Abstract
BackgroundMalnutrition is a major cause of child death, and many children suffer from acute and chronic malnutrition. Nigeria has the second-highest burden of stunting globally and a higher-than-average child wasting prevalence. Moreover, there is substantial spatial variation in the prevalence of stunting and wasting in Nigeria. This paper assessed the socioeconomic inequalities and determinants of the change in socioeconomic inequalities in child stunting and wasting in Nigeria between 2013 and 2018.MethodsData came from the 2013 and 2018 Nigeria Demographic and Health Survey. Socioeconomic inequalities in stunting and wasting were measured using the concentration curve and Erreygers’ corrected concentration index. A pro-poor concentration index is negative, meaning that the poor bear a disproportionately higher burden of stunting or wasting than the wealthy. A positive or pro-rich index is the opposite. Standard methodologies were applied to decompose the concentration index (C) while the Oaxaca-Blinder approach was used to decompose changes in the concentration indices (ΔC).FindingsThe socioeconomic inequalities in child stunting and wasting were pro-poor in 2013 and 2018. The concentration indices for stunting reduced from -0.298 (2013) to -0.330 (2018) (ΔC = -0.032). However, the concentration indices for wasting increased from -0.066 to -0.048 (ΔC = 0.018). The changes in the socioeconomic inequalities in stunting and wasting varied by geopolitical zones. Significant determinants of these changes for both stunting and wasting were changes in inequalities in wealth, maternal education and religion. Under-five dependency, access to improved toilet facilities and geopolitical zone significantly explained changes in only stunting inequality, while access to improved water facilities only significantly determined the change in inequality in wasting.ConclusionAddressing the socio-economic, spatial and demographic determinants of the changes in the socioeconomic inequalities in child stunting and wasting, especially wealth, maternal education and access to sanitation is critical for improving child stunting and wasting in Nigeria.
Highlights
Child malnutrition is a major cause of morbidity and mortality, with nutrition-related factors responsible for about 45% of all under-five deaths globally [1]
Addressing the socio-economic, spatial and demographic determinants of the changes in the socioeconomic inequalities in child stunting and wasting, especially wealth, maternal education and access to sanitation is critical for improving child stunting and wasting in Nigeria
A stratified three-stage cluster design was used for the 2013 Nigeria Demographic and Health Survey (NDHS), comprising 904 primary sampling units (PSUs) which served as the clusters: 372 urban and 532 rural
Summary
Child malnutrition is a major cause of morbidity and mortality, with nutrition-related factors responsible for about 45% of all under-five deaths globally [1]. Wasting, resulting from a rapid weight loss or failure to gain weight, confers a weakened immune system and susceptibility to long-term developmental delays as well as an increased risk of mortality on children. The probability of nutritional deficiency is higher among children from poor homes, which may lead to a serious risk of an intergenerational perpetuation of the vicious cycle of poverty and undernutrition [4]. Tackling nutritional deficiencies has obvious economic returns. Malnutrition is a major cause of child death, and many children suffer from acute and chronic malnutrition. Nigeria has the second-highest burden of stunting globally and a higher-thanaverage child wasting prevalence. This paper assessed the socioeconomic inequalities and determinants of the change in socioeconomic inequalities in child stunting and wasting in Nigeria between 2013 and 2018
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