Health Inequality In Bangladeshi Children Of Age 6–59 Months Using Hemoglobin Data: A Nonparametric Analysis

We estimate anemia prevalence and the Gini coefficient and its sampling variance to assess the health inequality among Bangladeshi children of age 6–59 months using hemoglobin (Hb) data. Anemia, primarily determined by the level of Hb in the blood of an individual, is a global health problem affecting about two billion people, with the highest prevalence among preschool-age children. The data was obtained from the Bangladesh Demographic and Health Survey 2011, a nationally representative sample survey that aims to detail statistics useful for assessing changes in development, including child and maternal health, education, and poverty eradication. We calcualte anemia prevalence and perform nonparametric test, ?2 test, to assess the children’s health condition. To evaluate children’s health inequality using Hb data, we estimate the Gini coefficient and its sampling variance using an analytical variance formula and the standard bootstrap method. In both cases, the sample is classified by children’s gender, age group, place of residence and household wealth status, to ascertain causes of anemia and inequality in Hb. Our results suggest that more than half of the children aged 6–59 months in Bangladesh suffer from anemia, and age of a child, place of residence and household wealth status are significant contributors to this health problem. On the other hand, health inequality in children, when measured by the Gini coefficient using hemoglobin levels, is almost double the level that might be expected for a corresponding healthy population. Although it is predominantly a national concern, we find no other factors than the age of a child plays an important role in inequality. With a significantly larger Gini coefficient, the Hb inequality among children under two years of age group is worse than children in the older age group (24–59 months). There are at least two policy implications of our findings. First, Bangladesh being a resource scare country, it’s policies should be directed focusing more on children under two living in rural areas and poor households to eradicate anemia crisis. Second, to reduce children’s health equality, when measured using the Hb level, those under two should primarily be targeted with immediate actions. Such actions can include educating parents on feeding young children following recommended guidelines and supporting households to increase nutritious food supply.