Health and Nutrition Status of Communities health and nutrition- A study to examine the relationship between household wealth inequality and chronic childhood malnutrition
The prevalence of malnutrition in Bangladesh is amongst the highest in the world. Millions of children and women suffer from one or more forms of malnutrition, including: low birth weight (LBW), stunting, underweight, vitamin A deficiency, iodine deficiency disorders and anemia. Malnutrition passes from one generation to the next because malnourished mothers give birth to infants who struggle to thrive or grow well. If they are girls, these children often become malnourished mothers themselves. Malnutrition contributes to about one half of all child deaths, often by weakening immunity. Survivors of malnutrition are left vulnerable to illness, stunted and intellectually impaired.The Government of Bangladesh (GoB) is committed to fulfilling children's rights to nutrition through its ratification of the Convention on the Rights of the Child and the Millennium Development Goals (MDG), many of which are closely linked with nutrition. With the assistance of development partners, the GoB has made substantial investments in nutrition, including the National Nutrition Programme (NNP) which provides comprehensive nutrition services to children and women at a community level. As a result, the country has made significant progress in eliminating some forms of malnutrition, including vitamin A deficiency and iodine deficiency. In Bangladesh, as in many other developing countries, under-nutrition is one of the leading causes of childhood morbidity and mortality. Childhood under-nutrition affects physical and cognitive growth, impairs the immune system, and increases the risk of morbidity and mortality. In developing countries around the world, an estimated 148 million children are stunted, 127 million are under-weight, and 46 million are wasted (UN report 2004). According to a recent comparative risk assessment by the World Health Organization (WHO), under-nutrition is estimated to be, by far, the largest contributor to the global burden of disease. Many people in developing countries still live in extreme poverty and in these countries economic growth tends to benefit only a small group of advantaged and affluent people and causes growing inequality in health and nutrition that affects particularly vulnerable groups of the population, such as children. Economic well-being at the household level operates mainly through availability of better food, more hygienic living conditions, and better access to health services in affecting the health and nutritional status of children .While there are numerous studies on childhood malnutrition in Bangladesh majority of these studies have looked at the contributions of individual-level (socio-economic and family planning) characteristics. A growing body of literature considers the importance of understanding of determinants of childhood malnutrition through an integrated analysis that considers linkages between demographic, household, and community structures. Thus, the contextual aspect of child malnutrition needs to be explored to understand the process of malnourishment as a whole. To expand our understanding of the effects of household wealth status on the risk of childhood malnutrition, the study argue that it is necessary to consider as additional risk factors the characteristics of the communities in which mothers and children live using multilevel analytic framework. Therefore, the purpose of this paper is to develop and test a model of childhood malnutrition that includes household wealth status, individual-level characteristics along with community-level characteristics. The second aim was to determine whether there is significant neighborhood variation in childhood malnutrition and whether neighborhood variation is explained by other factors at the individual-level and community-level.
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The prevalence of malnutrition in Bangladesh is amongst the highest in the world. Millions of children and women suffer from one or more forms of malnutrition, including: low birth weight (LBW), stunting, underweight, vitamin A deficiency, iodine deficiency disorders and anemia. Malnutrition passes from one generation to the next because malnourished mothers give birth to infants who struggle to thrive or grow well. If they are girls, these children often become malnourished mothers themselves. Malnutrition contributes to about one half of all child deaths, often by weakening immunity. Survivors of malnutrition are left vulnerable to illness, stunted and intellectually impaired.The Government of Bangladesh (GoB) is committed to fulfilling children's rights to nutrition through its ratification of the Convention on the Rights of the Child and the Millennium Development Goals (MDG), many of which are closely linked with nutrition. With the assistance of development partners, the GoB has made substantial investments in nutrition, including the National Nutrition Programme (NNP) which provides comprehensive nutrition services to children and women at a community level. As a result, the country has made significant progress in eliminating some forms of malnutrition, including vitamin A deficiency and iodine deficiency. In Bangladesh, as in many other developing countries, under-nutrition is one of the leading causes of childhood morbidity and mortality. Childhood under-nutrition affects physical and cognitive growth, impairs the immune system, and increases the risk of morbidity and mortality. In developing countries around the world, an estimated 148 million children are stunted, 127 million are under-weight, and 46 million are wasted (UN report 2004). According to a recent comparative risk assessment by the World Health Organization (WHO), under-nutrition is estimated to be, by far, the largest contributor to the global burden of disease. Many people in developing countries still live in extreme poverty and in these countries economic growth tends to benefit only a small group of advantaged and affluent people and causes growing inequality in health and nutrition that affects particularly vulnerable groups of the population, such as children. Economic well-being at the household level operates mainly through availability of better food, more hygienic living conditions, and better access to health services in affecting the health and nutritional status of children .While there are numerous studies on childhood malnutrition in Bangladesh majority of these studies have looked at the contributions of individual-level (socio-economic and family planning) characteristics. A growing body of literature considers the importance of understanding of determinants of childhood malnutrition through an integrated analysis that considers linkages between demographic, household, and community structures. Thus, the contextual aspect of child malnutrition needs to be explored to understand the process of malnourishment as a whole. To expand our understanding of the effects of household wealth status on the risk of childhood malnutrition, the study argue that it is necessary to consider as additional risk factors the characteristics of the communities in which mothers and children live using multilevel analytic framework. Therefore, the purpose of this paper is to develop and test a model of childhood malnutrition that includes household wealth status, individual-level characteristics along with community-level characteristics. The second aim was to determine whether there is significant neighborhood variation in childhood malnutrition and whether neighborhood variation is explained by other factors at the individual-level and community-level.
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