(P24-068-24) Patterns of Socioeconomic Inequalities Experienced by Adolescent Girls in Nutrition, Education and Health Care in Bangladesh, Ethiopia, India and Nigeria

Objectives: To document the nature and magnitude of inequalities faced by adolescent girls in low- and middle-income countries in utilization of nutrition, health and education services and related outcomes to inform future programs and policies.

Methods: We analyzed data on 15- to 19-year-old adolescent girls from recent Demographic and Health Surveys in Bangladesh, Ethiopia, India, and Nigeria. Erreygers Index was used to assess the direction and magnitude of inequalities across the wealth and education spectrums in low Body Mass Index (BMI), anemia, primary school completion, and maternal health care use, and access to health facilities. Country and within country disparities were analysed.

Results: Significant inequalities were observed in all countries that favored the well-off and better educated adolescent girls, but patterns varied across countries. Bangladesh and India showed lower levels of inequality that Ethiopia and Nigeria. Nutritional status showed less wealth inequality (highest score -0.154 for low BMI) as compared with schooling (highest score 0.651) while education inequality was high for health care related indicators (highest score 0.456 for 4+ ANC). Distances to health facilities and needing permission to visit facilities were influenced by socioeconomic status in Ethiopia more than in other countries. Urban and rural areas and administrative areas within countries showed variable patterns of inequality.

Conclusions: Targeted health, nutrition, and education services are needed for adolescent girls in specific socioeconomic groups and locations within countries where inequalities are highest. Lessons can be drawn from areas within countries that exhibit relatively better equality.

Funding Sources: Bill & Melinda Gates Foundation through Alive & Thrive, FHI 360