Vu Duy Kien1,2,3*§, Hwa-Young Lee4*§, You-Seon Nam4,5, Juhwan Oh4, Kim Bao Giang2,6 and Hoang Van Minh1,2
1Center for Population Health Sciences, Hanoi School of Public Health, Hanoi, Vietnam; 2Center for Health System Research, Hanoi Medical University, Hanoi, Vietnam; 3Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; 4JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea; 5Department of Family Medicine, Seoul National University Hospital, Seoul, Korea; 6Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
ABSTRACT
Background: Child malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention.
Objective: This study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011.
Design: Data were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities.
Results: Inequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting.
Conclusions: Although the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition.
Keywords: trend; malnutrition; inequality; decomposition; Vietnam
Full-text link: http://www.globalhealthaction.net/index.php/gha/article/view/29263
Source: Center for Population Health Sciences (CPHS) - Hanoi School of Public Health