Academic journal article Journal of Health Population and Nutrition

Gender Inequality and Severe Malnutrition among Children in a Remote Rural Area of Bangladesh

Academic journal article Journal of Health Population and Nutrition

Gender Inequality and Severe Malnutrition among Children in a Remote Rural Area of Bangladesh

Article excerpt


Bangladesh is one of the southeastern countries where female children experience higher mortality, especially after the neonatal period (1,2). Various factors, including discrimination against female children in intra-family food distribution and healthcare, were thought to be a possible mechanism that results in inferior health and less chance of survival for female than male (3-5). Health and development professionals are striving to find ways to deal with the problems of gender inequality in health and survival. While the socioeconomic and health-intervention programmes have shown positive impact on nutritional status and survival, it is largely unknown how effective these factors are in reducing gender inequalities in health. Keeping this in mind, this paper studied the relationship between gender inequality in nutritional status of children aged less than 5 years and various socioeconomic, demographic, and health-programme factors in a remote rural area of Bangladesh.


Study area The study area included 5 unions (lowest administrative unit of the government) in Chakaria thana, under Cox's Bazar district, in the southeast coast of the Bay of Bengal. The survey covered all villages in Baraitali, Kayerbeel, BM Char, Harbang, and Purbo Bheola unions.

During the study year (1994), the 5 unions had a population of about 120,000. The highway from Chittagong to Cox's Bazar passes through Chakaria. The east side of the area is hilly, while the west side is low and flattens toward the Bay of Bengal.

Chakaria is located in the high-risk area with sporadically occurring cyclones and tidal bores in addition to regular monsoon flooding. The last disastrous cyclone accompanied with a tidal bore hit in 1991, which killed a large number of inhabitants and cattle heads, damaged innumerable houses and other properties (6,7).

The area was typically characterized as one of the most conservative in terms of religion and openness to new ideas. Nearly half of the males and two-thirds of the females aged over 6 years had never been to school. It was also recognized as one of the impoverished areas in terms of health, family planning, and NGO activities (8).

Data collection

Data were collected during October-December 1994 as part of the baseline survey of the Chakaria Community Health Project of ICDDR,B. A systematic random sample of 12% households, considered adequate for most indicators included in the baseline survey, was selected. In total, 2,016 children, aged 6-60 months from different households, were included in the survey. Two separate sets of questionnaire were administered. The first was administered to the heads of households or any other senior persons of the household to collect information on household characteristics, and the second was administered to mothers of children aged less than 5 years.

The locally-recruited female interviewers received special training on interviewing and taking measurements of mid-upper arm circumference (MUAC) using a measuring tape developed by Teaching Aids at Low Cost (TALC), London, U.K. Measurements of MUAC by the field workers were standardized with that of the supervisor before starting the fieldwork each day. Details of the methodology used, along with findings from the survey, have been reported elsewhere (8).


MUAC of these children was used as an indicator of nutritional status. For analysis, children were categorized into 2 groups: one as 'severely malnourished' with MUAC less than or equal to 125 mm and the other as 'not severely malnourished' with MUAC greater than 125 mm. Three broad categories of independent variables were included in the study. These were: characteristics of children, mothers, and households. Children's characteristics included sex, age (measured in months on the day of interview), immunization status in terms of obtaining DPT1 and measles vaccine, indicators of healthcare-seeking behaviour, availability of health services, and whether the child had been ill during the 15 days preceding the survey. …

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