Socioeconomic inequalities and its spatial pattern in sanitary napkin use in Bangladesh: evidence from the 2019 multiple indicator cluster survey.

IF 2.5 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Population Health Metrics Pub Date : 2025-07-09 DOI:10.1186/s12963-025-00401-0

Emran Hasan, Salit Chakma, Moriam Khanam, Mohammad Hajizadeh

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引用次数: 0

Abstract

Background: Utilization of unhygienic menstrual products has been associated with various adverse health consequences, particularly in many low- and middle-income countries (LMICs), including Bangladesh. In this context, this study attempted to measure socioeconomic inequalities in sanitary napkin use among women aged 15-49 and assess its spatial pattern at the disaggregated level (district).

Methods: We used the latest available nationally representative cross-sectional Bangladesh Multiple Indicator Cluster Survey (MICS) 2019 data. The analytical sample size was 54,702 reproductive-aged (15-49 years) women. The Erreygers Index (EI) and the Wagstaff Index (WI) were employed to measure and decompose the socioeconomic inequalities in sanitary napkin use. Natural Break (Jenks) classification method, Global Moran's I and the Cluster and Outlier Analysis were used to analyze the spatial pattern of socioeconomic inequalities at the district level.

Results: The findings reveal that approximately 26.22% of women used sanitary napkins at the national level. Both the EI (0.41208; p-value < 0.001) and the WI (0.53251; p-value < 0.001) indicate a pro-rich inequality in sanitary napkin use. Decomposition results indicated that wealth status, educational attainment, household characteristics (particularly educational attainment of household head) and exposure to media were the most important factors accounting for socioeconomic inequalities. From the spatial analyses, we found significant district-level variations in both sanitary napkin use and its socioeconomic inequalities. Global Moran's I value indicated positive spatial autocorrelation, meaning that similar values tend to cluster together. Notably, a northwestern and southeastern divide was found between High-High and Low-Low clusters of socioeconomic inequalities.

Conclusions: Our study provides evidence for informed policymaking targeting women from the lower socioeconomic stratum, especially those living in the northwestern and southeastern regions to increase sanitary napkin use.

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孟加拉国卫生巾使用中的社会经济不平等及其空间格局：来自2019年多指标类集调查的证据

背景：使用不卫生的经期产品与各种不良健康后果有关，特别是在包括孟加拉国在内的许多低收入和中等收入国家。在此背景下，本研究试图衡量15-49岁女性卫生巾使用的社会经济不平等，并评估其在分类水平（地区）的空间格局。方法：我们使用了2019年孟加拉国多指标类集调查（MICS）最新的全国代表性横断面数据。分析样本量为54,702名育龄（15-49岁）妇女。采用埃雷格斯指数（EI）和瓦格斯塔夫指数（WI）来衡量和分解卫生巾使用中的社会经济不平等。采用自然断裂（Jenks）分类法、Global Moran’s I分类法和聚类与离群值分析法分析了区域经济社会不平等的空间格局。结果：调查结果显示，在全国范围内，约有26.22%的妇女使用卫生巾。EI (0.41208；p值结论：本研究为社会经济较低阶层妇女，特别是西北和东南地区妇女增加卫生巾使用的知情政策制定提供了证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.