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Beressa G, Desta F, Lencha B, Sahiledengle B, Atlaw D, Gomora D, Zenbaba D, Nigussie E, Ejigu N, Yazew T, Mesfin T, Beressa K. Iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia: A multilevel complex sample analysis of the Ethiopian mini-demographic and health survey 2019 data. PLoS One 2024; 19:e0305046. [PMID: 38833453 PMCID: PMC11149849 DOI: 10.1371/journal.pone.0305046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Children with inadequate iron consumption had slower growth, weaker immunity, and poor cognitive development. Although the public health importance of iron-rich consumption in Ethiopia is known, evidence for iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia is sparse. This study aimed to assess iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia. METHODS This study used Ethiopia mini demographic and health survey 2019 (EMDHS-2019) data with a total weighted sample size of 5,112 among children aged 6-59 months old. A multilevel mixed effect logistic regression analysis was used to identify predictors of good iron-rich food consumption. RESULTS The proportion of good consumption of iron-rich foods among children aged 6-59 months was 27.99% (24.22, 32.10%). The findings revealed that children born to mothers who completed primary education [AOR = 1.88, 95% CI: 1.11, 3.19], a higher education [AOR = 4.45, 95% CI: 1.28, 15.48], being born to the poorer family [AOR = 1.89, 95% CI: 1.04, 3.43], richer [AOR = 2.12, 95% CI: 1.03, 4.36], and richest [AOR = 3.57, 95% CI: 1.29, 9.93] were positively associated with good iron-rich food consumption among children aged 6-59 months old. Nevertheless, being 24-59 month-old children [AOR = 0.58, 95% CI: 0.44, 0.72], residents of the Afar [AOR = 0.23, 95% CI: 0.08, 0.67], Amhara region [AOR = 0.30, 95% CI: 0.14, 0.65], and Somali region [AOR = 0.01, 95% CI: 0.01, 0.07] were negatively associated with good iron-rich food consumption among children aged 6-59 months old. CONCLUSION The finding revealed that there was low consumption of iron-rich foods among children aged 6-59 months in Ethiopia compared to reports from East African countries. Improving women's literacy and economic empowerment would improve iron-rich food consumption among children aged 6-59 months old. This study's findings would have implications for policymakers in Ethiopia to enhance iron-rich food consumption.
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Affiliation(s)
- Girma Beressa
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
| | - Bikila Lencha
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
| | | | - Daniel Atlaw
- School of Medicine, Madda Walabu University, Goba, Ethiopia
| | - Degefa Gomora
- Department of Midwifery, Madda Walabu University, Goba, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, Madda Walabu University, Goba, Ethiopia
| | | | - Neway Ejigu
- Department of Midwifery, Madda Walabu University, Goba, Ethiopia
| | - Tamiru Yazew
- Department of Public Health, Salale University, Fitche, Ethiopia
| | - Telila Mesfin
- School of Medicine, Madda Walabu University, Goba, Ethiopia
| | - Kenenisa Beressa
- Department of English, Addis Ababa University, Addis Ababa, Ethiopia
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Belay DG, Wassie MM, Alemu MB, Merid MW, Norman R, Tessema GA. Socio-economic and spatial inequalities in animal sources of iron-rich foods consumption among children 6-23 months old in Ethiopia: A decomposition analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003217. [PMID: 38753686 PMCID: PMC11098381 DOI: 10.1371/journal.pgph.0003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Iron deficiency anaemia is the most common type of anaemia in young children which can lead to long-term health consequences such as reduced immunity, impaired cognitive development, and school performance. As children experience rapid growth, they require a greater supply of iron from iron-rich foods to support their development. In addition to the low consumption of iron-rich foods in low- and lower-middle-income countries, there are also regional and socio-economic disparities. This study aimed to assess contributing factors of wealth-related inequality and geographic variations in animal sources of iron-rich food consumption among children aged 6-23 months in Ethiopia. We used data from the Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019, a national survey conducted using stratified sampling techniques. A total of 1,461 children of age 6-23 months were included in the study. Iron-rich animal sources of food consumption were regarded when parents/caregivers reported that a child took at least one of the four food items identified as iron-rich food: 1) eggs, 2) meat (beef, lamb, goat, or chicken), 3) fresh or dried fish or shellfish, and 4) organs meat such as heart or liver. Concentration indices and curves were used to assess wealth-related inequalities. A Wagstaff decomposition analysis was applied to identify the contributing factors for wealth-related inequality of iron-rich animal source foods consumption. We estimated the elasticity of wealth-related inequality for a percentage change in socioeconomic variables. A spatial analysis was then used to map the significant cluster areas of iron-rich animal source food consumption among children in Ethiopia. The proportion of children who were given iron-rich animal-source foods in Ethiopia is 24.2% (95% CI: 22.1%, 26.5%), with figures ranging from 0.3% in Dire Dawa to 37.8% in the Oromia region. Children in poor households disproportionately consume less iron-rich animal-source foods than those in wealthy households, leading to a pro-rich wealth concentration index (C) = 0.25 (95% CI: 0.12, 0.37). The decomposition model explained approximately 70% of the estimated socio-economic inequality. About 21% of the wealth-related inequalities in iron-rich animal source food consumption in children can be explained by having primary or above education status of women. Mother's antenatal care (ANC) visits (14.6%), living in the large central and metropolitan regions (12%), household wealth index (10%), and being in the older age group (12-23 months) (2.4%) also contribute to the wealth-related inequalities. Regions such as Afar, Eastern parts of Amhara, and Somali were geographic clusters with low iron-rich animal source food consumption. There is a low level of iron-rich animal source food consumption among children, and it is disproportionately concentrated in the rich households (pro-rich distribution) in Ethiopia. Maternal educational status, having ANC visits, children being in the older age group (12-23 months), and living in large central and metropolitan regions were significant contributors to these wealth-related inequalities in iron-rich animal source foods consumption. Certain parts of Ethiopia such as, Afar, Eastern parts of Amhara, and Somali should be considered priority areas for nutritional interventions to increase children's iron-rich animal source foods consumption.
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Affiliation(s)
- Daniel G. Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Molla M. Wassie
- Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia
| | - Melaku Birhanu Alemu
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Richard Norman
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Gizachew A. Tessema
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Terefe B, Jembere MM, Abie Mekonnen B. Spatial variations and determinants of iron containing foods consumption among 6-23 months old children in Ethiopia: spatial, and multilevel analysis. Sci Rep 2024; 14:4995. [PMID: 38424119 PMCID: PMC10904735 DOI: 10.1038/s41598-024-54959-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
Consuming foods high in iron benefits metabolic processes as well as the development of the neonatal and fetal brain. Despite the significance of eating foods high in iron for public health, Ethiopian practices are still limited when compared to the World Health Organization's (WHO) assessment of its consumption of such foods. This study used the Ethiopia Demographic and Health Survey (EDHS) to evaluate the consumption of iron-rich foods, regional clustering, and related characteristics among children aged 6-23 months. The information was taken from the typical EDHS 2019 dataset, which included a weighted sample of 1572 young children aged 6-23 months old in total. Utilizing Kuldorff's SaTScan version 9.6 software, spatial scan statistics were produced. Software from ArcGIS 10.8 was used to display the regional distribution of inadequate consumption of foods high in iron. Utilizing multilevel or mixed effects logistic regression analysis, the associated determinants for a healthy diet rich in foods containing iron were found. In the final model, a P-value of < 0.05 was announced as a statistical significance variable. Overall, in Ethiopia, children aged 6-23 months consumed iron-rich foods at a rate of 27.14% (95% CI 24.99-29.39). Poor intake of foods heavy in iron is concentrated in Ethiopia's regional states of Afar, a sizable portion of Amhara, Oromia, Tigray, Somali, Gambela, and SNNPS. Primary and secondary education (AOR = 1.73, CI 95%: 1.23, 2.41), and (AOR = 1.97,CI 95%: 1.25, 3.10), having ≥ 2 under five children, and current status of breastfeeding (AOR = 0.62 (CI 95%: 0.45, 0.84), and (AOR = 0.32, CI 95%: 0.23, 0.44), giving birth at health facilities (AOR = 1.51, CI 95%: 1.06, 2.13),being from Afar and Somali regions (AOR = 0.39, 95%: 0.17, 0.93), and (AOR = 0.26, CI 95%: 0.10, 0.69) have shown statistically significant association with the outcome variable respectively. In Ethiopia, providing high-iron meals and supplements to under-2-year-old children represents minimal, but persistent, public health expenses. Based on the identified determinants, the Ethiopian federal ministry of health and other stakeholders should pay special attention to the locations designated as hot spots for maternal and child health service enhancement to promote the consumption of iron-rich meals among children aged 6-23 months.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Po. Box: 196, Gondar, Ethiopia.
| | - Mahlet Moges Jembere
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanu Abie Mekonnen
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Saha A, Muhammad T, Mandal B, Adhikary M, Barman P. Socio-demographic and behavioral correlates of excess weight and its health consequences among older adults in India: Evidence from a cross-sectional study, 2017-18. PLoS One 2023; 18:e0291920. [PMID: 37796783 PMCID: PMC10553247 DOI: 10.1371/journal.pone.0291920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/09/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Rapid population aging is expected to become one of the major demographic transitions in the twenty-first century due to the continued decline in fertility and rise in life expectancy. Such a rise in the aged population is associated with increasing non-communicable diseases. India has suffered from obesity epidemic, with morbid obesity affecting 5% of the population and continuing an upward trend in other developing countries. This study estimates the prevalence of excess weight among older adults in India, and examines the socio-demographic and behavioral factors and its health consequences. METHODS The study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total sample of 25,952 older adults (≥ 60 years) was selected for the study. Descriptive statistics, bivariate Chi-Square test, and logistic regression models were applied to accomplish the study objectives. Body mass index (BMI) has been computed for the study according to the classification of the World Health Organization, and "excess weight" refers to a score of BMI ≥ 25.0 kg/m2. RESULTS Overall, 23% of older adults (≥ 60 years) were estimated with excess weight in India, which was higher among women irrespective of socioeconomic and health conditions. The higher levels of excess weight (than the national average of ≥22.7%) were observed among older adults in states like Haryana, Tamil Nadu, Telangana, Maharashtra, Gujarat, Manipur, Goa, Kerala, Karnataka, Himachal Pradesh, Punjab, Sikkim and some other states. After adjusting for selected covariates, the odds of excess weight were higher among females than males [OR: 2.21, 95% CI: 1.89, 2.60]. Similarly, the likelihood of excess weight was 2.18 times higher among older adults who were living in urban areas compared to their rural counterparts [OR: 2.18; 95% CI: 1.90, 2.49]. Higher level of education is significantly positively correlated with excess weight. Similarly, higher household wealth index was significantly positively correlated with excess weight [OR: 1.98, CI: 1.62, 2.41]. Having hypertension, diabetes and heart diseases were associated with excess weight among older adults. Regional variations were also observed in the prevalence of excess weight among older adults. CONCLUSION The findings suggest that introducing measures that help to reduce the risk of non-communicable diseases, and campaigns to encourage physical activity, and community awareness may help reduce the high burden of excess weight and obesity among older Indians. The findings are important for identifying the at-risk sub-populations and for the better functioning of any public health programme and suitable intervention techniques to lower the prevalence and risk factors for excess weight in later life.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - Bittu Mandal
- Indian Institute of Technology, School of Humanities and Social Sciences, Indore, India
| | - Mihir Adhikary
- Department of Public health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Papai Barman
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
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Saha J, Chouhan P, Malik NI, Ghosh T, Das P, Shahid M, Ahmed F, Tang K. Effects of Dietary Diversity on Growth Outcomes of Children Aged 6 to 23 Months in India: Evidence from National Family and Health Survey. Nutrients 2022; 15:nu15010159. [PMID: 36615816 PMCID: PMC9824371 DOI: 10.3390/nu15010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Low dietary diversity significantly interplays with children’s growth failure. However, evidence of its crucial role in children’s health remains inconclusive in developing countries such as India. This study attempts to find the association between dietary diversity and growth outcomes among children aged between 6 and 23 months in India using the fourth round of the National Family Health Survey (NFHS), 2015−2016. A total of 67,278 mother-child pairs of children between the ages of 6−23 months and mothers aged 15−49 years were included in this study. Pearson’s chi-square significance test and multivariable logistic regression were used to determine the association between dietary diversity and child growth outcomes (stunted, wasted, and underweight). The study found that the prevalence of stunting and severe stunting among children aged between 6 and 23 months were 35.9% and 16.2%; 23.8% and 8.5% represented wasting, and severe wasting; and more than 32%, 10% were underweight and severely underweight respectively. This present study found that having an inadequate minimum dietary diversity (<4 food groups) significantly increases the risk of being stunted (adjusted odds ratio (AOR) = 1.29; 95% confidence interval (CI); 1.21−1.38), wasted (AOR = 1.29; 95% CI; 1.21−1.38), and underweight (AOR = 1.47; 95% CI; 1.39−1.56). Further, it was noted that children who did not intake dairy products, eggs, and other fruits and vegetables were more likely to be stunted, wasted, and underweight and more likely to be severely stunted, wasted, and underweight. Therefore, additional nutrition-specific interventions are urgently needed to strengthen and enhance existing feeding interventions aimed at improving infant and young child feeding (IYCF) practices, including complementary feeding practices among children aged between 6 and 23 months in India. The Government should focus such interventions more on states or regions where the prevalence of adequate minimum dietary diversity (MDD) and malnutrition is high.
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Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha 40100, Pakistan
| | - Tanmoy Ghosh
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Puja Das
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Muhammad Shahid
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China
| | - Farooq Ahmed
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- Department of Anthropology, Quaid-i-Azam University Islamabad, Islamabad 44000, Pakistan
- Correspondence: (F.A.); (K.T.); Tel.: +86-13-6711-29425 (K.T.)
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- Correspondence: (F.A.); (K.T.); Tel.: +86-13-6711-29425 (K.T.)
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Okyere J, Azure SA, Budu E, Mensah F, Ahinkorah BO, Ameyaw EK, Seidu AA. Trends and inequalities in children aged 6-59 months who received Vitamin A supplementation: evidence from the 2003, 2008 and 2014 Ghana Demographic and Health Survey. Trop Med Health 2022; 50:99. [PMID: 36578095 PMCID: PMC9795595 DOI: 10.1186/s41182-022-00488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/09/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Vitamin A deficiency is considered a public health issue, particularly among children under 5 years. Vitamin A supplementation is among the ten key essential nutrition actions put in place to tackle malnutrition in children and helps to reduce under-five mortality by almost a quarter in Vitamin A deficient areas. We, therefore, examined inequalities in Vitamin A uptake among children 6-59 months in Ghana. METHODS We used data from the 2003, 2008, and 2014 Ghana Demographic and Health Surveys. The WHO's HEAT version 3.1 software was used for all the analyses. We adopted six equity stratifiers (maternal age, economic status, level of education, place of residence, sex of the child, and region) to disaggregate Vitamin A supplementation among children 6-59 months. Four measures were used to compute inequality, namely, Difference (D), Population Attributable Risk (PAR), Population Attributable Fraction (PAF) and Ratio (R). RESULTS Over the 11-year period, the proportion of children who received Vitamin A supplementation declined from 78.6% to 65.2%. There were inequalities by maternal age, particularly in 2003 (D = 13.1, CI: 2.3, 23.9; PAF = 0.5, CI: - 12.3, 13.2). The widest inequality in Vitamin A supplementation by economic status was noted in 2003 (D = 8.8, CI: 3.3-14.2; PAF = 8.3, CI: 5, 11.5). In terms of sex, the indices revealed mild inequality in Vitamin A supplementation throughout the period studied. For education, the highest inequality was observed in 2014 (D = 11.6, CI: 6.0, 17.1), while the highest inequality in terms of place of residence was observed in 2003 (D = 4.0, CI: - 0.1-8.4). In the case of region, substantial inequality was noted in 2014 (D = 34.7, CI: 22.6, 46.8; PAF = 21.1, CI: 15.3, 27). CONCLUSIONS We conclude that there is a need for the government of Ghana to deploy targeted interventions to enhance the uptake of Vitamin A supplementation among the most disadvantaged subpopulations. Interventions targeted at these disadvantaged populations should be pro-poor in nature. In addition, the inequalities in the dimension of place of residence were mixed, favoring both rural and urban children at different points. This calls for a comprehensive and all-inclusive approach that enhances Vitamin A supplementation uptake in an equitable manner in both areas of residence. Empowerment of women through formal education could be an important step toward improving Vitamin A supplementation among children in Ghana.
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Affiliation(s)
- Joshua Okyere
- grid.413081.f0000 0001 2322 8567Department of Population and Health, University of Cape Coast, Cape Coast, Ghana ,grid.9829.a0000000109466120Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Simon Agongo Azure
- grid.412737.40000 0001 2186 7189Population and Reproductive Health Division, School of Public Health, University of Port Harcourt, Choba, Port Harcourt, Nigeria ,Department of Community Health, College of Health, Yamfo, Ghana
| | - Eugene Budu
- grid.415489.50000 0004 0546 3805Korle Bu Teaching Hospital, P.O. Box, 77, Accra, Ghana
| | - Felix Mensah
- grid.413081.f0000 0001 2322 8567Department of Data Science and Economic Policy, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- REMS Consult Ltd., Sekondi-Takoradi, Western Region Ghana ,grid.117476.20000 0004 1936 7611School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Edward Kwabena Ameyaw
- grid.117476.20000 0004 1936 7611School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia ,grid.411382.d0000 0004 1770 0716Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong, China ,L & E Research Consult Ltd., Wa, Upper West Region Ghana
| | - Abdul-Aziz Seidu
- REMS Consult Ltd., Sekondi-Takoradi, Western Region Ghana ,grid.511546.20000 0004 0424 5478Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana ,grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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Bhati D, Tripathy A, Mishra PS, Srivastava S. Contribution of socio-economic and demographic factors to the trend of adequate dietary diversity intake among children (6-23 months): evidence from a cross-sectional survey in India. BMC Nutr 2022; 8:153. [PMID: 36575545 PMCID: PMC9793661 DOI: 10.1186/s40795-022-00655-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The present study aims to estimate the factors contributing to the change adequate diversified dietary intake (ADDI) from 2005-06 to 2015-16 among children aged 6-23 months in India. METHODS A cross-sectional study was conducted using a large representative survey data. Data from the National Family Health Survey 2005-06 and 2015-16 was used. The effective sample size for the present study was 14,422 and 74,132 children aged 6-23 months in 2005-06 and 2015-16, respectively. The outcome variable was minimum adequate dietary diversity intake. Binary logistic regression was used to evaluate the factors associated with ADDI. Additionally, the Fairlie method of decomposition was used, which allows quantifying the total contribution of factors explaining the decadal change in the probability of ADDI among children aged 6-23 months in India. RESULTS There was a significant increase in ADDI from 2005-06 to 2015-16 (6.2%; p < 0.001). Additionally, compared to the 2005-06 years, children were more likely to have ADDI [AOR; 1.29, CI: 1.22-1.35] in 2015-16. Mother's education explained nearly one-fourth of the ADDI change among children. Further, the regional level contribution of 62.3% showed that the gap was widening across regions between the year 2005-06 and 2015-16 in ADDI among children. The child's age explained 5.2% with a positive sign that means it widened the gaps. Whereas the household wealth quintile negatively contributed and explained by -5.2%, that means between the years the gaps has reduced in ADDI among children aged 6-23 months. CONCLUSION Our findings indicate that increasing awareness of the use of mass media and improving the education levels of mothers would be beneficial for adequate dietary diversity intake among children aged 6-23 months. Investments should support interventions to improve overall infant and young children feeding practices in India.
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Affiliation(s)
| | - Abhipsa Tripathy
- grid.412779.e0000 0001 2334 6133PG Department of Statistics, Utkal University, Vani Vihar, Odisha Bhubaneswar, 751004 India
| | - Prem Shankar Mishra
- grid.464840.a0000 0004 0500 9573Population Research Centre, Institute for Social and Economic Change, Bengaluru, 560072 Karnataka India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600 Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, 400088 Maharashtra India
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Kundu S, Das P, Rahman MA, Al Banna MH, Fatema K, Islam MA, Srivastava S, Muhammad T, Dey R, Hossain A. Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis. Sci Rep 2022; 12:21712. [PMID: 36522494 PMCID: PMC9755277 DOI: 10.1038/s41598-022-26305-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.
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Affiliation(s)
- Satyajit Kundu
- grid.443020.10000 0001 2295 3329Global Health Institute, North South University, Dhaka, 1229 Bangladesh ,grid.263826.b0000 0004 1761 0489School of Public Health, Southeast University, Nanjing, 210096 China ,grid.443081.a0000 0004 0489 3643Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Pranta Das
- grid.24434.350000 0004 1937 0060Department of Statistics, University of Nebraska–Lincoln, Lincoln, NE 68583-0963 USA ,grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Ashfikur Rahman
- grid.412118.f0000 0001 0441 1219Development Studies Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Md. Hasan Al Banna
- grid.443081.a0000 0004 0489 3643Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Kaniz Fatema
- grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Akhtarul Islam
- grid.412118.f0000 0001 0441 1219Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, 9208 Bangladesh
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
| | - Rakhi Dey
- grid.472353.40000 0004 4682 8196Department of Statistics, Government Brajalal College, National University of Bangladesh, Gazipur, 1704 Bangladesh
| | - Ahmed Hossain
- grid.412789.10000 0004 4686 5317College of Health Sciences, University of Sharjah, 27272 Sharjah, United Arab Emirates ,grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
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Srivastava S, Kumar P, Paul R, Debnath P. Effect of change in individual and household level characteristics on anemia prevalence among adolescent boys and girls in India. BMC Public Health 2022; 22:1478. [PMID: 35922790 PMCID: PMC9351076 DOI: 10.1186/s12889-022-13863-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Anemia is a significant public health challenge that affects the population of all nations. Anemia among adolescents emerged as an alarming public health issue as it harms an individual’s physical capacity and cognitive and work performance. The study aims to determine the effect of changes in individual and household level factors on the prevalence of anemia among adolescent boys and girls. Method The study utilized data from two waves of the “Understanding the lives of adolescent and young adults” (UDAYA) survey, conducted in Bihar and Uttar Pradesh during 2015–16 (wave-1) and 2018–19 (wave-2). The sample size for the present study was 4216 and 5974 unmarried adolescent boys and girls aged 10–19 years in both waves. We performed descriptive analysis to observe the characteristics of adolescents during 2015–16. Further, changes in selected independent variables from wave-1 to wave-2 were examined using the proportion test. Moreover, random-effect regression models were employed to examine the association of changes in individual and household level factors with anemia prevalence among adolescents. Results The prevalence of anemia decreased over time among adolescent boys (33 to 30%), whereas it increased among adolescent girls (59 to 63%). The results from the random-effect model show that adolescent boys who used shared toilets were more anemic than those who used a private restroom [β:0.05, 95% CI:(0.01, 0.08)]. Moreover, underweight [β:0.05, CI:(0.01, 0.09)] and thin [β:0.04, CI:(0.00, 0.07)] adolescent boys were more likely to be anemic compared to their normal counterparts. Additionally, boys who belonged to the poorest [β:0.08, CI:(0.02, 0.14)] households had a higher risk of anemia than the richest household. Conclusion The anemia prevalence was higher among adolescents aged 10–19 years in Uttar Pradesh and Bihar. This study has filled an information gap by providing state-level representative estimates indicating underweight status and thinness as the common factors behind the anemia prevalence among adolescent boys than in girls. Iron deficiency anemia is the most prevalent in certain age groups in India. Hence, Anemia prevention efforts and iron-folic acid (IFA) supplementation programs are currently being strengthened in India, targeting the high-risk population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13863-w.
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Affiliation(s)
- Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Pradeep Kumar
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Ronak Paul
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - Paramita Debnath
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Lucha TA, Engida TA, Mengistu AK. Assessing the potential determinants of national vitamin A supplementation among children aged 6-35 months in Ethiopia: further analysis of the 2019 Ethiopian Mini Demographic and Health Survey. BMC Pediatr 2022; 22:439. [PMID: 35864488 PMCID: PMC9306167 DOI: 10.1186/s12887-022-03499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background Vitamin A is a nutrient that is required in a small amount for normal visual system function, growth and development, epithelia’s cellular integrity, immune function, and reproduction. Vitamin A has a significant and clinically important effect since it has been associated with a reduction in all-cause and diarrhea mortality. The aim of this study was to determine factors associated with national vitamin A supplementation among children aged 6–35 months. Method The data for this study was extracted from the 2019 Ethiopian Mini Demographic and Health Survey. A total weighted sample of 2242 women with children aged 6–35 months was included in the study. The analysis was performed using Stata version 14.2 software. Applying sampling weight for descriptive statistics and complex sample design for inferential statistics, a manual backward stepwise elimination approach was applied. Finally, statistical significance declared at the level of p value < 0.05. Result The overall coverage of vitamin A supplementation among children aged 6–35 months for the survey included was 44.4 95% CI (40.15, 48.74). In the multivariable analysis, mothers who had four or more antenatal visits [AOR = 2.02 (95% CI: 1.34, 3.04)] were two times more likely to receive vitamin A capsules for their children than mothers who had no antenatal visits. Children from middle-wealth quintiles had higher odds of receiving vitamin A capsules in comparison to children from the poorest wealth quintile [AOR = 1.77 (95% CI: 1.14, 2.73)]. Older children had higher odds of receiving vitamin A capsules than the youngest ones. Other factors that were associated with vitamin A supplementation were mode of delivery and region. Conclusion The coverage of vitamin A supplementation in Ethiopia remains low and it is strongly associated with antenatal visit, household wealth index and age of child. Expanding maternal health services like antenatal care visits should be prioritized.
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Affiliation(s)
- Tadele Abate Lucha
- Department of Neonatal Nursing, Menelik II Medical & Health Sciences College, Kotebe University of Education, Addis Ababa, Ethiopia.
| | - Teklu Assefa Engida
- Department of Neonatal Nursing, Menelik II Medical & Health Sciences College, Kotebe University of Education, Addis Ababa, Ethiopia
| | - Admassu Ketsela Mengistu
- Department of Pharmacy, Menelik II Medical & Health Sciences College, Kotebe University of Education, Addis Ababa, Ethiopia
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Bora K. Vitamin A supplementation among 9-59 month old children in India: geospatial perspectives and implications for targeted coverage. BMJ Glob Health 2022; 7:bmjgh-2021-007972. [PMID: 35902202 PMCID: PMC9137340 DOI: 10.1136/bmjgh-2021-007972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/02/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Vitamin A supplementation (VAS) is yet to reach all Indian children aged 9–59 months, despite guidelines for universal coverage. This study mapped geospatial patterns underlying VAS coverage across two policy-relevant administrative unit levels (states and districts) in India. The relationship between spatial distribution of VAS coverage and vitamin A deficiency (VAD) prevalence was also investigated. Methods The study draws on nationally representative cross-sectional data collected during National Family and Health Survey 4 (NFHS-4) and Comprehensive National Nutritional Survey (CNNS). VAS coverage was estimated using information obtained during NFHS-4 from mothers about whether their children (n=204 645) had received VAS within 6 months of the survey. VAD prevalence estimates were based on serum retinol measurements during CNNS in under-five children (n=9563). State-level and district-level choropleth maps of VAS coverage were constructed. Spatial patterns were probed using Moran’s statistics, scatter plots and local indicators of spatial association (LISA). Relationship between VAS coverage (as an explanatory variable) and VAD prevalence was explored using spatial autoregressive models. Results VAS coverage in India (overall 60.5%) ranged from 29.5% (Nagaland) to 89.5% (Goa) across the various states/union territories. Among districts, it ranged from 12.8% (Longleng district, Nagaland) to 94.5% (Kolar district, Karnataka). The coverage exhibited positive spatial autocorrelation, more prominently at the district-level (univariate Moran’s I=0.638, z-value=25.614, pseudo p value=0.001). LISA maps identified spatial clusters of high coverage and low coverage districts. No significant spatial association was observed between VAS coverage and VAD prevalence in the states during spatial error (R2=0.07, λ=0.30, p value=0.14) and spatial lag (R2=0.05, ρ=0.25, p value=0.23) regression. Conclusion Two out of every five eligible Indian children were not supplemented with vitamin A. The coverage was geographically heterogeneous with discernible spatial patterns. Their consequences on vitamin A status and associated health effects in the community deserve close monitoring.
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Affiliation(s)
- Kaustubh Bora
- Haematology Division, ICMR-Regional Medical Research Centre, North East Region, Dibrugarh, Assam, India
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12
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Belay DG, Aragaw FM, Teklu RE, Fetene SM, Negash WD, Asmamaw DB, Fentie EA, Alemu TG, Eshetu HB, Shewarega ES. Determinants of Inadequate Minimum Dietary Diversity Intake Among Children Aged 6-23 Months in Sub-Saharan Africa: Pooled Prevalence and Multilevel Analysis of Demographic and Health Survey in 33 Sub-Saharan African Countries. Front Nutr 2022; 9:894552. [PMID: 35845763 PMCID: PMC9284213 DOI: 10.3389/fnut.2022.894552] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Inappropriate feeding practices result in significant threats to child health by impaired cognitive development, compromised educational achievement, and low economic productivity, which becomes difficult to reverse later in life. There is minimal evidence that shows the burden and determining factors of inadequate dietary intake among children aged under 2 years in sub-Saharan African (SSA) countries. Therefore, this study aimed to assess the pooled magnitude, wealth-related inequalities, and other determinants of inadequate minimum dietary diversity (MDD) intake among children aged 6-23 months in the SSA countries using the recent 2010-2020 DHS data. Methods A total of 77,887 weighted samples from Demographic and Health Survey datasets of the SSA countries were used for this study. The Microsoft Excel and STATA version 16 software were used to clean, extract, and analyze the data. A multilevel binary logistic regression model was fitted. The concentration index and curve were applied to examine wealth-related inequalities in the outcomes. P-value < 0.05 with 95% CI was taken to declare statistical significance. Results The pooled magnitude of inadequate MDD intake among children aged 6-23 months in SSA was 76.53% (95% CI: 73.37, 79.70), ranging from 50.5% in South Africa to 94.40% in Burkina Faso. Individual-level factors such as women having secondary and above education (AOR = 0.66; 95% CI; 0.62, 0.70), being employed (AOR = 0.76; 95% CI; 0.72, 0.79), having household media exposure (AOR = 0.69; 95% CI; 0.66, 0.72), richest wealth (AOR = 0.46; 95% CI; 0.43, 0.50), having health institution delivery (AOR = 0.87;95% CI; 0.83, 0.91), and community-level factor such as living in upper middle-income country (AOR = 0.42; 95% CI; 0.38, 0.46) had a significant protective association, whereas rural residence (AOR = 1.29; 95% CI; 1.23, 1.36) has a significant positive association with inadequate MDD intake among children aged 6-23 months. Inadequate MDD intake among children aged 6-23 months in SSA was disproportionately concentrated on the poor households (pro-poor) (C = -0.24; 95% CI: -0.22, -0.0.26). Conclusion and Recommendations There is a high magnitude of inadequate minimum dietary diversity intake among children aged 6-23 months in SSA. Variables such as secondary and above maternal education, having an employed mother, having exposure to media, richest wealth, having health institution delivery, and living in the upper middle-income country have a significant negative association, whereas living in rural residence has a significant positive association with inadequate MDD intake. These findings highlight that to increase the MDD intake in the region, policy makers and other stakeholders need to give prior attention to enhancing household wealth status, empowering women, and media exposure.
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Affiliation(s)
- Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rediet Eristu Teklu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Samrawit Mihret Fetene
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ever Siyoum Shewarega
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Does Socio-economic Inequality Exist in One-person Household Among Older Adults in India? Evidence From National Family Health Survey, 2015–16. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09497-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mishra VK, Srivastava S, Muhammad T, Murthy PV. Relationship between tobacco use, alcohol consumption and non-communicable diseases among women in India: evidence from National Family Health Survey-2015-16. BMC Public Health 2022; 22:713. [PMID: 35410193 PMCID: PMC8996590 DOI: 10.1186/s12889-022-13191-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/01/2022] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Based on an increased prevalence of diabetes, asthma and hypertension among women in reproductive age, understanding the risk factors of non-communicable diseases (NCDs) is crucial to inform policy and program interventions to address the problem. In this study, we empirically assessed the associations of behavioural factors such as alcohol consumption and tobacco use and a variety of socioeconomic characteristics with prevalence of NCDs in adult women. METHODS The data were derived from the National Family Health Survey conducted in 2015-16. The effective sample size for the present paper was 699,686 women aged 15-49 years in India. Descriptive statistics along with bivariate analysis were conducted to find the preliminary results. Additionally, multivariable logistic regression analysis was conducted to find the relationship between NCDs and behavioural factors such as alcohol consumption and tobacco use. Moreover, population attributable risk was estimated in the present study. RESULTS It was revealed that 15.9% of women had any of the NCDs. A proportion of 0.8% of women smoked tobacco whereas 5.5% of women consumed smokeless tobacco. Also, a proportion of 1.2% of women consumed alcohol in the current study. The odds of having NCDs among women who smoked tobacco, consumed smokeless tobacco and consume alcohol were 16, 8 and 20% significantly higher than the odds of having NCDs among women who did not smoke tobacco, consume smokeless tobacco and consume alcohol respectively. The population attributable risk of having NCDs was 1.8% (p < 0.001) for women who smoked, 0.8% (p < 0.001) for women who consumed smokeless tobacco and 2.2% (p < 0.001) for women who consumed alcohol. Besides, the odds of having NCDs among overweight and obese women were 2.25 and 3.60 times greater than the odds of having NCDs among women who were underweight. CONCLUSION The findings revealed that smoking and using smokeless tobacco and alcohol consumption were risk factors of NCDs in women. The findings also alarm the focus of maternal and child health programs on NCDs' risk factors like maternal obesity, due to their adverse health consequences on their children too. Also, the coexistence of higher levels of tobacco use and alcohol consumption requires different strategies to address the vulnerability of women towards NCDs, including screening and early detection of NCDs especially among those who smoke or chew tobacco and consume alcohol.
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Affiliation(s)
- Vivek K. Mishra
- Department of Population Studies, Sri Venkateswara University, Tirupati, Andhra Pradesh 517 502 India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - P. V. Murthy
- Department of Population Studies and Social Work, College of Arts, Sri Venkateswara University, Tirupati, Andhra Pradesh 517502 India
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Belay DG, Taddese AA, Gelaye KA. Does socioeconomic inequality exist in minimum acceptable diet intake among children aged 6-23 months in sub-Saharan Africa? Evidence from 33 sub-Saharan African countries' demographic and health surveys from 2010 to 2020. BMC Nutr 2022; 8:30. [PMID: 35392989 PMCID: PMC8991825 DOI: 10.1186/s40795-022-00521-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background Child undernutrition is a major public health problem in many resource-poor communities in the world. More than two-thirds of malnutrition-related child deaths are associated with inappropriate feeding practices during the first 2 years of life. Socioeconomic inequalities are one of the most immediate determinants. Though sub-Saharan Africa (SSA) shares the huge burden of children undernutrition, as to our search of literature there is limited evidence on the pooled magnitude, socioeconomic inequalities of minimum acceptable diet intake and its contributing factors among children aged 6 to 23 months in the region. This study aimed to assess the level of socio-economic inequalities of minimum acceptable diet intake, and its contributor factors among children aged 6–23 months in SSA using recent 2010–2020 DHS data. Methods A total of 78,542 weighted samples from Demographic and Health Survey datasets of SSA countries were used for this study. The data were cleaned using MS excel and extracted and analyzed using STATA V.16 software. The concentration index and curve and wag staff type decomposition analysis were applied to examine wealth-related inequalities in the outcomes. P-value < 0.05 was taken to declare statistical significance. Results The pooled magnitude of MAD intake among children age 6–23 months in SSA was 9.89% [95%CI: 8.57, 11.21%] ranging from 3.10% in Guinea to 20.40% in Kenya. MAD intake in SSA was disproportionately concentrated on the rich households (pro-rich) [C = 0.191; 95% CI: 0.189, 0.193]. Residence (36.17%), media exposure (23.93%), and women’s education (11.63%) explained the pro-rich inequalities in MAD intake. The model explained 55.55% of the estimated socioeconomic inequality in MAD intake in SSA. Conclusion and recommendations Minimum acceptable diet intake in SSA is relatively low. There are moderate socioeconomic inequalities in MAD intake in SSA, mainly explained by residence, media exposure and women’s education. The government of sub-Saharan African countries should plan and work in short terms through the program that endorses women empowerment such as income generation, cash assistance for mothers who have under 2 years of children and women employment using affirmative actions, and nutrition education such as media campaigns and promoting breast feedings. Long-term plans are also needed for those SSA countries with lower income status through programs to enhance their country’s economy to the middle and higher economic level and to improve the wealth index of individual households to narrow the poor-rich gap in the minimum acceptable diet intake. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00521-y.
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Affiliation(s)
- Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chauhan S, Srivastava S, Kumar P, Patel R. Decomposing urban-rural differences in multimorbidity among older adults in India: a study based on LASI data. BMC Public Health 2022; 22:502. [PMID: 35291975 PMCID: PMC8922782 DOI: 10.1186/s12889-022-12878-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity; however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity. METHODS The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release cross-sectional data of the Longitudinal Ageing Study in India (LASI). Descriptive, bivariate, and multivariate decomposition analysis techniques were used. RESULTS Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p < 0.001). The multivariate decomposition analysis revealed that about 51% of the overall differences (urban-rural) in the prevalence of multimorbidity among older adults was due to compositional characteristics (endowments). In contrast, the remaining 49% was due to the difference in the effect of characteristics (Coefficient). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively. Work status and education were found to reduce the urban-rural gap in the prevalence of multimorbidity among older adults by 8% and 6%, respectively. CONCLUSIONS There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.
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Affiliation(s)
- Shekhar Chauhan
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Research Scholar, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Consultant- Research & Data Analysis, Population Council India Office, Zone 5A, India Habitat Centre, Lodi Road, 110003, New Delhi, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
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Muhammad T, Boro B, Kumar M, Srivastava S. Gender differences in the association of obesity-related measures with multi-morbidity among older adults in India: evidence from LASI, Wave-1. BMC Geriatr 2022; 22:171. [PMID: 35232371 PMCID: PMC8886975 DOI: 10.1186/s12877-022-02869-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Co-existence of multiple chronic diseases is increasingly becoming a norm among ageing population. The study aims to investigate the prevalence of multimorbidity and the association between anthropometric measures of obesity and multimorbidity among men and women aged 60 years and above in India. Methods The present study is based on the first wave of the Longitudinal Aging Study in India. The analytical sample size for the study was 28,050 older adults aged 60 years and above. Descriptive statistics and multivariable analysis using logistic regression models were conducted. Results Body Mass Index (BMI) based-obesity is more prevalent among older women than men (26.3% vs. 17.6%). Similarly, higher proportion of older women was at high-risk waist circumference (37.1% vs 8.9%) and waist-hip ratio (78.5 vs 75.4%) than men respectively. In Model-I, after controlling for several covariates, older adults with overweight/obesity were 1.6 times more likely to have multi-morbidity than non-obese older adults (Adjusted OR = 1.61; 95% CI: 1.48–1.74). Similarly, older adults with high-risk waist circumference [Adjusted OR: 1.66; 95% CI: 1.52–1.80] and waist-hip ratio [Adjusted OR: 1.45; 95% CI: 1.33–1.59] also had higher odds of having multi-morbidity in reference to their counterparts. In model-3 it was found that females with high-risk waist-hip ratio had 14% lower odds of multimorbidity than males with high-risk waist-hip ratio [Adjusted OR: 0.86; 95%CI: 0.78–0.94]. Conclusion The findings of the study show significant gender difference in the prevalence of multimorbidity, men being at increased risk in the multivariate analysis which is uncommon in the existing epidemiological research. Interactive effect of male gender with anthropometric measures on multimorbidity reported in our study probably due to increased unhealthy behaviours among men requires further research.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Bandita Boro
- Centre for the Study of Regional Development (CSRD), School of Social Sciences-3 (SSS 3), Jawaharlal Nehru University (JNU), New Delhi, 110067, India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
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Banerjee S, Kumar P, Srivastava S, Banerjee A. Association of anthropometric measures of obesity and physical activity with cardio-vascular diseases among older adults: Evidence from a cross-sectional survey, 2017-18. PLoS One 2021; 16:e0260148. [PMID: 34910748 PMCID: PMC8673620 DOI: 10.1371/journal.pone.0260148] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND With the increase in elderly population, the risk of cardiovascular diseases (CVD) among Indian older adults is also increasing. The present paper tries to assess how different anthropometric measures of obesity and physical activity affects cardiovascular disease risk among older adults in India. METHODS The data from Longitudinal Ageing Study in India (LASI) has been used. The total sample size for the present study is 31,464 older adults aged 60 years and above. Chi-square test and binary logistic regression has been used to measure the association of obesity measures and CVD prevalence. RESULTS About 35.2% (n = 11,058) of the older adults suffered from CVD. Moreover, 22.2% (n = 6,217) of the older adults were obese/overweight, 23.7% (n = 6,651) had high risk waist circumference and 77.0% (n = 21,593) had high risk waist-Hip ratio. The likelihood of CVD was 60%, 50%, and 34% significantly higher among older adults who were obese/overweight [Adjusted odds ratio (AOR): 1.60; CI: 1.48-1.72], had high risk waist circumference [AOR: 1.50; CI: 1.39-1.62] and high risk waist-Hip ratio [AOR: 1.34; CI: 1.25-1.44], respectively compared to older adults with normal BMI and those who do not have a high risk waist circumference and high risk waist hip ratio. Moreover, older adults who never did physical activity had 22 per cent higher risk of CVD than those who did frequent [AOR: 1.22; CI: 1.13-1.32] physical activity. CONCLUSION The burden of overweight and obesity along with physical inactivity increases the risk of CVD in older adults. These findings highlight the urgent need for framing direct and indirect strategies to control obesity in order to reduce the burden of CVD among older adults in India.
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Affiliation(s)
| | - Pradeep Kumar
- Population Council, India Country Office, India Habitat Centre, New Delhi, India
| | - Shobhit Srivastava
- Research and Innovation, MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Adrita Banerjee
- International Institute for Population Sciences, Mumbai, India
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Mishra PS, Sinha D, Kumar P, Srivastava S, Bawankule R. Newborn low birth weight: do socio-economic inequality still persist in India? BMC Pediatr 2021; 21:518. [PMID: 34798861 PMCID: PMC8603541 DOI: 10.1186/s12887-021-02988-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of preterm birth and subsequent low birth weight (LBW) are vital global public health issues. It contributes to high infant and child mortality in the early stages of life and later on in adult life; it increases the risk for non-communicable diseases. The study aims to understand the socio-economic status-related inequality for LBW among children in India. It hypothesises that there is no association between the socio-economic status of the household and the newborn's LBW in India. METHODS The study utilised data from the fourth round of the National Family Health Survey, a national representative cross-sectional survey conducted in 2015-16 (N = 127,141). The concentration index (CCI) and the concentration curve (CC) measured socio-economic inequality in low birth status among newborns. Wagstaff decomposition further analysed key contributors in CCI by segregating significant covariates. RESULTS About 18.2% of children had low birth weight status. The value of concentration was - 0.05 representing that low birth weight status is concentrated among children from lower socio-economic status. Further, the wealth quintile explained 76.6% of the SES related inequality followed by regions of India (- 44%) and the educational status of mothers (43.4%) for LBW among children in India. Additionally, the body mass index of the women (28.4%), ante-natal care (20.8%) and residential status (- 15.7%) explained SES related inequality for LBW among children in India. CONCLUSION Adequate attention should be given to the mother's nutritional status. Awareness of education and usage of health services during pregnancy should be promoted. Further, there is a need to improve the coverage and awareness of the ante-natal care (ANC) program. In such cases, the role of the health workers is of utmost importance. Programs on maternal health services can be merged with maternal nutrition to bring about an overall decline in the LBW of children in India.
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Affiliation(s)
- Prem Shankar Mishra
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, Karnataka 560072 India
| | - Debashree Sinha
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Rahul Bawankule
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Puranik A, N S. Anemia Among Children Under 5 Years in India: A District-Level Spatial Analysis Using NFHS-5 Data. Asia Pac J Public Health 2021; 34:206-212. [PMID: 34775809 DOI: 10.1177/10105395211058288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 2015/2016 National Family Health Survey (NFHS-4) revealed that the prevalence of anemia among children under 5 years is 58% in India. Lack of nutritional supplementation and lack of health care facilities are found to be important influential factors of anemia among children. We aimed to examine district-level spatial heterogeneity and clustering of associated factors with childhood anemia in India. Geographically weighted regression was applied on the NFHS-5 data for 335 districts. Factors such as prevalence of nutritional supplementation in children and mothers, birth order, antenatal care, diarrhea in children, and stunting were found to be significantly associated. Spatial scan statistics technique identified 3 significant local spatial clusters of anemia. This study provides findings based on the latest available data which can further assist in the design and execution of tailor-made policies.
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Affiliation(s)
- Amitha Puranik
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Shreya N
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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Srivastava S, Kumar P, Rashmi, Paul R, Dhillon P. Does substance use by family members and community affect the substance use among adolescent boys? Evidence from UDAYA study, India. BMC Public Health 2021; 21:1896. [PMID: 34666741 PMCID: PMC8527698 DOI: 10.1186/s12889-021-11911-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background Substance use among adolescents is risky behavior that had emerged as a concern in both developed and developing countries. Evidence revealed that substance use is more frequent among those adolescents whose immediate family members (parents, siblings and grandparents) also indulge in such consumption; however, scarce literature is present in the Indian context. Therefore, the present study examined whether substance use among family members and in the community is associated with the substance use behavior of adolescent boys in Uttar Pradesh and Bihar. Method We used the data for 5969 adolescent boys aged 10–19 years from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey conducted in 2016. A three-level random intercept logit model was utilized to understand the association of adolescent substance use behavior with familial and community context. Results We found that 16% of adolescent boys were using any substance (tobacco or alcohol or drug). The substance use was significantly higher among adolescent boys who were school dropouts (40%) than those who were currently in school. The prevalence of substance use is also high among those who were working (35%). Moreover, 19, 24 and 28% of the adolescents come from families where at least one of the family members consumed tobacco, alcohol and drugs, respectively. The odds of substance use were 2.13 times [CI:1.44–3.17] higher among those adolescent boys whose family members also indulged in substance use. Moreover, the likelihood of substance use was 1.24 times [CI:1.01–1.68] higher among the adolescent boys who come from a community with high substance use. Additionally, the risk of substance use is more likely among adolescent boys belonging to the same household of the same community. Conclusion It is evident that exposure to substance use in the family and community increases the likelihood of substance use among adolescent boys. There is a need for household- and community-level programmatic interventions to alleviate the risk of substance use among adolescents.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Pradeep Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Rashmi
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Preeti Dhillon
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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Kumar P, Chauhan S, Patel R, Srivastava S. Anaemia among mother-father-child pairs in India: examining co-existence of triple burden of anaemia in a family. BMC Public Health 2021; 21:1341. [PMID: 34233628 PMCID: PMC8265002 DOI: 10.1186/s12889-021-11408-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anaemia is a global health concern and is also a common comorbidity in multiple medical conditions. Very limited research is available examining anaemia among family members in India and across various countries. The present study aimed to examine the co-existence of the triple burden of anaemia among mother-father-child pairs in a family. METHODS The data utilized was from the National Family Health Survey conducted in 2015-16. The effective sample size for the study was 26,910 couples, along with children aged 6-59 months. The bivariate and binary logistic regression analysis were applied to assess the factors associated with family-level anaemia. In bivariate analysis, a chi-square test was performed to determine the association of socio-demographic factors with anaemic family. RESULTS More than half of the mothers (57.5%) and their children (58%), along with 10% of fathers, were found to be anaemic; however, the co-existence of triple burden of anaemia among mother-father-child pairs was 4.7% in the study. The likelihood of family-level anaemia was low when both the parents were educated [OR: 0.69, CI: 0.58-0.81], and it was high when both the parents were employed [OR: 1.40 CI: 1.10-1.80]. Families from the Scheduled Tribe had a 62% higher likelihood to suffer from anaemia [OR: 1.62, CI: 1.33-1.97]. CONCLUSIONS The suggested interventions include early diagnosis, effective management, and treatment of anaemia. Moreover, adequate complementary feeding practices for children shall also be promoted. Parental education on nutrition is also required, and community interventions are needed to improve parental education on nutrition. At last, there is a need for greater policy and program attention to improving nutritional knowledge among mothers so as to tackle the triple burden of anaemia among mother-father-child pairs.
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Affiliation(s)
- Pradeep Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shekhar Chauhan
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Ratna Patel
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Muhammad T, Srivastava S, Kumar P, Patel SK. What predicts the early sexual debut among unmarried adolescents (10-19 years)? Evidence from UDAYA survey, 2015-16. PLoS One 2021; 16:e0252940. [PMID: 34111205 PMCID: PMC8192016 DOI: 10.1371/journal.pone.0252940] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/25/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The societal norm in India is such that adolescents are expected to respect and follow traditional values and view early sexual debut as undesirable and deviant from the social mores. However, a dramatic shift in attitudes towards sex before marriage has been observed in India. We in this study, aim to study the factors associated with early sexual debut among unmarried adolescents. MATERIALS AND METHODS The study used data from the Understanding the lives of adolescents and young adults (UDAYA) survey conducted in 2016 with 15,388 adolescents aged 10-19 years from two Indian states. Bivariate and logistic regression analyses were performed to determine the associated factors. RESULTS Adolescent boys (9%) were more prone to early sexual debut compared to girls (4%). Both boys (17.2%) and girls (6%) who were school dropouts had significantly higher chances of early sexual debut. Boys who had rare [OR: 2.28; CI: 1.12-4.64] or frequent media exposure [OR: 2.70; CI: 1.36-5.32] were significantly more likely to report early sexual debut than those who had no media exposure. Further, the likelihood of early sexual debut was significantly higher among boys [OR: 3.01; CI: 2.34-3.87] and girls [OR: 1.87; CI: 1.12-3.12] who had exposure to pornography compared to their counterparts. The odds of early sexual debut were higher among boys [OR: 1.89; CI: 1.19-3.01] and girls [OR: 1.77; CI: 1.30-2.41] who had moderately-severe/severe depressive symptoms compared to their counterparts. CONCLUSIONS The results highlight that Indian unmarried adolescents demand the appropriate knowledge to promote safer sexual behavior and lead a responsible and healthy lifestyle. The preventive efforts must be multifaceted with involvement at the individual and parental levels. Especially, interventions appear advantageous to be parents-focused emphasizing family life education that can prevent risky sexual behaviors among adolescent boys and girls. And the public programs should focus on sexual health promotion considering the physical and psychosocial changes during early ages of sex life.
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Affiliation(s)
- T. Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Sinha D, Mishra PS, Srivastava S, Kumar P. Socio-economic inequality in the prevalence of violence against older adults - findings from India. BMC Geriatr 2021; 21:322. [PMID: 34016039 PMCID: PMC8135164 DOI: 10.1186/s12877-021-02234-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Violence against older adults is a well-recognised socio-psychological and public health problem. It is uncared-for, undiagnosed, and an untreated problem that is widespread across both developed and developing countries. The present paper aims to understand the extent of the socio-economic status related inequality in violence against older adults in India. METHODS The study uses data from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults is the outcome variable for the study and is defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socio-economic factors to violence against older adults (N = 9541). RESULTS The prevalence of violence faced by older adults was 11.2%. Older adults aged 80+ years [OR: 1.49; CI: 1.14-1.93] and working [OR: 1.26; CI: 1.02-1.56] had higher likelihood to face violence than their counterparts. On the other hand, older adults who were currently in union [OR: 0.79; CI: 0.65-0.95], lived with children [OR: 0.53; CI: 0.40-0.72] and who belonged to richer wealth quintile [OR: 0.35; CI:0.24-0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults were more prone to violence (Concentration index: - 0.20). Household's wealth status was responsible for explaining 93.7% of the socio-economic status related inequality whereas living arrangement of older adults explained 13.7% of the socio-economic related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively. CONCLUSION Though interpretation of the results requires a cautious understanding of the data used, the present study highlights some of the relevant issues faced by the country's older adults. With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.
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Affiliation(s)
- Debashree Sinha
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Prem Shankar Mishra
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, Karnataka 560072 India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Muhammad T, Srivastava S, Sekher TV. Association of self-perceived income status with psychological distress and subjective well-being: a cross-sectional study among older adults in India. BMC Psychol 2021; 9:82. [PMID: 34006311 PMCID: PMC8130272 DOI: 10.1186/s40359-021-00588-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As the older population aged 65 and over worldwide, is estimated to increase from 9% in 2019 to 16% in 2050, rapid aging will transform the aspects such as economic security, employment status, and family structure. The effects of lower levels of perceived income and poor socioeconomic status on the mental health of older adults appear to be large and enduring. Therefore, the present study contributes to the literature on understanding the association of socioeconomic conditions and self-perceived income status in particular, with self-assessed mental health outcomes (psychological distress and subjective well-being) among older adults in India. METHODS Data for the present study was derived from the Building Knowledge Base on Population Ageing (BKPAI) in India. Bivariate and binary logistic regression analyses were conducted to understand the relationship between socioeconomic status and outcome variables. RESULTS About 43% of older adults had no income whereas 7% had income but perceived as not sufficient to fulfil their basic needs. Nearly, 9% of older adults were retired from regular employment. Almost 70% older adults had received no pension and nearly 18% of older adults had no asset ownership. It is revealed that older adults with income that is partially sufficient to fulfil their basic needs were 2.23 times [OR: 2.23, CI: 1.75-2.84] and 1.96 times [OR: 1.96, CI: 1.55-2.47] significantly more likely to suffer from psychological distress and low subjective well-being than those who had income which was sufficient to fulfil their basic needs. CONCLUSIONS By focusing on four target areas such as the income support, education, family oriented initiatives and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals by which they do not have to remain as a financial burden on their children, may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.
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Affiliation(s)
- T. Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - T. V. Sekher
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
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Muhammad T, Srivastava S, Sekher TV. Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India. BMC Psychiatry 2021; 21:256. [PMID: 34001051 PMCID: PMC8130352 DOI: 10.1186/s12888-021-03257-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. METHODS Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. RESULTS About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21-1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72-0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. CONCLUSION The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.
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Affiliation(s)
- T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. V. Sekher
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Srivastava S, Singh SK, Kumar M, Muhammad T. Distinguishing between household headship with and without power and its association with subjective well-being among older adults: an analytical cross-sectional study in India. BMC Geriatr 2021; 21:304. [PMID: 33980164 PMCID: PMC8114520 DOI: 10.1186/s12877-021-02256-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/30/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The status of household headship accorded to the older members of the family is often symbolic and seldom vested with some control over resources. The increased dependency and diminished ability to contribute to household economy are major factors that lead to a decline in the respect accorded to older people and their status in the family. The present study aimed to understand the distinction between the functional and nominal household headship status of older adults based on their decision-making power and examine how it is associated with their subjective well-being. METHOD The present research used data from the 'Building a Knowledge Base on Population Aging in India' (BKPAI) which is nationally representative. The survey was conducted in 2011, across seven states of India. Descriptive statistics along with percentage distribution were calculated for subjective well-being over explanatory variables. For finding the association between subjective well-being over explanatory variables, binary logistic regression model was used. RESULTS The mean age of the study population was 68 years [CI: 67.8-68.2]. About 5 % of older adults had nominal while 95% had functional headship status. The prevalence of low subjective well-being (LSWB) was significantly higher among older adults with nominal headship status (58%) than functional headship status (23%). After controlling for several other variables, older adults with nominal headship status were 59% significantly more likely to have low subjective well-being than individuals with functional headship status (OR = 1.59; 95% CI: 1.10, 2.31). Further, older adults with psychological distress, chronic morbidity, poor self-reported health, no community involvement and no one to trust on were at higher risk of LSWB than their counterparts. CONCLUSIONS Findings suggest that older adults who do not have a household headship with power with active participation in household decision-making as well as those who have no involvement in social activities or have poor health conditions need to be given more attention. Thus, to keep a large proportion of older population gainfully engaged, their care and support should be ensured via providing appropriate services that would enhance their roles and responsibilities and overall wellbeing.
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Affiliation(s)
- Shobhit Srivastava
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - S. K. Singh
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Manish Kumar
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. Muhammad
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Srivastava S, Purkayastha N, Chaurasia H, Muhammad T. Socioeconomic inequality in psychological distress among older adults in India: a decomposition analysis. BMC Psychiatry 2021; 21:179. [PMID: 33823847 PMCID: PMC8025542 DOI: 10.1186/s12888-021-03192-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/31/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Older people coming from a lower wealth gradient are more vulnerable to have stressful life events further adding more risk for common mental health disorders and psychological distress situations. The present study explores the associations between socioeconomic and health-related variables and psychological distress among older adults in India and the contribution of such factors to the inequalities in psychological distress. METHODS A cross-sectional survey of 9181 older adults conducted as 'Building a Knowledge Base on Population Ageing in India' was assessed. Logistic regression and decomposition models were used to analyze the data. Psychological distress was measured from General Health Questionnaire (GHQ-12). The value of Cronbach's alpha was 0.90. It was having a scale of 0 to 12 on the basis of experiencing stressful symptoms and was re-coded as 0 (representing 6+ stressful symptoms) and 1 (representing 5 and fewer symptoms). RESULTS Older adults from the poored, suffering from multi-morbidity, disabled, with low activities of daily living and low instrumental activities of daily living and poor cognitive ability were suffering from high psychological distress in India. Further, factors such as religion, caste, education, living arrangements, and self-worth in the family were major contributors to the concentration of psychological distress in older adults from poor households (concentration index: - 0.23). CONCLUSION The study suggests that among older people, there is a wide disparity of experiencing psychological distress across different socio-economic groups with significant factors being responsible for inequality in psychological distress. There is a need to build a "win-win" circumstance across sectors, including a broad spectrum of health, social and economic benefits to the vulnerable older population.
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Affiliation(s)
- Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Naina Purkayastha
- grid.412023.60000 0001 0674 667XDepartment of Statistics, Dibrugarh University, Dibrugarh, Assam India
| | - Himanshu Chaurasia
- grid.416737.00000 0004 1766 871XNational Institute for Research in Reproductive Health, ICMR, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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