Socioeconomic inequalities in low birth weight in South Asia: A comparative analysis using Demographic and Health Surveys

Sathi, Nusrat Jahan; Ahammed, Benojir; Alam, Khorshed; Hashmi, Rubayyat; Lee, Ka Yiu; Keramat, Syed Afroz

doi:10.1016/j.ssmph.2022.101248

Cited by 7 publications

(11 citation statements)

References 36 publications

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“…Although the results obtained from unadjusted bivariate analysis showed a higher proportion of LBW children in rural compared urban areas, especially in Pakistan, the survey weight adjusted model revealed that mothers from urban areas have higher odds of having LBW children compared to their rural counterparts, which is consistent with findings from previous studies in this region [ 6 , 7 , 12 ]. However, this finding contradicts with some studies where opposite results were reported [ 30 ] or no significant difference was found between rural and urban [ 23 , 31 ].…”

Section: Discussionsupporting

confidence: 89%

“…Recent studies into infant mortality estimated that 60–68% children with LBW worldwide died within 28 days of [ 10 ], and a trend analysis between 2013–2018 found that on average birthweight decreased significantly in Africa (mean change = 36.51 g) and Central America (mean change = 53.07 g) but not Asia (mean change = 3.86) [ 11 ], hence LBW is trending up in both Africa and Central America but remains constant for Asia which is consistently high. In a recent study, Sathi et al [ 12 ] demonstrated that the prevalence of LBW reported in Afghanistan, Bangladesh, Nepal and Pakistan were 15.13%, 14.93%, 11.73% and 19.18%, respectively, and these were relatively high as compared to other LMICs in the region. The study also found higher level of inequalities among the families regarding their socio-economic status (SES) and wealth index in these countries.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia

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Bhowmik

Biswas

2022

IJERPH

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Child with Low Birth Weight (LBW) has a higher risk of infant mortality, learning difficulties in childhood due to stunted growth and impaired neurodevelopment, is more likely to develop heart diseases and diabetes in adulthood. This study aimed to evaluate the latest demographic and health surveys (DHSs) across multiple countries in South Asia to determine the factors associated with LBW among these countries. Latest available DHS data across Afghanistan (2015, n = 29,461), Bangladesh (2018, n = 20,127), Nepal (2016, n = 12,862), and Pakistan (2018, n = 15,068) were analysed. Complex survey adjusted generalized linear models were fitted to investigate the association of birth weight with sociodemographic and decision-making factors. Pakistan had the highest proportion of LBW at 18% followed by Afghanistan and Bangladesh at around 14% and Nepal had the lowest (13%). Children born in Pakistan were more likely to have LBW children than Afghanistan (AOR = 2.17, 95% CI = 1.49–3.14). Mothers living in rural areas (AOR = 0.77, 95% CI = 0.61–0.97), with highly educated partners and belonging to richer families were less susceptible to having child with LBW. To reduce 30% LBW in-line with the World Health Organisation’s 2025 goal, policymakers in SA should focus on women in urban areas with low-educated partners belonging to poor households to ease LBW burden.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia

Ngo

Bhowmik

Biswas

2022

IJERPH

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“…Utilization of ANC and delivery at home were found to be associated with higher birth weights, which is in line with findings from existing literature [25] , [45] , [46] . A few models suggest that in MICS 2012-2013 birth weight is observed to be significantly higher among mothers in higher wealth class as observed in other previous research [47] , [21] but in 2019 wealth class is observed to be an insignificant factor. Model comparison metrics show that in 2012-13, there are clear gains in the goodness of fit of sample data and in predictive accuracy when considering random cluster effects but marginal losses from adding further complexity like spatial correlation.…”

Section: Discussionsupporting

confidence: 58%

Unraveling birth weight determinants: Integrating machine learning, spatial analysis, and district-level mapping

Rubaiya,

Mansur,

Alam

et al. 2024

Heliyon

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“…The causes and associated factors were reviewed comprehensively at a global level by Kramer in the 1980s [ 11 ]. Several studies since then have highlighted the role of improved maternal health, nutrition, socioeconomic status, education, smoking, and alcohol consumption on LBW [ 12 , 13 ]. While addressing socioeconomic inequality and promoting the principles of justice within the healthcare system is a long-term solution to combat LBW [ 1 ], it is equally important to implement effective short-and mid-term strategies to bring about immediate improvements through the utilization of existing evidence-based routine services offered through most of the national health systems.…”

Section: Introductionmentioning

confidence: 99%

Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries

Khanal,

Bista,

Mishra

2024

BMC Public Health

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Background The prevalence of low birth weight (LBW) has remained high (24.9%) in the South Asian region with a significant impact on newborn survival. This region bears nearly 40% of global burden of LBW. While antenatal care (ANC) and iron-folic acid supplementation independently have been considered effective for improving maternal and newborn outcomes, the evidence on the combined effect of these two supplements on LBW is lacking. This study aimed to examine the synergistic association of ANC and iron-folic acid supplementation on LBW in the South Asian region using pooled data from six South Asian countries. Methods Nationally representative surveys from Nepal, India, Bangladesh, Pakistan, Maldives, and Afghanistan were included in the study. Birth weight and the prevalence of LBW for singleton last-born children were reported using descriptive statistics. The association between LBW and ANC visits and the interaction between iron-folic acid consumption and ANC were examined using multiple logistic regression. Results The mean birth weight in the region was 2841.8 g with an LBW prevalence of 17.1%. Country-specific prevalence ranged from 11.4% in Nepal to 22.4% in Pakistan. Not attending ANC visits (adjusted odds ratio (AOR): 1.24; 95% confidence interval (CI): 1.16, 1.34) and not consuming iron-folic acid (AOR: 1.14; 95% CI: 1.08, 1.21) were significantly associated with a higher likelihood of LBW. Furthermore, jointly, having < 4 ANC visits and < 180 days of iron-folic acid supplementation was associated with a higher likelihood (AOR: 1.29; 95% CI: 1.22, 1.36) of having LBW compared to those who had ≥ 4 ANC visits and ≥ 180 days of iron-folic acid consumption after controlling for key confounding factors. Conclusions The current study provides important evidence on the synergy between ANC visits and iron-folic acid consumption during pregnancy to capitalize on the existing national maternal health programs in the South Asian region, including low-and middle-income countries for positive foetal outcomes.

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Socioeconomic inequalities in low birth weight in South Asia: A comparative analysis using Demographic and Health Surveys

Cited by 7 publications

References 36 publications

Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia

Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia

Unraveling birth weight determinants: Integrating machine learning, spatial analysis, and district-level mapping

Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries

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