Abstract
BackgroundMeasuring social inequalities in health is common; however, research examining inequalities in child cognitive function is more limited. We investigated household expenditure-related inequality in children’s cognitive function in Indonesia in 2000 and 2007, the contributors to inequality in both time periods, and changes in the contributors to cognitive function inequalities between the periods.MethodsData from the 2000 and 2007 round of the Indonesian Family Life Survey (IFLS) were used. Study participants were children aged 7–14 years (n = 6179 and n = 6680 in 2000 and 2007, respectively). The relative concentration index (RCI) was used to measure the magnitude of inequality. Contribution of various contributors to inequality was estimated by decomposing the concentration index in 2000 and 2007. Oaxaca-type decomposition was used to estimate changes in contributors to inequality between 2000 and 2007.ResultsExpenditure inequality decreased by 45% from an RCI = 0.29 (95% CI 0.22 to 0.36) in 2000 to 0.16 (95% CI 0.13 to 0.20) in 2007 but the burden of poorer cognitive function was higher among the disadvantaged in both years. The largest contributors to inequality in child cognitive function were inequalities in per capita expenditure, use of improved sanitation and maternal high school attendance. Changes in maternal high school participation (27%), use of improved sanitation (25%) and per capita expenditures (18%) were largely responsible for the decreasing inequality in children’s cognitive function between 2000 and 2007.ConclusionsGovernment policy to increase basic education coverage for women along with economic growth may have influenced gains in children’s cognitive function and reductions in inequalities in Indonesia.
Highlights
In 1970 Indonesia was among the poorest countries in the world with 60% of the population living in absolute poverty [1]
The average log per capita expenditures was 11.93 rupiah (SD 0.70) in 2000 and 12.82 rupiah (SD 0.65) in 2007, which is equivalent to an increase from approximately 16 to 37 USD per month
The relative concentration index (RCI) in 2000 was 0.29 and was 0.16 in 2007, showing the burden of poorer cognitive function was higher among the disadvantaged in both years
Summary
In 1970 Indonesia was among the poorest countries in the world with 60% of the population living in absolute poverty [1]. Measuring inequalities in health related outcomes is relatively common [6,7,8], but research examining inequalities in children’s development is more limited. Children under five living in poorer socioeconomic circumstances in low and middle income countries are often exposed to a multitude of risk factors such as poverty, malnutrition, poor housing conditions and sanitation that influence their opportunities for healthy child development [9,10]. Inequality in early life socioeconomic circumstances contributes to inequality in children’s cognitive outcomes as measured through literacy [25,26] and math scores [26,27]. Measuring social inequalities in health is common; research examining inequalities in child cognitive function is more limited. We investigated household expenditure-related inequality in children’s cognitive function in Indonesia in 2000 and 2007, the contributors to inequality in both time periods, and changes in the contributors to cognitive function inequalities between the periods
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