Inequalities in Nutrition between Cambodian Women over the Last 15 Years (2000–2014)

Abstract

This study aimed to describe the trends over four nationally representative Demographic Health Surveys (2000, 2005, 2010, and 2014) of the nutritional status of women of reproductive age in Cambodia and to assess the main factors of inequality with regards to nutrition. The prevalence of undernutrition and over-nutrition evolved in opposite trends from 2000 to 2014, with a significant decrease in underweight and a significant increase in overweight women. This results in a shift, with overweight prevalence in women being higher than underweight for the first time in 2014. Anemia was constantly high and still affected 45% of women in 2014. Multivariate analysis showed that age, wealth index, maternal education, number of children, year of survey, and anemia were contributing factors for being underweight. Being overweight was positively related to increase in age, wealth index, number of children, and year of survey; and negatively related to anemia and increase in education level. The risk of anemia was higher in the poorest households and for less-educated women and women living in rural areas. Consequently, policies should target the most vulnerable women, especially the youngest, and support integrated interventions in the health, social, and agriculture sectors to reduce inequalities in nutrition between women.

Anemia among Women of Reproductive Age: An Overview of Global Burden, Trends, Determinants, and Drivers of Progress in Low- and Middle-Income Countries

“…The 21 studies included in this review [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] include data from 38 countries from Asia, Africa and Latin America ( Figure 3 ), and assess trends in anemia among WRA between 1990 and 2017. The characteristics and quality appraisal scores of the included studies, as well as the observed annualized reduction in WRA anemia, are presented in Table S1 .…”

“…The median methodological quality score was 7 (range: 5.5–8), resulting in eight studies classified as low quality, eight studies [ 19 , 24 , 27 , 29 , 30 , 32 , 34 , 36 ] classified as moderate, and five studies [ 20 , 28 , 33 , 38 , 39 ] classified as high quality. Reduction in WRA anemia varied widely across the included studies, with CAGR ranging from −0.4 to −13.0%, with a median of −3.8%.…”

“…Over a ten-year period in India, one additional year of increase in maternal educational attainment was associated with a 1.8% decrease in anemia [ 22 ]. In Cambodia, improvement in maternal education between 2000 and 2014 was also associated with a decrease in the prevalence of anemia (adjusted β −0.08, 95% CI −0.13 to −0.03) [ 27 ]. Similarly in Ethiopia, the odds of anemia among lactating women who were employed outside the home decreased significantly between 2005 and 2011, compared to women who were not employed (aOR 0.71; 95% CI 0.63 to 0.80) [ 31 ].…”

Data needed to respond appropriately to anemia when it is a public health problem

“…In this type of context, anemia reduction programs may also need to prioritize strategies that reduce nonnutritional causes of anemia. We use published information on Bangladesh and Cambodia, two countries that have recent relevant data on anemia etiology and program effectiveness to reduce anemia, as examples of how different data may help inform and understand the anemia public health response and effectiveness.…”

“…Karakochuk et al . reported IDA prevalence 10 times higher among women with Hb disorders, compared with those without Hb disorders in a rural province of Cambodia, but nationally representative analyses suggest that anemia could not be explained by nutritional deficiencies or Hb disorders . Based on the national ID prevalence (<7% regardless of inflammation‐adjustment), national iron delivery interventions are likely not needed .…”