A decomposition analysis of inequalities in low birth weight in Sri Lanka: findings from the Demographic and Health Survey - 2016

Birth weight is a crucial indicator of mothers and infants nutritional status. It determines a newborn's likelihood of survival, their growth and their psychological development. This study examines the socio-economic inequalities of low birth weight in Sri Lanka using the first island-wide Demographic and Health Survey (DHS) conducted in 2016. Nearly 17% of babies are reported as low birth weight (LBW) and the prevalence has stagnated for nearly two decades in Sri Lanka. LBW is indicative of inequalities in particular population subgroups. There is a lack of research on LBW inequalities and the contribution of different socio-economic determinants to these inequalities in Sri Lanka. A stepwise multivariate linear regression, health inequality measures and decomposition method are used to examine inequalities in LBW. Maternal body mass index (BMI), height, antenatal visits, birth interval, wealth and ethnicity are significantly associated with mean birth weight. Findings reveal that inequalities exist, where LBW is concentrated among the poorest households. The decomposition results highlight maternal BMI, education and ethnicity as major contributing factors for such inequalities. These findings suggest prioritising the nutritional needs of mothers and relevant interventions to address inequalities in birth weight to reduce the stagnated LBW in Sri Lanka.