We use cookies to ensure that we give you the best experience on our website. By continuing to browse this repository, you give consent for essential cookies to be used. You can read more about our Privacy and Cookie Policy.

Durham e-Theses
You are in:

The relative effects of socioeconomic inequalities and nutritional factors in explaining child linear growth in Bangladesh

CHOUDHURY, NUZHAT (2024) The relative effects of socioeconomic inequalities and nutritional factors in explaining child linear growth in Bangladesh. Doctoral thesis, Durham University.

Full text not available from this repository.
Author-imposed embargo until 27 February 2025.


Background: While nutrition is essential, an individual’s socioeconomic position (SEP) within hierarchical societies can be influential in determining adequate child growth. This study assessed the relative effects of SEP inequalities and nutritional factors (NF) on linear growth, i.e., height-for-age-Z-score (HAZ), using data from Bangladesh.

Methods: Data from mother-child dyads were analysed using: 1) the nationally representative ‘Food Security Nutrition Surveillance Project (FSNSP)’ (2011–2014), n=37,929 (children <5 years); and 2) an evaluation of a multisectoral nutrition programme, Suchana, targeting the most vulnerable households in northeast Bangladesh (2016 and 2019), n=13,062 (children <2 years). Applying polychoric principal component analysis, a composite SEP scale was constructed combining parental education, occupation, land ownership, assets, and other household characteristics. Difference in HAZ between SEP groups [FSNSP: “richest” (5th quintile) vs. “poorest” (1st quintile); Suchana: “poor” (SEP values median and above) vs. “poorest” (below median)] reflected SEP inequalities. The NF included child’s minimum dietary diversity (MDD) and morbidity status. Multiple linear regression model for the HAZ outcome included SEP groups and NF as main variables of interests, adjusted for covariates (child age, sex, birth order, wasting, maternal short stature, BMI, household size). Standardised beta coefficients were utilised to compare relative effects of SEP and NF.

Results: In both contexts, SEP group inequalities was significantly associated with a larger difference in HAZ (FSNSP: 0.22 SD units, 95% CI: 0.19,0.25; Suchana: 0.13 SD units, 95% CI: 0.09,0.17). Achieving MDD was significantly associated with better HAZ (0.06, 95% CI: 0.03,0.09) for FSNSP, but not for Suchana. However, morbidity and HAZ had no significant association in either model.

Conclusions: This research suggest socioeconomic inequalities have stronger effects on HAZ than NF, raising questions about international development priorities. Efforts to achieve optimal linear growth for children would require an integrated approach: prioritising this to address the wider issue of social inequalities rather than just nutrition.

Item Type:Thesis (Doctoral)
Award:Doctor of Philosophy
Keywords:Socioeconomic inequalities, linear growth, Bangladesh
Faculty and Department:Faculty of Social Sciences and Health > Anthropology, Department of
Thesis Date:2024
Copyright:Copyright of this thesis is held by the author
Deposited On:06 Mar 2024 12:19

Social bookmarking: del.icio.usConnoteaBibSonomyCiteULikeFacebookTwitter