Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000–2011

Kien, Vu Duy; Lee, Hwa Young; Nam, You Seon; Oh, Juhwan; Giang, Kim Bảo; Minh, Hoang Van

doi:10.3402/gha.v9.29263

Cited by 54 publications

(58 citation statements)

References 18 publications

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“…Socio‐economic status is clearly a strong driver of child stunting (P. H. Nguyen et al, ), but our analysis only included poverty at the commune level, and household wealth can vary substantially within communes of various socio‐economic status. Furthermore, stunting and other indicators of malnutrition have improved, whereas socio‐economic and ethnic inequalities have increased, highlighting the need for policies and comprehensive measures beyond the health sector that aim to reduce socio‐economic disparities (Benjamin, Brandt, & McCaig, ; Kien et al, ).…”

Section: Discussionmentioning

confidence: 99%

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Child stunting is associated with child, maternal, and environmental factors in Vietnam

Beal

Trinh

et al. 2019

Maternal & Child Nutrition

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Child stunting in Vietnam has reduced substantially since the turn of the century but has remained relatively high for several years. We analysed data on children 6–59 months (n = 85,932) from the Vietnam Nutritional Surveillance System, a nationally representative cross‐sectional survey. Multivariable Poisson regression models were used to estimate relative risk (RR) of stunting, stratified by child age and ecological region. Covariates at the child, maternal, household, and environmental levels were included based on available data and the World Health Organization conceptual framework on child stunting. Among children 6–23 months, the strongest associations with child stunting were child age in years (RR: 2.49; 95% CI [2.26, 2.73]), maternal height < 145 cm compared with ≥150 cm (RR: 2.04; 95% CI [1.85, 2.26]), living in the Northeast compared with the Southeast (RR: 2.01; 95% CI [1.69, 2.39]), no maternal education compared with a graduate education (RR: 1.77; 95% CI, [1.44, 2.16]), and birthweight < 2,500 g (RR: 1.75; 95% CI [1.55, 1.98]). For children 24–59 months, the strongest associations with child stunting were no maternal education compared with a graduate education (RR: 2.07; 95% CI [1.79, 2.40]), living in the Northeast compared with the Southeast (RR: 1.94; 95% CI [1.74, 2.16]), and maternal height < 145 cm compared with ≥150 cm (RR: 1.81; 95% CI [1.69, 1.94]). Targeted approaches that address the strongest stunting determinants among vulnerable populations are needed and discussed. Multifaceted approaches outside the health sector are also needed to reduce inequalities in socioeconomic status.

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Section: Discussionmentioning

confidence: 99%

“…Regional variations in stunting risk factors were striking and suggest that tailoring policies and programmes by region will more effectively address the most relevant stunting determinants. (Benjamin, Brandt, & McCaig, 2017;Kien et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Child stunting is associated with child, maternal, and environmental factors in Vietnam

Beal

Trinh

et al. 2019

Maternal & Child Nutrition

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“…For example, based on findings from the Nepal Demographic and Health Survey 2011, increased household wealth, improved food security, optimal breastfeeding practices and residence in the hill versus mountain agroecological zones were associated with a lower risk of stunting in preschool-aged children (Tiwari, Ausman, & Agho, 2014). In Vietnam, MICS 2000 and 2011 findings have identified rising maternal education as a critical explanatory factor for an observed reduction in stunting (Kien et al, 2016). Prevalence rates of wasting (2.6%) and underweight (7.4%) estimated in the current analysis are slightly lower than rates of 4.3% and 9.0%, respectively, reported earlier from the Bhutan NNS…”

Section: Time Trend Of Nutritional Statusmentioning

confidence: 99%

Nutritional status and risk factors for stunting in preschool children in Bhutan

Kang

Aguayo

Campbell

et al. 2018

Maternal & Child Nutrition

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Childhood malnutrition remains endemic in South Asia, although the burden varies by country. We examined the anthropometric status and risk factors for malnutrition among children aged 0–59 months through the 2015 National Nutrition Survey in Bhutan. We assessed in 1,506 children nutritional status (by z ‐scores of height‐for‐age [HAZ], weight‐for‐height [WHZ], and weight‐for‐age [WAZ]), estimating prevalence, adjusted for survey design, of stunting, wasting, underweight, and overweight (<−2 for HAZ, WHZ, and WAZ and >2 for WHZ). Children were also assessed for pedal oedema. We conducted multivariable linear/logistic regression analysis to identify child, maternal, and household risk factors for childhood undernutrition and overweight, excluding children with oedema (1.7%). Mean (SE) HAZ, WHZ, and WAZ were −0.82 (0.13), 0.10 (0.04), and −0.42 (0.05), respectively. Prevalence of stunting, wasting, underweight, and overweight were 21.2%, 2.6%, 7.4%, and 2.6%, respectively. In multivariable regressions, risk of stunting significantly increased by age: 5.3% at <6 months (reference), 16.8% at 6–23 months (OR = 3.06, 95% CI [0.63, 14.8]), and 25.0% at 24–59 months (OR = 5.07, [1.16, 22.2]). Risk of stunting also decreased in a dose–response manner with improved maternal education. None of the examined variables were significantly associated with wasting or overweight. Despite a WHZ distribution comparable with the World Health Organization reference (with ~2.6% vs. an expected 2.5% of children beyond 2 z in each tail), stunting persists in one fifth of preschool Bhutanese children, suggesting that other nutrient deficits or nonnutritional factors may be constraining linear growth for a substantial proportion of children.

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“…In addition to this inequality among countries, there are also socioeconomic inequalities within countries and children in lower social groups bear a greater burden of malnutrition. Nutritional status of children is affected by many socioeconomic factors such as mother's education and nutritional status, residential area, household wealth, and demographic characteristics (3)(4)(5)(6)(7)(8)(9). For the first time in Iran, the concentration index and decomposition method was used to analyze the socio-economic inequalities in child mortality at the national level and with regard to the provinces (10).…”

Section: Introductionmentioning

confidence: 99%

A Decomposition Analysis of Inequality in Malnutrition among Under-Five Children in Iran: Findings from Multiple Indicator Demographic and Health Survey, 2010

Kia

Goodarzi

Asadi

et al. 2019

ijph

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Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.

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Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000–2011

Cited by 54 publications

References 18 publications

Child stunting is associated with child, maternal, and environmental factors in Vietnam

Child stunting is associated with child, maternal, and environmental factors in Vietnam

Nutritional status and risk factors for stunting in preschool children in Bhutan

A Decomposition Analysis of Inequality in Malnutrition among Under-Five Children in Iran: Findings from Multiple Indicator Demographic and Health Survey, 2010

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