Neonatal & Child Health · 2025–2028

Intergenerational Disadvantage and Pediatric Health Disparities in Acute Respiratory Illness and Diarrhea in the Chitwan Valley Family Study

Overview

This study investigates how intergenerational disadvantage influences the burden of acute respiratory infection (ARI) and diarrheal disease among children under five years of age. The research combines existing data from the Chitwan Valley Family Study (CVFS) with new information collected through symptom diaries and weekly follow-up interviews.

The project examines how persistent disadvantage across generations affects childhood illness, healthcare utilization, and access to health services. It also explores the role of distance to healthcare facilities and neighborhood-level disadvantage in shaping health outcomes.

Objectives

• Estimate associations between intergenerational disadvantage and the frequency and duration of ARI and diarrheal illness among children under five.
• Examine how illness burden and intergenerational disadvantage influence healthcare utilization, barriers to care, and treatment-related expenditures.
• Assess the effects of place, including distance to healthcare services and neighborhood-level disadvantage, on illness burden and healthcare-seeking behavior.

Study Population

The study includes children aged 3–59 months living in western Chitwan whose households are enrolled in the Chitwan Valley Family Study.

Data Collection

Following a baseline interview, caregivers complete a daily symptom diary recording symptoms including diarrhea, fever, cough, runny nose, fast or labored breathing, and vomiting.

Participants receive weekly telephone follow-up interviews for 52 weeks to document illness episodes and healthcare utilization. Completed symptom diaries are collected approximately every four to six weeks. The same procedures will be repeated approximately 24 months after the initial round of data collection for eligible households.

Expected Outcomes

• Evidence on how persistent intergenerational disadvantage influences childhood illness and healthcare utilization.
• Improved understanding of barriers to healthcare access among young children and their families.
• Strengthened research capacity through data collection and analysis activities.
• Dissemination through scientific publications, policy briefs, and conference presentations.
• Open access data archiving through ICPSR to support future research.