Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh

Abstract Introduction Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. Methods This study extracted the children dataset from the 2017–18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. Results The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children’s birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. Conclusion Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

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Constructing composite indices

International Journal of Sociology and Social Policy ◽

10.1108/ijssp-12-2016-0135 ◽

2018 ◽

Vol 38 (1/2) ◽

pp. 58-86 ◽

Cited By ~ 1

Author(s):

Eman Refaat ◽

Ali Hadi

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Composite Index ◽

Policy Formulation ◽

Social Rights ◽

Content Type ◽

Rural And Urban ◽

Composite Indices ◽

Margin Of Error ◽

The Right

Purpose The purpose of this paper is to construct, for the first time, composite index for Egypt that measures the economic and social rights fulfillment (ESRF) based on socioeconomic surveys at the household/individual levels. Design/methodology/approach The paper highlights some of the statistical debatable issues about composite indices and focuses mainly on six of them. Those issues are indicators selection, handling missing data, identification of and dealing with outliers, scale of measurement, computing the margin of error, weights assigned for indicators and domains and aggregation method. Handling these problematic issues gave rise to a rigorous index. Findings The quality of economic and social rights fulfillment index (ESRFI) is judged by its bootstrap standard error. Based on these margin of errors, confidence intervals can be computed and rigorous comparisons across all disaggregation levels of the ESRFI can be made. The results shows that the overall index is accurate and representative in measuring the ESRF in Egypt. Comparisons between rural and urban regions indices show that the rural areas are always worse than the urban areas in all levels of dimensions, especially for the Right to Education and Adequate Housing. Research limitations/implications The ESRFI is not very current because it is based on the 2010 Egyptian Household Conditions Observatory Survey (EHCOS), which is the latest published version of the survey with complete variables for the index data. When the next EHCOS becomes available, an updated ESRFI can be easily and quickly constructed. Practical implications The ESRFI could strengthen policy formulation that takes into account ESRF, especially by highlighting the situation in different regions and disaggregation levels. Social implications The proposed ESRFI would strengthen policy formulation that takes into account ESRF, especially by highlighting the situation in different regions and different disaggregation levels. Originality/value The paper emphasizes the importance of recognizing and handling of the six problematic issues that arise when constructing composite indices. The paper presents the first ESRFI for Egypt and demonstrates the rigor of its construction.

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An intersectional analysis of the composite index of anthropometric failures in India

International Journal for Equity in Health ◽

10.1186/s12939-021-01499-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sabu Ulahannan Kochupurackal ◽

Yogish Channa Basappa ◽

Sangeetha Joice Vazhamplackal ◽

Prashanth N Srinivas

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Descriptive Analysis ◽

Group Analysis ◽

Composite Index ◽

Family Health ◽

Nutritional Interventions ◽

Child Undernutrition ◽

Economic Position ◽

And Gender

Abstract Background Nutritional inequality in India has been estimated typically using stunting, wasting and underweight separately which hide the overall magnitude and severity of undernutrition. We used the Composite Index of Anthropometric Failure (CIAF) that combines all three forms of anthropometric failures to assess the severity of undernutrition and identify the most vulnerable social groups and geographical hotspots. Method CIAF was constructed using child anthropometric data from the fourth round of the National Family Health Survey (NFHS-4, 2015–16). We considered 24 intersecting sub-groups based on intersections across four main axes of inequality i.e., caste [Scheduled Tribe (ST), Scheduled Caste (SC) and Other], economic position (poor and non-poor), place of residence (rural and urban) and gender (male and female) (eg. ST-Poor-Rural-Female). Cross-tabulation and logistic regression were done to assess the odds of CIAF among intersecting groups and to identify the most vulnerable sub-groups. Concentration curve was plotted to visualise economic position inequality in child undernutrition across caste categories. Choropleth maps were constructed and descriptive analysis of the district-level prevalence of CIAF was performed to identify the geographic clustering of undernutrition. Results Overall 55.32% of children were undernourished by CIAF and 6.62% of children have simultaneous three anthropometric failure. In sub-group analysis, children from ST and SC caste have a higher risk of undernutrition irrespective of other axis of inequality. Compared with CIAF, economic position inequality was amplified for simultaneous-three-failures among all caste categories. Economic position inequalities within caste are more for other caste and SC categories than with ST. Economic position, caste and gender based inequality in all three failures is more consistent in rural areas than with urban areas. Based on the analysis of the high prevalence in the co-occurrence of two or three failures, 111 districts from 12 of 29 states in India were identified across four geographic clusters. Conclusions The study shows social and eco-geographical clustering of multi-dimensional anthropometric failures and indicates the need for focused nutritional interventions among SC and ST community in general and ST children from the poor households. Furthermore, governance interventions that target entire regions across districts and states combined with decentralised planning are needed.

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An Intersectional Analysis of the Composite Index of Anthropometric Failures in India

10.21203/rs.3.rs-36685/v2 ◽

2021 ◽

Author(s):

Sabu K Ulahannan ◽

Yogish Channa Basappa ◽

Sangeetha V Joice ◽

Prashanth N Srini

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Descriptive Analysis ◽

Group Analysis ◽

Composite Index ◽

Family Health ◽

Nutritional Interventions ◽

Child Undernutrition ◽

Economic Position ◽

And Gender

Abstract Background: Nutritional inequality in India has been estimated typically using stunting, wasting and underweight separately which hide the overall magnitude and severity of undernutrition. We used the Composite Index of Anthropometric Failure (CIAF) that combines all three forms of anthropometric failures to assess the severity of undernutrition and identify the most vulnerable social groups and geographical hotspots.Method: CIAF was constructed using child anthropometric data from the fourth round of the National Family Health Survey (NFHS-4, 2015-16). We considered 24 intersecting sub-groups based on intersections across four main axes of inequality i.e., caste [Scheduled Tribe (ST), Scheduled Caste (SC) and Other], economic position (poor and non-poor), place of residence (rural and urban) and gender (male and female) (eg. ST-Poor-Rural-Female). Cross-tabulation and logistic regression were done to assess the odds of CIAF among intersecting groups and to identify the most vulnerable sub-groups. Concentration curve was plotted to visualise economic position inequality in child undernutrition across caste categories. Choropleth maps were constructed and descriptive analysis of the district-level prevalence of CIAF was performed to identify the geographic clustering of undernutrition.Results: Overall 55.32% of children were undernourished by CIAF and 6.62% of children have simultaneous three anthropometric failure. In sub-group analysis, children from ST and SC caste have a higher risk of undernutrition irrespective of other axis of inequality. Compared with CIAF, economic position inequality was amplified for simultaneous-three-failures among all caste categories. Economic position inequalities within caste are more for other caste and SC categories than with ST. Economic position, caste and gender based inequality in all three failures is more consistent in rural areas than with urban areas. Based on the analysis of the high prevalence in the co-occurrence of two or three failures, 111 districts from 12 of 29 states in India were identified across four geographic clusters.Conclusions: The study shows social and eco-geographical clustering of multi-dimensional anthropometric failures and indicates the need for focused nutritional interventions among SC and ST community in general and ST children from the poor households. Furthermore, governance interventions that target entire regions across districts and states combined with decentralised planning are needed.

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What is known about the role of rural-urban residency in relation to self-management in people affected by cancer who have completed primary treatment? A scoping review

Supportive Care in Cancer ◽

10.1007/s00520-020-05645-0 ◽

2020 ◽

Vol 29 (1) ◽

pp. 67-78 ◽

Cited By ~ 1

Author(s):

David Nelson ◽

Ian McGonagle ◽

Christine Jackson ◽

Ros Kane

Keyword(s):

Scoping Review ◽

Rural Areas ◽

Urban Areas ◽

Primary Treatment ◽

Self Management ◽

Urban Context ◽

Eligibility Criteria ◽

Rural And Urban Areas ◽

Rural And Urban ◽

The Usa

Abstract Purpose Despite wide acknowledgement of differences in levels of support and health outcomes between urban and rural areas, there is a lack of research that explicitly examines these differences in relation to self-management in people affected by cancer following treatment. This scoping review aimed to map the existing literature that examines self-management in people affected by cancer who were post-treatment from rural and urban areas. Methods Arksey and O’Malley’s framework for conducting a scoping review was utilised. Keyword searches were performed in the following: Academic Search Complete, CINAHL, MEDLINE, PsycINFO, Scopus and Web of Science. Supplementary searching activities were also conducted. Results A total of 438 articles were initially retrieved and 249 duplicates removed leaving 192 articles that were screened by title, abstract and full text. Nine met the eligibility criteria and were included in the review. They were published from 2011 to 2018 and conducted in the USA (n = 6), Australia (n = 2) and Canada (n = 1). None of the studies offered insight into self-managing cancer within a rural-urban context in the UK. Studies used qualitative (n = 4), mixed methods (n = 4) and quantitative designs (n = 1). Conclusion If rural and urban populations define their health in different ways as some of the extant literature suggests, then efforts to support self-management in both populations will need to be better informed by robust evidence given the increasing focus on patient-centred care. It is important to consider if residency can be a predictor of as well as a barrier or facilitator to self-management.

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Thematic Maps of the Impact of Urbanization and Socioeconomic Factors on the Distribution of the Incidence of Cutaneous Leishmaniasis Cases in Sefrou Province, Central North of Morocco (2007–2011)

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2020/8673091 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Fatima Zahra Talbi ◽

Nordine Nouayti ◽

Hajar El Omari ◽

Mohamed Najy ◽

Khadija Lahouiti ◽

...

Keyword(s):

Statistical Analysis ◽

Socioeconomic Factors ◽

Cutaneous Leishmaniasis ◽

Rural Areas ◽

Urban Areas ◽

Pearson Correlation ◽

Correlation Study ◽

Poverty Rate ◽

Impact Of Urbanization ◽

The Impact

Background. Leishmaniases are vector-borne diseases with health risks. They cause a big health problem. These parasitic diseases are transmitted by the parasite of the genus Leishmania through sandflies. Objective. The aim of this work is to study the distribution of the incidence of cutaneous leishmaniasis (CL) cases and the impact of urbanization and socioeconomic factors and their effects as leishmaniasis risk factors. Methods. We conducted a retrospective study of CL cases collected at the level of Sefrou Province during the period from 2007 to 2011. The data was collected from registers of the Medical Delegation of Sefrou Province. The socioeconomic data, namely, the poverty rate, the popular density, and the type of environment (urban/rural) of Sefrou Province, were obtained from the High Commission for Planning. Statistical analysis was performed by SPSS software (version 20). The data were registered in a Microsoft Excel 2010 file. Statistical analysis was based on one-way analysis of variance (ANOVA), and then a correlation study was carried out (Pearson correlation). The results were considered significant when p was less than 0.05. The database was analyzed by QGIS 2.18, which is open source software. Results. A total of 349 cases of CL were collected at Sefrou Province from 2007 to 2011. A percentage of 49% of the cases come from urban areas, while 51% of the cases come from rural areas. In the statistical analysis, the division of the incidence of CL cases was found to be significantly associated only with urbanization. For the other factors, the number of people or the poverty rate is not taken into account in the incidence dynamics. Conclusion. This study may be useful for the implementation of future adequate measures and controls. Getting rid of leishmaniasis requires a comprehensive approach by acting on the sources of contamination through good continuous surveillance, appropriate management, effective vector control, and awareness-raising strategies.

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Demographic and socioeconomic factors affecting infant mortality in Egypt

Journal of Biosocial Science ◽

10.1017/s002193200001885x ◽

1990 ◽

Vol 22 (4) ◽

pp. 447-451 ◽

Cited By ~ 4

Author(s):

Hassan Y. Aly

Keyword(s):

Infant Mortality ◽

Socioeconomic Factors ◽

Rural Areas ◽

Urban Areas ◽

Factors Affecting ◽

Rural And Urban Areas ◽

Positive Effects ◽

Rural And Urban ◽

Reduce Infant Mortality ◽

Nationally Representative

SummaryThis paper analyses the relative importance of demographic and socioeconomic factors with respect to their role in reducing infant mortality in Egypt.Logit analyses of data from a nationally representative sample of Egyptian households, and for urban and rural households separately, indicate that demographic factors have more effect on infant mortality than socioeconomic factors. The results also show the need to improve housing in urban areas and sewerage systems in rural areas in order to reduce infant mortality. One of the most important policy conclusions, however, concerns the importance of providing a vigorous educational campaign to enlighten mothers and prospective mothers in both rural and urban areas on the positive effects of breast-feeding, longer birth intervals, and fewer children on the survival of infants.

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Oral hygiene, dietary habits and prevalence of dental caries in adolescents from rural and urban areas in Rio Grande do Sul, Brazil

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720170002000073255 ◽

2017 ◽

Vol 65 (2) ◽

pp. 139-147

Author(s):

Tássia Silvana BORGES ◽

Moisés Zacarias CARDOSO ◽

Mixianni Justo FORTUNA ◽

Cézane Priscila REUTER ◽

Simone IMPERATORE ◽

...

Keyword(s):

Dental Caries ◽

Oral Hygiene ◽

Rural Areas ◽

Urban Areas ◽

Dietary Habits ◽

Bivariate Analysis ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Mother’S Education ◽

Mother's Education

ABSTRACT Objective: To determine the condition of oral hygiene, dietary habits and prevalence of dental caries in adolescents, listing these habits and comparing residents from rural and urban areas. Methods: Cross-sectional study involving of 623 adolescents of both sexes, aged 12 to 17 year old in Santa Cruz do Sul, Brazil. Data were collected through sociodemographic questionnaires and dental examination. We conducted a descriptive analysis of the exposure variables and outcome. A bivariate analysis was then performed using the Chi-square test. Results: The prevalence of caries was 63.6%, in which adolescents living in rural areas had a prevalence of 70.7% and 56.4% in the urban area. The level of mother’s education ≤4 years and socioeconomic class B1/B2 and C1/C2 showed statistically significant differences between the areas of residence. Among the demographic variables, the rural area showed a higher prevalence of caries. Conclusion: The results showed a high prevalence of dental caries among the adolescents studied and indicate a correlation between prevalence and the low level of mother’s education, socioeconomic status (low to medium) and residence in rural areas. It should be understood that, while the multifactorial nature and stratified caries actions are not taken into consideration, the actions implemented will continue to fail, frustrating the expectations set by government entities.

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Socioeconomic Determinants of Malaria in Selected Urban and Rural Areas in Anambra State, Nigeria

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i2230412 ◽

2020 ◽

pp. 53-64

Author(s):

C. C. Nduka ◽

H. N. Chineke ◽

P. O. Adogu ◽

A. F. Chizoba

Keyword(s):

Socioeconomic Factors ◽

Rural Areas ◽

Urban Areas ◽

Control Measures ◽

Health Concern ◽

Skilled Workers ◽

Quality Health Care ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban

Malaria, a disease of poverty, is of significant public health concern. It is endemic in Nigeria with the risk of transmission appearing to be high because of favorable climatic and environmental factors. Increased susceptibility to malaria has also been linked to dirty surroundings that favor the breeding and propagation of the vector, poor access to quality health care and ignorance especially of malaria prevention strategies. However, this study investigated the role of socioeconomic factors responsible for the observed difference in malaria prevalence between selected rural and urban areas of Anambra, Nigeria. A descriptive comparative cross-sectional study, data on demographic and socioeconomic variables were collected from 202 urban and rural respondents, then analyzed using SPSS platform to generate chi-square test of significance. The results were presented in figures, table and charts for clarity. All the subjects were aware of the term malaria but only 63.4% had adequate specific knowledge of malaria. Generally, 25.7% of rural participants had no formal education while the urban group had only 4% of that particular category. About 52.5% of rural participants earned below 50,000 naira monthly, with 14.9% earning above 100,000 naira while the reverse was the case in the urban area. Also, the number of malaria episodes was inversely proportional to the household monthly income (X2=24.30, p<0.001). More episodes of malaria were also reported among the unskilled workers and skilled workers (71.3%) compared to Professionals (28.7%), yet all the participants reported the presence of a healthcare facility <3km from their houses with 95% and 80.2% of them in the rural and urban areas respectively having to pay out-of-pocket for healthcare services. It is clear that socioeconomic factors play a role in the persistence of malaria as an endemic disease in Nigeria. Therefore, existing control measures should incorporate strategies to end poverty and ignorance especially among the rural populace.

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Eating Habits of Elderly in Aceh-Indonesia and the Associated Demographic Factors

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2021/v42i1130496 ◽

2021 ◽

pp. 36-42

Author(s):

Sufyan Anwar ◽

Maiza Duana ◽

. Marniati

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Eating Habits ◽

Demographic Factors ◽

The Elderly ◽

Cross Sectional Study ◽

Bivariate Analysis ◽

Sectional Study ◽

Elderly Age ◽

Cross Sectional

Aims: The study aims to prove the correlation between demographic factors and the eating habits of the elderly in Aceh, Indonesia. Study Design: A cross-sectional study. Place and Duration of Study: The study was conducted in Aceh Barat district, Aceh province-Indonesia between June and October 2019. Methodology: This cross-sectional study was carried out by involving the elderly (age of 60 years or above) in 483 participants. Bivariate analysis was conducted through a chi-square test using SPSS version 21 to answer the research hypothesis. Results: Four hundred and eighty three (483) elderly people with mean age of 69.76 years were enrolled, of these, 68.9% were women and 58.2% were unemployed. Fifty-nine percent of respondents live in rural areas and 64.39% had good eating habits. Finding unveiled that age had a significant correlation with eating habits (P=0,05), gender did not correlate with eating habits (P>0,05). Occupation correlated with eating habits (P=0.05), and area of residence correlated with eating habits (P=0,05).. Conclusion: The study concluded that younger age (60-69 years old), employed, and living in urban areas positively contribute to establishing healthy eating habits in the elderly in Aceh. Furthermore, it is necessary to conduct intervention studies in the occupation variable as a modifiable variable.

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Open defecation free: where do we need to focus ?

Health Prospect ◽

10.3126/hprospect.v19i0.27394 ◽

2020 ◽

Vol 19 (1) ◽

pp. 1-6

Author(s):

Ramesh Adhikari ◽

Sudha Ghimire

Keyword(s):

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Positive Association ◽

Bivariate Analysis ◽

Contributing Factors ◽

Open Defecation ◽

Chi Square ◽

Middle Income

BackgroundDespite major national and international efforts, many households in Nepal (as in other low-income and middle-income countries) still lack toilets. This paper assesses various determinants that act as main contributing factors because of which households in Nepal still do not have toilets. MethodsData from the Nepal Demographic and Health Survey (NDHS) 2016 was used for this study. Bivariate analysis was done to assess the association between dependent variables (toilet status- having and not having toilets in the household) and independent variables (demographic, socio-economic and geographical characteristics) using Chi-square test. Then, a multi variate logistic regression model was used to assess significant predictors for a household not having a toilet after controlling other variables. ResultsOut of the total number of sampled households (11040), nearly a fifth (18%) belonged to province no. 2, where nearly half of the households (49%) did not have toilet facilities. Similarly, households in rural areas were found to be less likely to have toilets than households in urban areas (aOR=1.56, CI1.35-1.80). In the Terai, households were almost ten times as likely not to have toilets (aOR=9.65, CI6.56-14.19) as compared to households in the mountain region. Furthermore, there is a strong positive association between households with toilets and their economic status. Poorest (aOR=15.19, CI11.26-20.47), poorer (aOR=8.75, CI6.89-11.11) and middle income (aOR=5.12, CI4.15-6.32) households were less likely to have a toilet than richer or richest households. ConclusionsDespite some real achievements and progress in Open Defecation Free (ODF) status, Nepal still has a large number of residences without a toilet. Thus, it is crucial to address all the multifaceted factors such as geographical, provincial and economic when considering sustainable ODF programming.

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