目的 了解农村地区0～3岁儿童生长发育的公平性,探索社会经济因素对儿童生长发育公平性的贡献。方法 收集贵州、山西农村地区的2 120名儿童及其家庭的基本信息;采用WHO 2006年的标准评价儿童的生长发育状况;采用集中曲线和集中指数评价儿童生长发育的公平性,并对集中指数进行分解以分析社会经济因素对儿童生长发育公平性的贡献。结果 调查儿童生长迟缓、低体重、消瘦的集中指数分别为-0.106 2、-0.177 4和-0.074 7,生长迟缓的不公平主要来源于居住地、家庭经济水平、看护人文化程度的差异。结论 加大扶贫力度,并为贫困家庭的儿童提供奶粉、营养包,保障0～6岁儿童健康管理的执行力度和执行质量,进一步推进教育公平等应能在改善儿童整体健康的同时减小儿童的健康差异。
Abstract
Objective To evaluate the equity of growth of children aged 0 to 3 years old in rural of China,and to explore the effects of socioeconomic factors on the equity of children′s growth. Methods Information of 2 120 infants and their families in rural Guizhou and Shanxi provinces were collected.The WHO growth standard was used to assess children′s growth.The concentration curve and concentration index were used to assess the equity of children′s growth.Decomposition analysis was used to assess the contribution of socioeconomic factors on the equity of children′s growth. Results The concentration index of stunting,underweight and wasting was -0.1062,-0.1774 and -0.0747,respectively.Most of inequity of stunting came from inequity of region,family economic status and caregiver′s education. Conclusions Government should strengthen efforts in poverty alleviation and provide milk,yingyangbao for the poor children.Government should guarantee the strength and quality of implementation of health management for children under six years old,and should promote the equity of education further.These suggestions above should be able to improve the overall health of children as well as narrow the health difference of children.
关键词
生长发育 /
公平性研究 /
集中指数 /
婴幼儿
Key words
growth /
health equity /
concentration index /
infant
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参考文献
[1] 冯星淋,沈娟,郭岩.儿童健康公平性的社会决定因素研究[J].北京大学学报:医学版,2010,42(3):252-257.
[2] Whitehead M.The concepts and principles of equlity and health[J].Health Promotion International,1991,6(3):217-228.
[3] WHO.World Health Statistics 2014[M].Geneva:WHO,2014.
[4] 中华人民共和国卫生部.中国0~6岁儿童营养发展报告(2012)[EB/OL].2012.
[5] 袁平,王燕.我国6县农村5岁以下儿童生长发育公平性分析[J].中国儿童保健杂志,2008,16(4):384-386.
[6] 程建鹏,郭岩,李明颖.中国部分贫困地区农村儿童生长发育公平性研究[J].中国农村卫生事业管理,2005,25(8):54-57.
[7] Pei L,Wang D,Ren L,et al.Evaluation of the rural primary health care project on undernutrition equity among children in rural Western China[J].Health Policy and Planning,2013,28(4):429-434.
[8] Wagstaff A,Doorslaer E,Watanabe N.On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam[J].Jouranl of Econometrics,2003,30(112):207-223.
[9] World Bank Institute.Analyzing health equity using household survey data-A guide to techniques and their implementation[M].Washington DC:World Bank Institute,2008.
[10] Zere E,McIntyre D.Inequities in under-five child malnutrition in South Africa[J].International Journal for Equity in Health,2003,2(1):7.
[11] Limwattananon S,Tangcharoensathien V,Prakongsai P.Equity in maternal and child health in Thailand[J].Bulletin of the World Health Organization,2010,88(6):420-427.
[12] 谢金生,卢永昌.中国省市经济发展水平的数量分类[J].现在财经,2011,31(3):94-97.
[13] Kohen DE,Brooks-Gunn J,Leventhal T,et al.Neighborhood income and physical and social disorder in Canada:associations with young children′s competencies[J].Child Development,2002,73(6):1844-1860.
[14] Goli S,Doshi R,Perianayagam A.Pathways of economic inequalities in maternal and child health in urban India:a decomposition analysis[J].PLoS One,2013,8(3):e58573.
基金
联合国儿童基金会“Health and Nutrition”项目(0315-China/YH702)
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