TY - JOUR
T1 - Are pre-school girls more likely to be under-nourished in rural Thatta, Pakistan?-a cross-sectional study
AU - Nuruddin, Rozina
AU - Hadden, Wilbur C.
N1 - Funding Information:
Authors are thankful to Assistant Professor Iqbal Azam of the Aga Khan University for providing technical assistance during data organization, to Late Professor Lim Meng Kin of the National University of Singapore for his advice on interpretation of findings and to the journal reviewers for their constructive comments. We gratefully acknowledge the contribution of field investigators, supervisors and participants in data collection process. The analysis and opinions in this paper are those of the authors and not of their employing or funding agencies. We declare that there is no conflict of interest between the authors. Funding support for the survey came from International Development Research Centre (IDRC), Canada.
Publisher Copyright:
© 2015 Nuruddin and Hadden.
PY - 2015/12/21
Y1 - 2015/12/21
N2 - Background: Pakistan ranks third lowest on a global gender index (2013) and 13th highest on the prevalence of underweight among under-five children (2010). Through this population-based study, we examined gender differentials in the prevalence of stunting, wasting and under-weight defined by World Health Organization (WHO) Growth Standard among rural pre-school Pakistani children. Methods: We performed secondary analysis of data collected through a cross-sectional survey of Thatta district during 1992-93. Prevalence ratios were calculated for 1051 children aged 0-35 months from 95 randomly selected villages of rural Pakistan using a clustered adjusted log binomial model. Level 1 variables included child and household characteristics and level 2 included village characteristics. Results: Based on the new WHO growth reference, a major proportion of children were stunted (52.9 %), wasted (22.9 %) and under-weight (46.5 %). In a two-level model, compared to boys, girls had significantly greater risk of stunting [Prevalence Ratio (PR) (95 % C.I.) = 1.18 (1.03, 1.36)] and under-weight [P.R. (95 % C.I.) 1.14 (1.03, 1.26)], after adjustment of maternal literacy and village variables. Risk of wasting did not differ with gender [P.R. (95 % C.I.) = 1.04 (0.99, 1.15)]. Mothers of stunted and underweight children were respectively, 21 and 20 % more likely to be illiterate than those of normally nourished children. Sick children were at 16 % greater risk of wasting than those not reported ill. Conclusion: Greater prevalence of stunting and under-weight among girls suggests adoption of a gender sensitive approach in nutritional intervention programmes. Prompt management of childhood illnesses may reduce prevalence of wasting. Better literacy among rural mothers may reduce prevalence of stunting and under-weight. Whether gender differences in nutrition status are an underlying pathway for excessive girl mortality in rural Thatta needs further examination.
AB - Background: Pakistan ranks third lowest on a global gender index (2013) and 13th highest on the prevalence of underweight among under-five children (2010). Through this population-based study, we examined gender differentials in the prevalence of stunting, wasting and under-weight defined by World Health Organization (WHO) Growth Standard among rural pre-school Pakistani children. Methods: We performed secondary analysis of data collected through a cross-sectional survey of Thatta district during 1992-93. Prevalence ratios were calculated for 1051 children aged 0-35 months from 95 randomly selected villages of rural Pakistan using a clustered adjusted log binomial model. Level 1 variables included child and household characteristics and level 2 included village characteristics. Results: Based on the new WHO growth reference, a major proportion of children were stunted (52.9 %), wasted (22.9 %) and under-weight (46.5 %). In a two-level model, compared to boys, girls had significantly greater risk of stunting [Prevalence Ratio (PR) (95 % C.I.) = 1.18 (1.03, 1.36)] and under-weight [P.R. (95 % C.I.) 1.14 (1.03, 1.26)], after adjustment of maternal literacy and village variables. Risk of wasting did not differ with gender [P.R. (95 % C.I.) = 1.04 (0.99, 1.15)]. Mothers of stunted and underweight children were respectively, 21 and 20 % more likely to be illiterate than those of normally nourished children. Sick children were at 16 % greater risk of wasting than those not reported ill. Conclusion: Greater prevalence of stunting and under-weight among girls suggests adoption of a gender sensitive approach in nutritional intervention programmes. Prompt management of childhood illnesses may reduce prevalence of wasting. Better literacy among rural mothers may reduce prevalence of stunting and under-weight. Whether gender differences in nutrition status are an underlying pathway for excessive girl mortality in rural Thatta needs further examination.
KW - Gender
KW - Pakistan
KW - Preschool children
KW - Under-nutrition
KW - WHO growth reference
UR - http://www.scopus.com/inward/record.url?scp=84954077250&partnerID=8YFLogxK
U2 - 10.1186/s12939-015-0287-3
DO - 10.1186/s12939-015-0287-3
M3 - Article
C2 - 26689821
AN - SCOPUS:84954077250
SN - 1475-9276
VL - 14
JO - International Journal for Equity in Health
JF - International Journal for Equity in Health
IS - 1
M1 - 151
ER -
