Advanced Search
MyIDEAS: Login

La dynamique de l'inégalité de la malnutrition des enfants en Afrique. Une analyse comparative fondée sur une décomposition de régression

Contents:

Author Info

Abstract

Une analyse comparative pour trois pays d'Afrique – Burkina Faso, Cameroun et Togo –des facteurs de l'inégalité socio-économique relative du retard de croissance des enfants, ainsi que des variations de ces disparités dans le temps, est proposée. Cette investigation, mobilisant pour chaque pays deux enquêtes démographiques et de santé relatives aux années 1990, suggère plusieurs conclusions. Premièrement, on observe une persistance, voire une aggravation, de l'incidence et/ou de l'inégalité socio-économique relative du retard de croissance des enfants de moins de 60 ou 36 mois. Par ailleurs, bien que la prévalence de la malnutrition des enfants soit plus forte dans les campagnes et parmi les ménages pauvres, l'inégalité du retard de croissance est plus élevée dans les villes, où elle s'est parfois accrue. Néanmoins, des disparités de situation prévalent selon les pays. Dans ce contexte, le statut nutritionnel des enfants est positivement corrélé au niveau de vie des familles – appréhendé à l'aide d'un indice d'actifs des ménages –, au niveau d'instruction des mères, et à la localisation urbaine, et inversement lié à l'âge des enfants. Par contre, le sexe des enfants, l'âge des mères, la taille du ménage et l'appartenance ethnique ont des effets contrastés selon les pays et la période considérés. Deuxièmement, la décomposition de l'indice de concentration de la taille des enfants en pourcentage de la médiane de référence, montre que les disparités de niveau de vie des ménages et, dans une moindre mesure, de leur localisation spatiale, sont les facteurs les plus importants qui contribuent à rehausser le niveau de l'inégalité de la malnutrition des enfants. Par contre, l'âge des enfants a un effet inverse dans tous les pays et pour les différentes périodes, tandis que d'autres éléments ont un rôle plus secondaire – sauf les disparités d'instruction des mères, ayant un fort impact inégalitaire au Cameroun. Troisièmement, l'examen de la dynamique de l'inégalité du retard de croissance des enfants suggère plusieurs commentaires. Tout d'abord, la décomposition totale indique que la variation du niveau de vie des ménages a joué un rôle de premier plan, en réduisant ou en accentuant les disparités de malnutrition. Ce facteur a été renforcé par la variation de l'effet net de l'âge des enfants, et contrebalancé par l'impact de la localisation spatiale. Ensuite, la décomposition de type Oaxaca montre que dans deux pays sur trois – Burkina Faso et Cameroun –, l'effet des élasticités l'emporte sur celui des inégalités –, bien que des situations contrastées soient observées selon les pays et les facteurs pris en compte. Ce constat général prévaut surtout pour le niveau de vie, la localisation spatiale, l'instruction des mères et la dimension des ménages. Enfin, la décomposition différentielle totale révèle un impact relativement contrasté de la variation des coefficients de régression, des moyennes des déterminants de la malnutrition, et de l'inégalité des déterminants de la malnutrition, sur les changements de l'inégalité du retard de croissance des enfants. Par ailleurs, dans l'ensemble, la décomposition montre que le poids relatif des moyennes des déterminants est plus fort que celui des coefficients des différentes sources d'inégalité. De plus, les résultats de la décomposition mettent en évidence la complexité des effets des déterminants de la malnutrition sur cette dernière, et la possibilité de conflit entre un « effet de croissance » et un « effet de distribution ». A comparative analysis for three countries of Africa – Burkina Faso, Cameroon and Togo– of the factors of the relative socioeconomic inequality in stunting of the children, as wellas variations of these disparities in time, is proposed. This investigation, mobilizing for eachcountry two demographic and health surveys relating to the 90s, suggests several conclusions. Firstly, one observes a persistence, even an aggravation, of the incidence and/or relativesocioeconomic inequality in stunting of the children of less than 60 or 36 months. In addition,although the prevalence of the children's malnutrition is stronger in the campaigns and amongthe poor households, the inequality in stunting is higher in the cities, where it sometimesincreased. Nevertheless, some disparities of situations prevail according to countries. In thiscontext, the nutritional statute of the children is positively correlated on the standard ofliving of the families – apprehended by an index of assets of the households –, on theeducational level of the mothers, and with the urban localization, and conversely dependent tothe age of the children. On the other hand, the sex of the children, the age of the mothers, thesize of the household and the ethnic membership have contrasted effects according to the countries and the period considered. Secondly, the decomposition of the concentration index ofthe height-for-age of the children expressed as a percentage of the median of reference, showsthat the welfare disparities of the households and, to a lesser extent, their spatiallocalization, are the most significant factors which contribute to raise the level of theinequality of the children's malnutrition. On the other hand, the age of the children has anopposite effect in all the countries and for the various periods, while other elements have amore secondary role – except the disparities in instruction of the mothers, having a strong uneven impact in Cameroon. Thirdly, the study of the dynamics of the inequality in stunting ofthe children suggestsseveral comments. First of all, the total decomposition indicates thatthe variation of thestandard of living of the households played a significant role, whilereducing or by accentuating the disparities of malnutrition. This factor was reinforced by thevariation of the net effect of the age of the children, and was counterbalanced by the impact ofthe spatial localization. Then, the Oaxaca-type decomposition shows that in two countries out ofthree – Burkina Faso and Cameroon –, the effect of elasticities exceeds that of the inequalities– although contrasted situations are observed according to the countries and factors taken intoaccount. This general observation prevails especially for the standard of living, the spatiallocalization, the instruction of the mothers and the size of the households. Lastly, totaldifferential decomposition reveals an impact relatively contrasted of the variation of thecoefficients of regression, averages of the determinants of malnutrition, and inequality of thedeterminants of malnutrition, on the changes of the inequality in stunting of the children. Inaddition, as a whole, the decomposition suggests that the relative weight of the averages of thedeterminants is stronger than that of the coefficients of the various sources of inequality.Moreover, the results of the decomposition highlight the complexity of the effects of thedeterminants of malnutrition on the latter, and the possibility of conflict between a « growth effect » and a « distributive effect». (Full text in French)

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
File URL: http://ged.u-bordeaux4.fr/ceddt86.pdf
Download Restriction: no

Bibliographic Info

Paper provided by Groupe d'Economie du Développement de l'Université Montesquieu Bordeaux IV in its series Documents de travail with number 86.

as in new window
Length: 25 pages
Date of creation: Aug 2003
Date of revision:
Handle: RePEc:mon:ceddtr:86

Contact details of provider:

Related research

Keywords:

Find related papers by JEL classification:

References

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
as in new window
  1. Cotton, Jeremiah, 1988. "On the Decomposition of Wage Differentials," The Review of Economics and Statistics, MIT Press, vol. 70(2), pages 236-43, May.
  2. Wagstaff, Adam & Van Doorslaer, Eddy & Watanabe, Naoko, 2001. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Policy Research Working Paper Series 2714, The World Bank.
  3. Lee, Lung-fei & Rosenzweig, Mark R. & Pitt, Mark M., 1997. "The effects of improved nutrition, sanitation, and water quality on child health in high-mortality populations," Journal of Econometrics, Elsevier, vol. 77(1), pages 209-235, March.
  4. Fields, Gary S & Yoo, Gyeongjoon, 2000. "Falling Labor Income Inequality in Korea's Economic Growth: Patterns and Underlying Causes," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 46(2), pages 139-59, June.
  5. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
  6. Shorrocks, A F, 1980. "The Class of Additively Decomposable Inequality Measures," Econometrica, Econometric Society, vol. 48(3), pages 613-25, April.
  7. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
  8. Barrera, Albino, 1990. "The role of maternal schooling and its interaction with public health programs in child health production," Journal of Development Economics, Elsevier, vol. 32(1), pages 69-91, January.
  9. Jean-Pierre Lachaud, 1996. "Pauvreté,vulnérabilité et marché du travail au Burkina Faso," Série de recherche 02, Groupe d'Economie du Développement de l'Université Montesquieu Bordeaux IV.
  10. Lerman, Robert I. & Yitzhaki, Shlomo, 1989. "Improving the accuracy of estimates of Gini coefficients," Journal of Econometrics, Elsevier, vol. 42(1), pages 43-47, September.
  11. Wagstaff, Adam & Nga Nguyet Nguyen, 2002. "Poverty and survival prospects of Vietnamese children under Doi Moi," Policy Research Working Paper Series 2832, The World Bank.
  12. Reimers, Cordelia W, 1983. "Labor Market Discrimination against Hispanic and Black Men," The Review of Economics and Statistics, MIT Press, vol. 65(4), pages 570-79, November.
  13. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
Full references (including those not matched with items on IDEAS)

Citations

Lists

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Statistics

Access and download statistics

Corrections

When requesting a correction, please mention this item's handle: RePEc:mon:ceddtr:86. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ().

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.