Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa
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ORIGINAL ARTICLE
Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa Derek Asuman 1
&
Charles Godfred Ackah 1,2 & Ama P. Fenny 1 & Frank Agyire-Tettey 3
Received: 10 January 2019 / Accepted: 25 March 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Aim Health and nutrition in early childhood are essential for survival, growth and adult life outcomes. As such, a number of global and national interventions have been pursued to improve early childhood health and nutrition. However, child malnutrition is pervasive and endemic across the sub Saharan Africa. This paper therefore assesses the nature and trends of socioeconomic inequalities in child stunting. The paper proceeds to decompose the causes of such socioeconomic-related inequalities over the period covered. Subjects and methods We used data from Demographic and Health Surveys (DHSs) for ten sub-Saharan African countries conducted between 2000 and 2016. The study employs an extension to the concentration index for binary health outcomes to measure socioeconomic inequalities in stunting and decompose the causes of inequalities in stunting using a generalized decomposition technique based on recentered influence function regressions. Results The results show substantial pro-rich inequalities in child stunting across sub-Saharan Africa. The incidence of stunting are concentrated among children living in households with low socioeconomic status. In spite of persistent declines in the prevalence of stunting among children under 5 years across the study countries since 2000, trends in socioeconomic inequalities in stunting are mixed. We find significant contributions of child, maternal, and household characteristics to inequalities in child stunting. Conclusion The results suggest that there is the need to design and target nutrition-based interventions at children in low socioeconomic households. In addition, promoting female education and improving access to health and nutrition information will be key to improving child nutrition across the region. Keywords Malnutrition . Stunting . Inequalities . Decomposition . Africa
Introduction Investments in health and nutrition during early childhood have been found to be crucial to later life outcomes in cognitive ability, school attainment, productivity, and earnings Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10389-019-01068-2) contains supplementary material, which is available to authorized users. * Derek Asuman [email protected] 1
Institute of Statistical, Social and Economic Research, University of Ghana, P. O. Box LG 74, Legon, Accra, Ghana
2
Centre for Social Policy Studies, University of Ghana, Legon, Ghana
3
Department of Economics, University of Ghana, Legon, Ghana
(Alderman et al. 2006; Currie and Almond 2011). Socioeconomic inequalities in health and nutrition at the critical stages of child development may have dire consequences, perpetuating intergenerational inequalities through th
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