Peer-reviewed article
Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa
Kaleab Baye, Arnaud Laillou, Stanley Chitweke ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study looks at child stunting (poor growth due to malnutrition) across Sub-Saharan Africa over the past decade. Researchers used national survey data to compare stunting rates by household wealth and by rural versus urban location. They found that stunting has decreased overall, and dropped faster among the poorest and rural children in half of the countries studied. However, gaps in children's diet quality and access to health care between rich and poor, and between rural and urban areas, have not improved. The authors call for better coordination between food and health systems to reduce stunting more fairly.
Key points
- Stunting significantly decreased over the past decade across Sub-Saharan Africa
- Reductions were faster for the poorest and rural groups, but only in 50% of countries studied
- Inequalities in Minimum Dietary Diversity Score persisted by wealth quintile (p<0.01)
- Inequalities in the Composite Coverage Index (health care access) persisted by wealth quintile and rural/urban residence (p<0.001)
- Progress in reducing stunting has not been accompanied by improved equity
Limitations
The study relies on survey data (DHS/MICS) and proxy indicators for diet and health care access rather than direct measurement, and does not evaluate a specific intervention.
Abstract
Stunting in children less than five years of age is widespread in Sub-Saharan Africa. We aimed to: (i) evaluate how the prevalence of stunting has changed by socio-economic status and rural/urban residence, and (ii) assess inequalities in children’s diet quality and access to maternal and child health care. We used data from nationally representative demographic and health- and multiple indicator cluster-surveys (DHS and MICS) to disaggregate the stunting prevalence by wealth quintile and rural/urban residence. The composite coverage index (CCI) reflecting weighed coverage of eight preventive and curative Reproductive, Maternal, Neonatal, and Child Health (RMNCH) interventions was used as a proxy for access to health care, and Minimum Dietary Diversity Score (MDDS) was used as a proxy for child diet quality. Stunting significantly decreased over the past decade, and reductions were faster for the most disadvantaged groups (rural and poorest wealth quintile), but in only 50% of the countries studied. Progress in reducing stunting has not been accompanied by improved equity as inequalities in MDDS (p < 0.01) and CCI (p < 0.001) persist by wealth quintile and rural-urban residence. Aligning food- and health-systems’ interventions is needed to accelerate stunting reduction more equitably.