| Objective To learn the current neglected situation and impact factors ofchildren aged0-17years old in two provinces in western China; findimpact factors and provide scientific evidences for effective interventions.Methods The participants of this study:(1) The investigation of ruralchildren aged0-6years old was conducted by using multistage stratifiedcluster sampling method. Three cities or districts were randomly chosenfrom Chongqing and Shanxi province, and the countries or towns werechosen by the three levels (set as high, middle and low) of economy andculture. One village was included in the present study from each country ortown respectively, and5boys and5girls of every range, from0to6yearsold,60in total, were randomly chosen from each village.(2) Theinvestigation of urban children aged from6to17years old was conductedby using multistage stratified cluster sampling method. Two cities ordistricts were randomly chosen from Chongqing and Shanxi province bythe level of economy and culture. One primary school and one seniormiddle school (included both senior and junior) were chosen in each city ordistrict. In each school, one class was randomly chose from every grade (primary school: from one to six grade; junior middle school: from one tothree grade; senior high school: from one to three grade), and the allstudents in that class were participated in this study.The method of investigation: the rural participants aged from0-6andthe primary students aged from6to8, the questionnaire was filled by theirguardian; and the participants aged from9-17, the questionnaire wasanswered by themselves. The investigation of rural children in theChongqing and Shanxi province was conducted during Dec2010to Mar2011, and the investigation of primary and high school students was takenduring Nov2008to Dec2008.The standard and the method of evaluation: the scale of questionaireabout neglected children contains the question of the child’s physical,emotional, education, security, medical and social aspects.For each alternative answers, forward questions was set the score of1,2,3and4, respectively. The reverse question before the letter coding andend the letter with "R" was set as the score of4,3,2and1respectively, foreach alternative answers. According to the survey, we calculate the totalscore of neglected and six level of score of neglected. Once survey in anylayer of the surface of the score exceed the level prescribed cutoff point, weshould identify that it is the neglected level; and the survey at any one levelhas been neglected, then that will be eventually identified as being ignored,the total neglect. The neglected situation of children was determined by the neglect rate and degree of neglect; the neglect rate was calculated by thenumber of neglected children and the number of children who recruited; theneglect rate reflected the frequency of children being neglected, the degreeof neglect was calculated by the neglected score of children and the totalscore of neglected; the degree of neglect reflected the degree of childrenneglected.Results:(1) The results of the rural children investigation:①1488subjects, aged from0to6, were recruited in the present study. Resultsshowed that the total prevalence of neglected rural children were31.59%,48.32%respectively. No significant was found on the prevalence ofneglected for boys (32.63%) and girls (30.38%)(χ2=0.86, U=1.51, P>0.05).The total neglected rate of children aged0-2and3-6years old was30.25%and32.75%respectively. The degree of neglected was47.36and49.16,and showed no significant difference as well (U=-5.33, P<0.05). The totalneglected rate and the degree of neglected in Shanxi province were lowerthan that of Chongqing (χ2=9.42, U=8.40, P<0.05). Total neglected rate anddegree of neglected in three generations and the core families were lowerthan that of single and remarried families (χ2=10.03, F=2.83, P<0.05).Further, the total neglected rate and the degree of neglected in left-behindchildren was higher than that of non left-behind children.(2) There was nosignificant difference at the rate of neglected between boys and girls(χ2=2.22, P>0.05). However, the degree of neglected of boys was higher than that of girls in Chongqing (U=2.34, P<0.05). The neglected rate anddegree of0-2and3-6years old children showed no significant difference(χ2=2.10, U=-0.56, P>0.05). There were no significant difference amongdifferent type of families on the rate and degree of neglected (χ2=2.22,F=1.09, P>0.05). The neglected rate and degree of left behind childrenwere higher than that of non-left behind children (χ2=12.34, U=-5.12,P<0.01).(3) There was no significant difference at the rate and degree ofneglected between boys and girls (χ2=0.04, U=0.04, P>0.05). However, therate of neglected of children aged from0-2was higher than that of childrenaged from3-6in Shanxi province (χ2=5.15, P<0.05), and the degree ofneglected of children aged from0-2was lower than that of children agedfrom3-6(U=-4.81, P<0.001). There were significant among different typeof families on the neglected rate and degree (χ2=17.10, F=-3.92, P<0.05),and the neglected rate and degree of left behind children were all higherthan that of non-left behind children (χ2=11.70, F=5.64, P<0.05).Based on multivariate non-conditional logistic regression analysis, thedeterminants of stunting among the strand children were: left-behind(OR=1.54;95%CI,1.20-1.97); the style of family(OR=1.38;95%CI,1.16-1.65); father’s occupation (OR=0.87;95%CI,0.78-0.97); the educationof children’s mother (OR=1.27;95%CI,1.07-1.52); relationship betweenchildren and their fathers (OR=1.43;95%CI,1.07-1.91).(2) The results of the rural children investigation:1604subjects, aged from6to17, were recruited in the present study. Results showed that thetotal prevalence of neglected primary and secondary school students were30.30%, and the total neglected degrees were45.27±8.71; also, theprevalence of neglected of boys and girls were34.88%and25.23%respectively (χ2=17.62, P<0.001), and the neglected rate of boys werehigher than that of girls (χ2=17.62, P<0.001). The neglected degrees were46.50±8.79and43.92±8.42, and the neglected degree of boys were higherthan that of girls (U=5.99, P<0.001). The prevalence of neglected on6-8,9-11and12-17years age groups were30.69%,28.74%,31.71%(χ2=1.41,P>0.05) respectively, and the neglected degrees were43.34±6.86,42.90±8.42,48.49±8.69(F=84.49, P<0.001) respectively. Our datademonstrated the neglected degrees in12-17years age group were highest;further, both the prevalence and degree of neglected in three generationsfamilies were lowest, however, they were highest in single-parent families(χ2=9.44, F=4.53, P<0.05); the one child families were significantly lowerthan non-one child families both in the prevalence and degree of neglected(χ2=11.27, U=-6.38, P<0.05).Based on multivariate non-conditional logistic regression analysis, thedeterminants of stunting among the children were: boys (OR=0.63;95%CI,0.50-0.79); young primary students’ group (OR=0.84;95%CI,0.72-0.98);living in the capital cities or municipalities (OR=0.79;95%CI,0.63-0.98);the low education of children’s father (OR=1.40;95%CI,1.25-1.56); relationship between children and their parents (OR=2.89;95%CI,2.27-3.67).Conclusions:(1) The neglected situation of rural children was seriousin the Shanxi and Chongqing provinces. The frequencies of neglected ofrural children from aged0-6in these places were lower than that of thenation at the same period, however, the degree of neglected was higherthan that of the nation. The main impact factors were the left-behindchildren, single parent or remarried family, the migrant work or homefarming of father, the low level of maternal education and the estrangedfather-child relationships.(2) The neglected situation of urban primary and secondary schoolstudents were serious in the western China. The frequencies and degree ofneglected of children who aged from6-8,9-11and12-17in these placeswas higher than that of the nation at the same period. The main impactfactors were: boys, younger primary students, live in the capital cities ormunicipalities, the low level of paternal education, the bad relationshipamong parents. |
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