Declines in Childhood Anemia in Kazakstan: How Fast and for Whom?

Benjamin Moulton, University of Texas at Austin
Amanda Maedgen, University of Texas at Austin

Declines in Childhood Anemia in Kazakstan: How Fast and For Whom? Cynthia Buckley, Population Research Center, The University of Texas, Austin Amanda Maedgen According to Demographic and Health Survey Data, between 1995 and 1999 the percent of children under 5 with moderate or severe anemia in Kazakhstan declined from 38.9% in 1995 to 19.5% in 1999. The largest declines in anemia rates were found in urban areas, where moderate and severe anemia rates fell from 29.2% to 12.4% . Rural anemia rates decline 47.5% during the four year period, but remain nearly twice as high as urban rates (24.4% of rural children were measured as severely or moderately anemic in 1999). What accounts for the dramatic improvements in childhood anemia in Kazakstan? Did changes in health policy, education attempts, or new social programs play a role in the decline? Are health improvements observable across the population, or do they concentrate within specific socio-cultural groups? This poster presents findings from a paper examining the decline in childhood anemia in Kazakstan between 1995 and 1999. Combining analyses of two rounds of DHS data, the 1999 Kazak Census, and focus groups with young mothers conducted with the Institute for Healthy Lifestyles in Almaty (Kazakstan), we find that improvements in maternal education, increased access to both private and public health care, changes in public health policy (particularly aid to young families), and government education campaigns appear to play a significant role in improving child health between 1995 and 1999. Analyses of government policies during the period between 1995 and 1999 do support the interpretation that structural and institutional adjustments assisted in lowering childhood anemia rates. Young mothers in Almaty echo this interpretation, citing improvements in pre and post natal training and the availability of vitamins and nutritional information and guidance. Declines in fertility, especially at high parities for Kazaks, and at younger maternal ages (15 to 24) for Russians and Kazaks are also likely contributors to a smaller, but healthier cohort of children. However, minority population members, especially ethnic Uzbeks and Tadjiks within Kazakstan, continue to experience significantly higher levels of anemia. Observed child health improvements remain concentrated among families with high maternal education, Russian or Kazak ethnicity, high housing resources, and stable incomes. While the improvements in child anemia rates are significant, benefits are concentrated among socio-cultural groups who exhibit low rates of anemia in the initial study (1995). Logistic regression results indicate that the patterns of significant socio-cultural risk factors for severe and moderate childhood anemia remain stable between 1995 and 1999, while the odds associated with risk factors (particularly minority ethnic status) increase, indicating increasing health disparities within the population. The rapid improvement in childhood anemia in the Kazak case highlights the powerful role of health care reform, fertility declines, and education can play in improving child health, even over short time horizons. Yet the persistent importance of familial level characteristics in determining anemia risks indicates that such macro level changes do not completely lessen micro level health disparities within populations, and may exacerbate them. While reductions in severe and moderate childhood anemia in Kazakstan are dramatic, child health disparities within the population remain significant. ***This paper is NOT being submitted to a regualr session in order to provide a promising undergraduate student the opportunity for her first presentation. Poster form is most appropriate for her professionalization, and for the study results****