SOCIOECONOMIC INFLUENCES ON GENDER INEQUALITIES IN CHILD HEALTH IN RURAL BANGLADESH

Objective: To investigate gender inequalities in child growth and nutr itional status in relation to socio-economic status in Bangladesh. Des ign: A 16-month longitudinal study of child growth measuring anthropom etric and socioeconomic status. Setting: A rural area of Jamalpur dist rict, northern Bangladesh. Subjects: 1366 children from 2 to 6 years o f age, Methods: Child height and weight were measured monthly. Morbidi ty, food intake and health-seeking behaviours were assessed fortnightl y. Multivariable analyses were performed on the growth and nutritional status of male and female children in relation to socio-economic Fact ors including father's occupation: parental education, birth order and family size. Results: There was no evidence of gender bias in farming and trading/employee households but landless female children had sign ificantly poorer height-for-age (P < 0.001) and weight-for-age (P ( 0. 001) than their male counterparts. During a period of natural disaster ; a statistically significant interaction was observed between father' s occupation and sex (P < 0.05) such that the combination of being fem ale and being landless was more detrimental to nutritional status than either variable alone. Over the following 16-months, catch-up-growth was apparent in landless female children who grew significantly more i n height-for-age (P < 0.001) and weight-for-age (P < 0.001) than their male counterparts. Conclusions: Gender inequalities in health in Bang ladesh varied significantly according to occupational status, such tha t the effect of sex was dependent upon occupation. These effects were statistically significant during the period of natural disaster but be came insignificant as local conditions improved. This demonstrates bot h temporal and socio-economic variation in gender inequalities in heal th.