이중차이분석을 활용한 콩고민주공화국 5세 미만 아동 영양개선 프로그램의 가구 소득수준별 효과 평가 = The Effect of Nutrition Program for Under-5 Children by Household's Poverty Status in the DR Congo: A Difference-in-Difference Analysis

국문 초록 (Abstract)

본 연구의 목적은 콩고민주공화국에서 5세 미만 아동을 대상으로 실시한 영양개선 프로그램의 가구 소득수준에 따른 효과를 파악함에 있으며, 향 후 영양 중재프로그램 관리를 위한 근거를 제시하기 위함이다. 본 연구는 지역사회기반에서 빈곤층과 비-빈곤층으로 실시한 비동등성 대조군 사전 및 사후연구로 설계되었으며, 콩고민주공화국 5세 미만 영양실조 아동들을 대상으로 RUTF(Ready-to-Use Therapeutic Foods)를 제공한 영양개선 프로그램이 중재이다. 본 연구의 측정도구는 UNICEF의 Multiple Indicator Cluster Survey(MICS) 2011 설문지를 사업지역 환경에 맞게 재구성하였으며, WHO의 Weight-for-length/height Z-Score(WHZ)와 UNICEF의 Mid-Upper Arm Circumference(MUAC)를 사용하여 영양상태를 측정하였다. 설문조사는 2014년에 기초선조사, 2017년에 종료선조사를 실시하였다. 수집된 자료를 이용하여, 영양개선 프로그램의 성과를 분석하기 위해 이중차이 로지스틱 회귀분석을 실시하였으며, 종속변수는 5세 미만 아동의 영양실조여부이다. 연구 결과, 영양개선 프로그램으로 빈곤층 가정의 5세 미만 아동은 중재 프로그램 전 대비 영양상태가 2.538배 개선되 것으로 확인되었으나, 비-빈곤층 가정의 5세 미만 아동은 영양상태 개선효과가 없는 것으로 나타났다. 아프리카 개발도상국의 소득상위계층의 영양실조는 감소되었지만 소득하위계층은 2배 이상 증가되었다. 하지만 현재 아프리카 개발도상국에서 실시하고 있는 영양개선 프로그램은 가구의 소득을 구분하여 시행하고 있지는 않다. 이에, 향후 콩고민주공화국을 포함한 개발도상국에서 5세 미만 아동을 대상으로 영양개선 프로그램을 시행할 때 소득수준도 고려하여 계획할 필요가 있다.

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