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. 2018 Jul 26:52:73.
doi: 10.11606/S1518-8787.2018052000394.

Socioeconomic context of the community and chronic child malnutrition in Colombia

[Article in English, Spanish]
Ana María Osorio  1 , Gustavo Alfonso Romero  2 , Harold Bonilla  3 , Luis Fernando Aguado  1
Affiliations

Socioeconomic context of the community and chronic child malnutrition in Colombia

[Article in English, Spanish]
Ana María Osorio et al. Rev Saude Publica. .

Abstract
in English, Spanish

Objective: To analyze the influence of the socioeconomic context of the community on chronic child malnutrition in Colombia.

Methods: We estimated multilevel logistic models using data from the National Demographic and Health Survey in Colombia in 2010. The final sample included 11,448 children under the age of five gathered in 3,528 communities. In addition, we used the Principal Component Analysis with polychoric correlations for the construction of composed indicators of wealth, autonomy of the woman, and the use and access to the health system.

Results: The average level of community wealth was significantly and independently associated with chronic malnutrition in early childhood, more than the socioeconomic status of the household itself. At the individual and household level, the probability of chronic malnutrition was higher for children from mothers with low levels of autonomy and use and access to the health system, mothers who had their first child in adolescence, and mothers who live in homes in the lowest wealth quintiles. In contrast, children from mothers with a body mass index > 25 and with at least secondary education (versus no education) were less likely to suffer from chronic malnutrition.

Conclusions: Research, programs, and interventions need to take into account the physical, economic, and social context of communities to contribute with the improvement of the nutritional status of early childhood in Colombia.

OBJETIVO: Analizar la influencia del contexto socioeconómico de la comunidad sobre la desnutrición infantil crónica en Colombia.

MÉTODOS: Utilizando datos de la Encuesta Nacional de Demografía y Salud en Colombia en 2010, se estimaron modelos logísticos multinivel. La muestra final incluyó 11.448 niños menores de cinco años anidados en 3.528 comunidades. Además, se utilizó el Análisis de Componentes Principales usando correlaciones policóricas para la construcción de indicadores compuestos de riqueza, autonomía de la mujer y el uso y acceso al sistema de salud.

RESULTADOS: El nivel de riqueza promedio de la comunidad resultó significativa e independientemente asociado con la desnutrición crónica en la primera infancia, por encima y más allá del propio estatus socioeconómico del hogar. A nivel individual y del hogar, la probabilidad de desnutrición crónica fue mayor para niños de madres con bajos niveles de autonomía y uso y acceso al sistema de salud, que han tenido su primer hijo en la adolescencia y que viven en hogares en los quintiles más bajos de riqueza. En contraste, niños de madres con un índice de masa corporal > 25 y con al menos educación secundaria (versus sin educación) tuvieron menor probabilidad de padecer desnutrición crónica.

CONCLUSIONES: Investigaciones, programas e intervenciones que tengan en cuenta el contexto físico, económico y social de las comunidades son necesarias para contribuir a mejorar el estado nutricional de la primera infancia en Colombia.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Sample selection flow, National Demographic and Health Survey. Colombia, 2010.
Figure 2
Figure 2. Conceptual framework for social determinants of child health.
See this image and copyright information in PMC

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