Between 1997 and 2012, Paraguay achieved not only remarkable improvements in child nutrition, but also a surprising elimination of the rural-urban differential in child height-for-age Z score (HAZ) and stunting. Our decomposition analysis, applied to four rounds of Paraguayan National Household Surveys, allows us to directly infer not only the contributions of changes in determinants of child nutritional status to the improvements in child nutritional status in rural and urban areas, but also their contribution to closing the rural-urban gap. We find that while common determinants of child nutritional status such as income, maternal education, sanitation, and access to piped water are strongly associated with improvements in child nutrition, they have contributed little to reducing the rural-urban gap (10%, p < 0.05). Improvements in health care utilization, family planning, and demographics have been the main drivers in closing the rural-urban gap in child nutritional status in Paraguay (32%, p < 0.05). The results highlight the potential need for multipronged nutritional strategies that consider the distinct needs of rural and urban communities.

译文

在1997年至2012年之间,巴拉圭不仅在儿童营养方面取得了显着改善,而且在儿童年龄身高Z评分 (HAZ) 和发育迟缓方面也令人惊讶地消除了城乡差异。我们的分解分析应用于四轮巴拉圭全国家庭调查,不仅使我们能够直接推断出儿童营养状况决定因素的变化对改善农村和城市地区儿童营养状况的贡献,而且还可以推断出它们对缩小城乡差距的贡献。我们发现,虽然儿童营养状况的共同决定因素,如收入、孕产妇教育、卫生和获得自来水与儿童营养的改善密切相关,但它们对缩小城乡差距的贡献不大 (10%,p <  0.05)。保健利用、计划生育和人口结构的改善是缩小巴拉圭儿童营养状况城乡差距的主要驱动力 (32%,p <  0.05)。结果强调了考虑农村和城市社区独特需求的多管齐下营养战略的潜在需求。

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