Essays on maternal and child health, care and malnutrition in early childhood: Analysis from inequality and armed conflict in Colombia
- Autor: Gustavo A. Romero Olmedo
- Director/es: Jorge E. Martínez Pérez, Ildefonso Méndez Martínez
- Defensa: 14/11/2024 - Universidad de Murcia
- Tribunal: José Mª Abellán Perpiñán, Ismael Sanz Labrador, Gema Zamarro Rodríguez
- Calificación: Sobresaliente cum laude
- Ver publicaciones relacionadas
En el análisis del bienestar socioeconómico, toman relevancia los indicadores de salud, entre ellos la malnutrición infantil. Países con mayores niveles de desnutrición también tienen menores niveles de desarrollo socioeconómico, reflejando la importancia de estos indicadores en la lucha contra la pobreza y la desigualdad. La desigualdad social y la pobreza, que a menudo están relacionadas con el conflicto armado, pueden afectar a la salud materno infantil.
La desigualdad en Colombia se debe a varios factores, como la pobreza, la falta de acceso a la educación y flexibilidad en el mercado laboral formal, la violencia y la inseguridad, y la carencia de políticas sociales y tributarias efectivas. Colombia es el país más desigual de todos los países de la OCDE, con un índice de Gini en el 2023 de 54.6.Esta investigación en el segundo capítulo examina la influencia de la intensidad del conflicto armado en las visitas de atención prenatal en Colombia. Se emplearon modelos de regresión logística multinivel, incorporando datos de la Encuesta de Demografía y Salud de Colombia (ENDS) de 2015 y del Centro Nacional de Memoria Histórica, de 1985 a 2015. Los resultados indican que, en igualdad de condiciones, las mujeres que residen en departamentos (primera subdivisión administrativa de Colombia) con alta intensidad de conflicto tienen menos probabilidades de asistir a cuatro o más visitas prenatales en comparación con las de departamentos con baja intensidad de conflicto (OR = 0.737, p < 0.005).
En el tercer capítulo se identifica la contribución de los factores que explican la brecha en desnutrición crónica y exceso de peso entre niños menores de 5 años pobres y no pobres en zonas urbanas de Colombia. Utilizamos datos de la ENDS de 2015, y dos técnicas de descomposición no lineal basadas en el método de descomposición clásica desarrollado por Blinder-Oaxaca. Con una muestra de 6,877 observaciones, los resultados mostraron que la brecha intraurbana de desnutrición crónica entre niños pobres y no pobres en zonas urbanas fue de 4.8 puntos porcentuales. En el caso del exceso de peso, la brecha fue de -2.1 puntos porcentuales.
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In Colombia, although it can be said that, on average children living in urban areas have better quality of life than their rural peers, it is also true that within cities, there are high levels of socioeconomic inequality. Our objective is to identify the contribution of the factors that explain the gap in stunting and excess weight between poor and non-poor children under 5 years of age in urban areas of Colombia. We use data from the 2015 National Nutritional Status Survey, and two nonlinear decomposition techniques based on the classical decomposition method developed by Blinder-Oaxaca. With a sample of 6877 observations, the results show that the intraurban gap of stunting between poor and non-poor children in urban areas is 4.8 percentage points. Its main determinants are the mother’s educational level (46.5%), afliation to the health system by the mother (19.4%), and assisted delivery in a medical institution (16.6%). For excess weight, the gap is−2.1 percentage points, and its main determinants are the mother’s educational level (39.2%) and birth attended by a physician (21.8%). This study suggests the coexistence of a double burden of malnutrition (DBM) in children under 5 years of age living in urban areas of Colombia. Stunting is associated with low-income levels while excess weight is associated with higher income levels. The identifcation of the main determinants of DBM and its relative importance, constitutes a contribution for public policy makers aimed at reducing socioeconomic gaps.
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Publicaciones relacionadas
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