Deconstructing the sex gap in child undernutrition in India: Are Indian boys at elevated risk of anthropometric failure than the girls?

IF 1.6 4区医学 Q1 ANTHROPOLOGY American Journal of Human Biology Pub Date : 2024-05-22 DOI:10.1002/ajhb.24092

Pritam Ghosh

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Abstract

Backgrounds & Objectives

The privileging of boys in immunization coverage, breastfeeding, and other child care practices in Indian patriarchal society raises questions about whether there are sex differences in the prevalence of undernutrition among children. This study evaluates the sex gap in the prevalence of Composite Index of Anthropometric Failure (CIAF) among Indian children from 2015–16 to 2019–21. Additionally, it seeks to identify the sex-specific determinants and persistent sex gap at national and subnational levels (social, economic, religious, and geopolitical regions) in anthropometric failure among the children from 2015–16 to 2019–21.

Materials and Methods

The study utilizes the 4th (2015–16) and 5th (2019–21) rounds of the National Family Health Survey data. Logistic regression models and the Fairlie decomposition technique were employed to explore the persistent and significant sex gap in the prevalence of CIAF, as well as the sex-specific determinants of CIAF among children in 2015–16 and 2019–21.

Results

The study reveals a significant sex gap (approximately 4%-points), with boy's disadvantage in the prevalence of CIAF from 2015–16 to 2019–21 at both the national and subnational levels (social, religious, socioeconomic groups, and geopolitical regions). The gap is more pronounced in the first year of life and decreases in later stages. A comparatively faster CIAF decline among girls from 2016 to 2021 has widened the sex gap in final year than the previous. Child, mother, household, community, and geographic backgrounds explains about 5%–6% of the sex gap in the prevalence of CIAF from 2015–16 to 2019–21. The remaining 94%–95% of the unexplained sex gap may be attributed to biological factors or other factors. Currently, a heightened boy's disadvantage in CIAF risk is observed in ST community, wealthiest families, and the northern India.

Conclusion

The findings suggest a special attention for boys under 3 years to offset biological disadvantages like greater disease sensitivity and fragility compared to girls early on.

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解构印度儿童营养不良的性别差距：印度男孩人体测量不合格的风险比女孩高吗？

背景与目标：在印度的父权制社会中，男孩在免疫接种覆盖率、母乳喂养和其他儿童护理实践中享有特权，这引发了儿童营养不良患病率是否存在性别差异的问题。本研究评估了 2015-16 年至 2019-21 年印度儿童人体测量不合格综合指数（CIAF）患病率的性别差异。此外，该研究还试图确定 2015-16 年至 2019-21 年期间国家和次国家层面（社会、经济、宗教和地缘政治地区）儿童人体测量不合格的性别特定决定因素和持续存在的性别差距：研究利用了第四轮（2015-16 年）和第五轮（2019-21 年）全国家庭健康调查数据。采用逻辑回归模型和费尔利分解技术，探讨了2015-16年和2019-21年儿童CIAF患病率持续存在的显著性别差距，以及CIAF的性别特异性决定因素：研究显示，从 2015-16 年到 2019-21 年，在国家和次国家层面（社会、宗教、社会经济群体和地缘政治地区），CIAF 的流行率存在明显的性别差距（约 4%-点），男孩处于劣势。这种差距在孩子出生后的第一年更为明显，并在以后阶段逐渐缩小。从 2016 年到 2021 年，女童的 CIAF 下降速度相对较快，这使得最后一年的性别差距比前一年有所扩大。儿童、母亲、家庭、社区和地理背景解释了 2015-16 年至 2019-21 年 CIAF 患病率性别差异中约 5%-6%的原因。其余94%-95%无法解释的性别差距可能归因于生物因素或其他因素。目前，在ST社区、最富裕家庭和印度北部地区观察到，男孩在CIAF风险中处于更加不利的地位：结论：研究结果表明，应特别关注 3 岁以下的男孩，以尽早消除他们的生理劣势，如与女孩相比，男孩对疾病更敏感、更脆弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Human Biology 生物-生物学

CiteScore

4.80

自引率

13.80%

发文量

124

审稿时长

4-8 weeks

期刊介绍： The American Journal of Human Biology is the Official Journal of the Human Biology Association. The American Journal of Human Biology is a bimonthly, peer-reviewed, internationally circulated journal that publishes reports of original research, theoretical articles and timely reviews, and brief communications in the interdisciplinary field of human biology. As the official journal of the Human Biology Association, the Journal also publishes abstracts of research presented at its annual scientific meeting and book reviews relevant to the field. The Journal seeks scholarly manuscripts that address all aspects of human biology, health, and disease, particularly those that stress comparative, developmental, ecological, or evolutionary perspectives. The transdisciplinary areas covered in the Journal include, but are not limited to, epidemiology, genetic variation, population biology and demography, physiology, anatomy, nutrition, growth and aging, physical performance, physical activity and fitness, ecology, and evolution, along with their interactions. The Journal publishes basic, applied, and methodologically oriented research from all areas, including measurement, analytical techniques and strategies, and computer applications in human biology. Like many other biologically oriented disciplines, the field of human biology has undergone considerable growth and diversification in recent years, and the expansion of the aims and scope of the Journal is a reflection of this growth and membership diversification. The Journal is committed to prompt review, and priority publication is given to manuscripts with novel or timely findings, and to manuscripts of unusual interest.