Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis
Abstract Background What explains the underlying causes of educational inequalities in diarrhoea among under-five children in low- and middle-income countries (LMIC) is poorly exploited, operationalized, studied and understood. This paper aims to assess the magnitude of educational-related inequalit...
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BMC
2021-06-01
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| Series: | Archives of Public Health |
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| Online Access: | https://doi.org/10.1186/s13690-021-00639-8 |
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| author | Adeniyi Francis Fagbamigbe Olukemi Grace Adebola Natisha Dukhi Omon Stellamaris Fagbamigbe Olalekan A. Uthman |
| author_facet | Adeniyi Francis Fagbamigbe Olukemi Grace Adebola Natisha Dukhi Omon Stellamaris Fagbamigbe Olalekan A. Uthman |
| author_sort | Adeniyi Francis Fagbamigbe |
| collection | DOAJ |
| description | Abstract Background What explains the underlying causes of educational inequalities in diarrhoea among under-five children in low- and middle-income countries (LMIC) is poorly exploited, operationalized, studied and understood. This paper aims to assess the magnitude of educational-related inequalities in the development of diarrhoea and decompose risk factors that contribute to these inequalities among under-five children (U5C) in LMIC. Methods Secondary data of 796,150 U5C from 63,378 neighbourhoods in 57 LMIC was pooled from the Demographic and Health Surveys (DHS) conducted between 2010 and 2019. The main determinate variable in this decomposition study was mothers’ literacy levels. Descriptive and inferential statistics comprising of bivariable analysis and binary logistic multivariable Fairlie decomposition techniques were employed at p = 0.05. Results Of the 57 countries, we found a statistically significant pro-illiterate odds ratio in 6 countries, 14 showed pro-literate inequality while the remaining 37 countries had no statistically significant educational-related inequality. The countries with pro-illiterate inequalities are Burundi (OR = 1.11; 95% CI: 1.01–1.21), Cameroon (OR = 1.84; 95% CI: 1.66–2.05), Egypt (OR = 1.26; 95% CI: 1.12–1.43), Ghana (OR = 1.24; 95% CI: 1.06–1.47), Nigeria (OR = 1.80; 95% CI: 1.68–1.93), and Togo (OR = 1.21; 95% CI: 1.06–1.38). Although there are variations in factors that contribute to pro-illiterate inequality across the 6 countries, the overall largest contributors to the inequality are household wealth status, maternal age, neighbourhood SES, birth order, toilet type, birth interval and place of residence. The widest pro-illiterate risk difference (RD) was in Cameroon (118.44/1000) while the pro-literate risk difference was widest in Albania (− 61.90/1000). Conclusions The study identified educational inequalities in the prevalence of diarrhoea in children with wide variations in magnitude and contributions of the risk factors to pro-illiterate inequalities. This suggests that diarrhoea prevention strategies is a must in the pro-illiterate inequality countries and should be extended to educated mothers as well, especially in the pro-educated countries. There is a need for further studies to examine the contributions of structural and compositional factors associated with pro-educated inequalities in the prevalence of diarrhoea among U5C in LMIC. |
| first_indexed | 2024-12-19T06:18:10Z |
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| id | doaj.art-97fe7aa54aa54e0cb0ed405ea8da17c0 |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-12-19T06:18:10Z |
| publishDate | 2021-06-01 |
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| spelling | doaj.art-97fe7aa54aa54e0cb0ed405ea8da17c02022-12-21T20:32:47ZengBMCArchives of Public Health2049-32582021-06-0179111710.1186/s13690-021-00639-8Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysisAdeniyi Francis Fagbamigbe0Olukemi Grace Adebola1Natisha Dukhi2Omon Stellamaris Fagbamigbe3Olalekan A. Uthman4Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of IbadanGeneral Studies Unit, School of Sciences, Federal University of TechnologyHuman and Social Capabilities Division, Human Sciences Research CouncilTechmodiaWarwick Centre for Global Health, Division of Health Sciences, University of WarwickAbstract Background What explains the underlying causes of educational inequalities in diarrhoea among under-five children in low- and middle-income countries (LMIC) is poorly exploited, operationalized, studied and understood. This paper aims to assess the magnitude of educational-related inequalities in the development of diarrhoea and decompose risk factors that contribute to these inequalities among under-five children (U5C) in LMIC. Methods Secondary data of 796,150 U5C from 63,378 neighbourhoods in 57 LMIC was pooled from the Demographic and Health Surveys (DHS) conducted between 2010 and 2019. The main determinate variable in this decomposition study was mothers’ literacy levels. Descriptive and inferential statistics comprising of bivariable analysis and binary logistic multivariable Fairlie decomposition techniques were employed at p = 0.05. Results Of the 57 countries, we found a statistically significant pro-illiterate odds ratio in 6 countries, 14 showed pro-literate inequality while the remaining 37 countries had no statistically significant educational-related inequality. The countries with pro-illiterate inequalities are Burundi (OR = 1.11; 95% CI: 1.01–1.21), Cameroon (OR = 1.84; 95% CI: 1.66–2.05), Egypt (OR = 1.26; 95% CI: 1.12–1.43), Ghana (OR = 1.24; 95% CI: 1.06–1.47), Nigeria (OR = 1.80; 95% CI: 1.68–1.93), and Togo (OR = 1.21; 95% CI: 1.06–1.38). Although there are variations in factors that contribute to pro-illiterate inequality across the 6 countries, the overall largest contributors to the inequality are household wealth status, maternal age, neighbourhood SES, birth order, toilet type, birth interval and place of residence. The widest pro-illiterate risk difference (RD) was in Cameroon (118.44/1000) while the pro-literate risk difference was widest in Albania (− 61.90/1000). Conclusions The study identified educational inequalities in the prevalence of diarrhoea in children with wide variations in magnitude and contributions of the risk factors to pro-illiterate inequalities. This suggests that diarrhoea prevention strategies is a must in the pro-illiterate inequality countries and should be extended to educated mothers as well, especially in the pro-educated countries. There is a need for further studies to examine the contributions of structural and compositional factors associated with pro-educated inequalities in the prevalence of diarrhoea among U5C in LMIC.https://doi.org/10.1186/s13690-021-00639-8DiarrhoeaEducational inequalitiesFairlie decompositionLow and middle-income countriesRisk difference |
| spellingShingle | Adeniyi Francis Fagbamigbe Olukemi Grace Adebola Natisha Dukhi Omon Stellamaris Fagbamigbe Olalekan A. Uthman Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis Archives of Public Health Diarrhoea Educational inequalities Fairlie decomposition Low and middle-income countries Risk difference |
| title | Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis |
| title_full | Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis |
| title_fullStr | Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis |
| title_full_unstemmed | Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis |
| title_short | Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis |
| title_sort | exploring the socio economic determinants of educational inequalities in diarrhoea among under five children in low and middle income countries a fairlie decomposition analysis |
| topic | Diarrhoea Educational inequalities Fairlie decomposition Low and middle-income countries Risk difference |
| url | https://doi.org/10.1186/s13690-021-00639-8 |
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