Changes in inequality of childhood morbidity in Bangladesh 1993-2014: a decomposition analysis

Rashidul Alam Mahumud, Khorshed Alam, Andre M. N. Renzaho, Abdur Razzaque Sarker, Marufa Sultana, Nurnabi Sheikh, Lal B. Rawal, Jeff Gow

Research output: Contribution to journalReview article

Abstract

Introduction Child health remains an important public health concern at the global level, with preventable diseases such as diarrheal disease, acute respiratory infection (ARI) and fever posing a large public health burden in low- and middle-income countries including Bangladesh. Improvements in socio-economic conditions have tended to benefit advantaged groups in societies, which has resulted in widespread inequalities in health outcomes. This study examined how socioeconomic inequality is associated with childhood morbidity in Bangladesh, and identified the factors affecting three illnesses: diarrhea, ARI and fever. Materials and methods A total of 43,860 sample observations from the Bangladesh Demographic and Health Survey, spanning a 22-year period (1993–2014), were analysed. Concentration curve and concentration index methods were used to evaluate changes in the degree of household wealth-related inequalities and related trends in childhood morbidity. Regression-based decomposition analyses were used to attribute the inequality disparities to individual determinants for the three selected causes of childhood morbidity. Results The overall magnitude of inequality in relation to childhood morbidity has been declining slowly over the 22-year period. The magnitude of socio-economic inequality as a cause of childhood morbidity varied during the period. Decomposition analyses attributed the inequalities to poor maternal education attainment, inadequate pre-delivery care, adverse chronic undernutrition status and low immunisation coverage. Conclusions High rates of childhood morbidity were observed, although these have declined over time. Socio-economic inequality is strongly associated with childhood morbidity. Socio-economi-cally disadvantaged communities need to be assisted and interventions should emphasise improvements of, and easier access to, health care services. These will be key to improving the health status of children in Bangladesh and should reduce economic inequality through improved health over time.

LanguageEnglish
Article numbere0218515
Number of pages19
JournalPLoS ONE
Volume14
Issue number6
DOIs
Publication statusPublished - 19 Jun 2019

Fingerprint

Bangladesh
childhood
morbidity
Health
Morbidity
Decomposition
Economics
degradation
Public health
socioeconomics
Immunization
Pulmonary diseases
fever
Health care
public health
Respiratory Tract Infections
Education
acute course
Fever
Public Health

Keywords

  • morbidity
  • child health
  • fevers
  • malnutrition
  • Bangladesh

Cite this

Mahumud, R. A., Alam, K., Renzaho, A. M. N., Sarker, A. R., Sultana, M., Sheikh, N., ... Gow, J. (2019). Changes in inequality of childhood morbidity in Bangladesh 1993-2014: a decomposition analysis. PLoS ONE, 14(6), [e0218515]. https://doi.org/10.1371/journal.pone.0218515
Mahumud, Rashidul Alam ; Alam, Khorshed ; Renzaho, Andre M. N. ; Sarker, Abdur Razzaque ; Sultana, Marufa ; Sheikh, Nurnabi ; Rawal, Lal B. ; Gow, Jeff. / Changes in inequality of childhood morbidity in Bangladesh 1993-2014 : a decomposition analysis. In: PLoS ONE. 2019 ; Vol. 14, No. 6.
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abstract = "Introduction Child health remains an important public health concern at the global level, with preventable diseases such as diarrheal disease, acute respiratory infection (ARI) and fever posing a large public health burden in low- and middle-income countries including Bangladesh. Improvements in socio-economic conditions have tended to benefit advantaged groups in societies, which has resulted in widespread inequalities in health outcomes. This study examined how socioeconomic inequality is associated with childhood morbidity in Bangladesh, and identified the factors affecting three illnesses: diarrhea, ARI and fever. Materials and methods A total of 43,860 sample observations from the Bangladesh Demographic and Health Survey, spanning a 22-year period (1993–2014), were analysed. Concentration curve and concentration index methods were used to evaluate changes in the degree of household wealth-related inequalities and related trends in childhood morbidity. Regression-based decomposition analyses were used to attribute the inequality disparities to individual determinants for the three selected causes of childhood morbidity. Results The overall magnitude of inequality in relation to childhood morbidity has been declining slowly over the 22-year period. The magnitude of socio-economic inequality as a cause of childhood morbidity varied during the period. Decomposition analyses attributed the inequalities to poor maternal education attainment, inadequate pre-delivery care, adverse chronic undernutrition status and low immunisation coverage. Conclusions High rates of childhood morbidity were observed, although these have declined over time. Socio-economic inequality is strongly associated with childhood morbidity. Socio-economi-cally disadvantaged communities need to be assisted and interventions should emphasise improvements of, and easier access to, health care services. These will be key to improving the health status of children in Bangladesh and should reduce economic inequality through improved health over time.",
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Mahumud, RA, Alam, K, Renzaho, AMN, Sarker, AR, Sultana, M, Sheikh, N, Rawal, LB & Gow, J 2019, 'Changes in inequality of childhood morbidity in Bangladesh 1993-2014: a decomposition analysis' PLoS ONE, vol. 14, no. 6, e0218515. https://doi.org/10.1371/journal.pone.0218515

Changes in inequality of childhood morbidity in Bangladesh 1993-2014 : a decomposition analysis. / Mahumud, Rashidul Alam; Alam, Khorshed; Renzaho, Andre M. N.; Sarker, Abdur Razzaque; Sultana, Marufa; Sheikh, Nurnabi; Rawal, Lal B.; Gow, Jeff.

In: PLoS ONE, Vol. 14, No. 6, e0218515, 19.06.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Changes in inequality of childhood morbidity in Bangladesh 1993-2014

T2 - PLOS One

AU - Mahumud, Rashidul Alam

AU - Alam, Khorshed

AU - Renzaho, Andre M. N.

AU - Sarker, Abdur Razzaque

AU - Sultana, Marufa

AU - Sheikh, Nurnabi

AU - Rawal, Lal B.

AU - Gow, Jeff

PY - 2019/6/19

Y1 - 2019/6/19

N2 - Introduction Child health remains an important public health concern at the global level, with preventable diseases such as diarrheal disease, acute respiratory infection (ARI) and fever posing a large public health burden in low- and middle-income countries including Bangladesh. Improvements in socio-economic conditions have tended to benefit advantaged groups in societies, which has resulted in widespread inequalities in health outcomes. This study examined how socioeconomic inequality is associated with childhood morbidity in Bangladesh, and identified the factors affecting three illnesses: diarrhea, ARI and fever. Materials and methods A total of 43,860 sample observations from the Bangladesh Demographic and Health Survey, spanning a 22-year period (1993–2014), were analysed. Concentration curve and concentration index methods were used to evaluate changes in the degree of household wealth-related inequalities and related trends in childhood morbidity. Regression-based decomposition analyses were used to attribute the inequality disparities to individual determinants for the three selected causes of childhood morbidity. Results The overall magnitude of inequality in relation to childhood morbidity has been declining slowly over the 22-year period. The magnitude of socio-economic inequality as a cause of childhood morbidity varied during the period. Decomposition analyses attributed the inequalities to poor maternal education attainment, inadequate pre-delivery care, adverse chronic undernutrition status and low immunisation coverage. Conclusions High rates of childhood morbidity were observed, although these have declined over time. Socio-economic inequality is strongly associated with childhood morbidity. Socio-economi-cally disadvantaged communities need to be assisted and interventions should emphasise improvements of, and easier access to, health care services. These will be key to improving the health status of children in Bangladesh and should reduce economic inequality through improved health over time.

AB - Introduction Child health remains an important public health concern at the global level, with preventable diseases such as diarrheal disease, acute respiratory infection (ARI) and fever posing a large public health burden in low- and middle-income countries including Bangladesh. Improvements in socio-economic conditions have tended to benefit advantaged groups in societies, which has resulted in widespread inequalities in health outcomes. This study examined how socioeconomic inequality is associated with childhood morbidity in Bangladesh, and identified the factors affecting three illnesses: diarrhea, ARI and fever. Materials and methods A total of 43,860 sample observations from the Bangladesh Demographic and Health Survey, spanning a 22-year period (1993–2014), were analysed. Concentration curve and concentration index methods were used to evaluate changes in the degree of household wealth-related inequalities and related trends in childhood morbidity. Regression-based decomposition analyses were used to attribute the inequality disparities to individual determinants for the three selected causes of childhood morbidity. Results The overall magnitude of inequality in relation to childhood morbidity has been declining slowly over the 22-year period. The magnitude of socio-economic inequality as a cause of childhood morbidity varied during the period. Decomposition analyses attributed the inequalities to poor maternal education attainment, inadequate pre-delivery care, adverse chronic undernutrition status and low immunisation coverage. Conclusions High rates of childhood morbidity were observed, although these have declined over time. Socio-economic inequality is strongly associated with childhood morbidity. Socio-economi-cally disadvantaged communities need to be assisted and interventions should emphasise improvements of, and easier access to, health care services. These will be key to improving the health status of children in Bangladesh and should reduce economic inequality through improved health over time.

KW - morbidity

KW - child health

KW - fevers

KW - malnutrition

KW - Bangladesh

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SN - 1932-6203

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Mahumud RA, Alam K, Renzaho AMN, Sarker AR, Sultana M, Sheikh N et al. Changes in inequality of childhood morbidity in Bangladesh 1993-2014: a decomposition analysis. PLoS ONE. 2019 Jun 19;14(6). e0218515. https://doi.org/10.1371/journal.pone.0218515