compared with only 3-6 % of children from households with 41 possessions (over 13 % in the richest quintile). Conclusions: Maternal education and possession score were the main predictors of a child's nutritional status. Possession score was a much better indicator of undernutrition than the poverty index.

Maternal nutritional status (as measured by height, weight and BMI) in Bangladesh: trends and socio-economic association over the period 1996 to 2007

“…The possession variable was then categorized into five categories of 0 to 4, where 0 means the household had no assets and 4 means that family had all four assets. The 'possession score' was used because a previous study in Bangladesh indicated that this score provided much greater discrimination of undernutrition than a wealth index generated by the principal component analysis technique (15) . All continuous data were checked for skewness using the Cox test (coefficient of skewness divided by the standard error of skewness) as well as examination of the frequency distribution with a normal curve.…”

Reducing health inequalities among girls and adolescent women living in poverty: the success of Bangladesh

“…The effect of relative poverty on gender inequalities in undernutrition was examined by partitioning the sample according to the household possession score; a measure of household socio-economic status that has been previously validated as a predictor of child undernutrition in Bangladesh (Mohsena et al, 2010). The results showed no gender inequalities in health across the different possession score groups, and a similar level of nutritional status across all possession score groups.…”

“…A possession index was calculated based upon responses to the questionnaire about household ownership of electricity; a motorcycle; radio or television. This followed a previously validated possession score (Mohsena et al, 2010) except that the present study asked about the possession of a motorcycle whereas Mohsena et al, (2010) included the possession of a bicycle. This possession score has been shown to be a better predictor of undernutrition among under 5 year old children in Bangladesh than the poverty index (Mohsena et al, 2010).…”

Educating the adult brain: How the neuroscience of learning can inform educational policy

“…These factors may vary substantially across and within countries and impact on learning in more than one way. In many developing nations, low SES correlates with poor nutritional status (Adeladza 2009;Mohsena et al 2010), which can have a fundamental impact on brain development and learning (Dani et al 2005; and see Tanner and Finn-Stevenson 2002;and Bhargava 2001 for reviews and policy implications in developed and developing nations respectively). Nutrition should therefore be seen not only as fundamental for physical health but also as relevant to educational health.…”