Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa

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.