Research

Relationship between household wealth inequality and chronic childhood under-nutrition in Bangladesh

Rathavuth Hong¹ , James E Banta^1* and Jose A Betancourt^2*

¹  George Washington University, School of Public Health and Health Services, 2300 Eye Street N.W. Washington, DC 20037, USA

²  Academy of Health Sciences, U.S. Army Medical Department Center & School, 2250 Stanley Road, Fort Sam Houston, TX 78234, USA

author email corresponding author email* Contributed equally

International Journal for Equity in Health 2006, 5:15doi:10.1186/1475-9276-5-15

Published:	5 December 2006

Abstract

Background

Household food insecurity and under-nutrition remain critically important in developing countries struggling to emerge from the scourge of poverty, where historically, improvements in economic conditions have benefited only certain privileged groups, causing growing inequality in health and healthcare among the population.

Methods

Utilizing information from 5,977 children aged 0-59 months included in the 2004 Bangladesh Demographic and Health Survey , this study examined the relationship between household wealth inequality and chronic childhood under-nutrition. A child is defined as being chronically undernourished or whose growth rate is adversely stunted, if his or her z-score of height-for-age is more than two standard deviations below the median of international reference. Household wealth status is measured by an established index based on household ownership of durable assets. This study utilized multivariate logistic regressions to estimate the effect of household wealth status on adverse childhood growth rate.

Results

The results indicate that children in the poorest 20% of households are more than three time as likely to suffer from adverse growth rate stunting as children from the wealthiest 20% of households (OR=3.6; 95% CI: 3.0, 4.3). The effect of household wealth status remain significantly large when the analysis was adjusted for a child's multiple birth status, age, gender, antenatal care, delivery assistance, birth order, and duration that the child was breastfed; mother's age at childbirth, nutritional status, education; household access to safe drinking water, arsenic in drinking water, access to a hygienic toilet facility, cooking fuel cleanliness, residence, and geographic location (OR=2.4; 95% CI: 1.8, 3.2).

Conclusion

This study concludes that household wealth inequality is strongly associated with childhood adverse growth rate stunting. Reducing poverty and making services more available and accessible to the poor are essential to improving overall childhood health and nutritional status in Bangladesh.