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Child Malnutrition in Indonesia: Can Education, Sanitation and Healthcare Augment the Role of Income?

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  • Sumarto, Sudarno
  • de Silva, Indunil

Abstract

In spite of sustained economic growth and progress in poverty reduction, the status of child nutrition in Indonesia is abysmal, with chronic malnutrition rates continuing to remain at very high levels. In this backdrop, this study attempts to shed light on the channels through which various socioeconomic risk factors affect children’s nutritional status in Indonesia. We investigated the impact of child, parental, household characteristics, access and utilization of healthcare, and income effects on children’s height-for-age and on the probability of early childhood stunting. Using recent data from IFLS surveys and Indonesia’s National Health Survey, and controlling for an exhaustive set of socioeconomic factors, the study revealed that maternal education, water and sanitation conditions, household poverty and access to healthcare strongly influence chronic malnutrition in Indonesian children. Child stunting rates were surprisingly high even in the wealthiest quintile of households, implying that income growth will not automatically solve the nutritional problem. Our findings bear important policy implications and represent a further step towards an improved understanding of the complex determinants of child malnutrition. As a policy recommendation, we suggest the implementation of direct supply-side policies aimed at child malnutrition. In particular, two kinds of strategies are noteworthy. First to maximize impact, nutrition-specific interventions targeting the poorest and high burden regions in Indonesia may include, for example, breastfeeding promotion, vitamin and mineral supplements, improved sanitation facilities, public healthcare services and insurance coverage. Second, adopting nutrition-sensitive development planning across all sectors in the country will help ensure that development agendas fully utilize their potential to contribute to reductions in child malnutrition in Indonesia .

Suggested Citation

  • Sumarto, Sudarno & de Silva, Indunil, 2015. "Child Malnutrition in Indonesia: Can Education, Sanitation and Healthcare Augment the Role of Income?," MPRA Paper 66631, University Library of Munich, Germany, revised 09 Sep 2015.
  • Handle: RePEc:pra:mprapa:66631
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    1. Subramanian, Shankar & Deaton, Angus, 1996. "The Demand for Food and Calories," Journal of Political Economy, University of Chicago Press, vol. 104(1), pages 133-162, February.
    2. Mark McGillivray & Indranil Dutta & Nora Markova, 2009. "Health inequality and deprivation," Health Economics, John Wiley & Sons, Ltd., vol. 18(S1), pages 1-12, April.
    3. Thomas, Duncan & Lavy, Victor & Strauss, John, 1996. "Public policy and anthropometric outcomes in the Cote d'Ivoire," Journal of Public Economics, Elsevier, vol. 61(2), pages 155-192, August.
    4. Stephan Klasen, 2008. "Poverty, undernutrition, and child mortality: Some inter-regional puzzles and their implicationsfor research and policy," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 6(1), pages 89-115, March.
    5. J. Gibson & S. Rozelle, 2002. "How Elastic is Calorie Demand? Parametric, Nonparametric, and Semiparametric Results for Urban Papua New Guinea," Journal of Development Studies, Taylor & Francis Journals, vol. 38(6), pages 23-46.
    6. Borooah, Vani K., 2005. "The height-for-age of Indian children," Economics & Human Biology, Elsevier, vol. 3(1), pages 45-65, March.
    7. Malavika A Subramanyam & Ichiro Kawachi & Lisa F Berkman & S V Subramanian, 2011. "Is Economic Growth Associated with Reduction in Child Undernutrition in India?," PLOS Medicine, Public Library of Science, vol. 8(3), pages 1-15, March.
    8. Alok Bhargava, 2006. "Malnutrition and the Role of Individual Variation with Evidence from India and the Philippines," World Scientific Book Chapters, in: Econometrics, Statistics And Computational Approaches In Food And Health Sciences, chapter 8, pages 113-123, World Scientific Publishing Co. Pte. Ltd..
    9. Bouis, Howarth E., 1994. "The effect of income on demand for food in poor countries: Are our food consumption databases giving us reliable estimates?," Journal of Development Economics, Elsevier, vol. 44(1), pages 199-226, June.
    10. David E. Sahn & David Stifel, 2003. "Exploring Alternative Measures of Welfare in the Absence of Expenditure Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 49(4), pages 463-489, December.
    11. Masset, Edoardo & White, Howard, 2003. "Infant and Child Mortality in Andhra Pradesh: Analysing changes over time and between states," MPRA Paper 11206, University Library of Munich, Germany.
    12. Michael Kremer & Jessica Leino & Edward Miguel & Alix Peterson Zwane, 2011. "Spring Cleaning: Rural Water Impacts, Valuation, and Property Rights Institutions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(1), pages 145-205.
    13. Guilkey, David K. & Riphahn, Regina T., 1998. "The determinants of child mortality in the Philippines: estimation of a structural model," Journal of Development Economics, Elsevier, vol. 56(2), pages 281-305, August.
    14. David Cutler & Grant Miller, 2005. "The role of public health improvements in health advances: The twentieth-century United States," Demography, Springer;Population Association of America (PAA), vol. 42(1), pages 1-22, February.
    15. Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996. "Quality of health care, survival and health outcomes in Ghana," Journal of Health Economics, Elsevier, vol. 15(3), pages 333-357, June.
    16. Roemling, Cornelia & Qaim, Matin, 2012. "Obesity Trends, Determinants and Policy Implications in Indonesia," 2012 Conference, August 18-24, 2012, Foz do Iguacu, Brazil 126208, International Association of Agricultural Economists.
    17. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    18. Dean Spears, 2012. "How much international variation in child height can sanitation explain?," Working Papers 1436, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    19. Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711, Elsevier.
    20. Cheolsung Park, 2010. "Children¡¯S Health Gradient In Developing Countries: Evidence From Indonesia," Journal of Economic Development, Chung-Ang Unviersity, Department of Economics, vol. 35(4), pages 25-44, December.
    21. Subha Mani, 2014. "Socioeconomic Determinants of Child Health: Empirical Evidence from Indonesia," Asian Economic Journal, East Asian Economic Association, vol. 28(1), pages 81-104, March.
    22. Abdulai, Awudu & Aubert, Dominique, 2004. "Nonparametric and parametric analysis of calorie consumption in Tanzania," Food Policy, Elsevier, vol. 29(2), pages 113-129, April.
    23. Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, March.
    24. Christiaensen, Luc & Alderman, Harold, 2004. "Child Malnutrition in Ethiopia: Can Maternal Knowledge Augment the Role of Income?," Economic Development and Cultural Change, University of Chicago Press, vol. 52(2), pages 287-312, January.
    25. Malavika A Subramanyam & Ichiro Kawachi & Lisa F Berkman & S V Subramanian, 2011. "Is Economic Growth Associated with Reduction in Child Undernutrition in India?," Working Papers id:3926, eSocialSciences.
    26. Behrman, Jere R. & Wolfe, Barbara L., 1987. "How does mother's schooling affect family health, nutrition, medical care usage, and household sanitation?," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 185-204.
    27. Ariel Fiszbein & Norbert Schady & Francisco H.G. Ferreira & Margaret Grosh & Niall Keleher & Pedro Olinto & Emmanuel Skoufias, 2009. "Conditional Cash Transfers : Reducing Present and Future Poverty," World Bank Publications - Books, The World Bank Group, number 2597, December.
    28. Boyle, Michael H. & Racine, Yvonne & Georgiades, Katholiki & Snelling, Dana & Hong, Sungjin & Omariba, Walter & Hurley, Patricia & Rao-Melacini, Purnima, 2006. "The influence of economic development level, household wealth and maternal education on child health in the developing world," Social Science & Medicine, Elsevier, vol. 63(8), pages 2242-2254, October.
    29. Behrman, Jere R & Deolalikar, Anil B, 1987. "Will Developing Country Nutrition Improve with Income? A Case Study for Rural South India," Journal of Political Economy, University of Chicago Press, vol. 95(3), pages 492-507, June.
    30. Andrew Hodge & Sonja Firth & Tiara Marthias & Eliana Jimenez-Soto, 2014. "Location Matters: Trends in Inequalities in Child Mortality in Indonesia. Evidence from Repeated Cross-Sectional Surveys," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-10, July.
    31. Peabody, John W. & Gertler, Paul J. & Leibowitz, Arleen, 1998. "The policy implications of better structure and process on birth outcomes in Jamaica," Health Policy, Elsevier, vol. 43(1), pages 1-13, January.
    32. Filmer, Deon*Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
    33. Pitt, Mark M & Rosenzweig, Mark R, 1985. "Health and Nutrient Consumption across and within Farm Households," The Review of Economics and Statistics, MIT Press, vol. 67(2), pages 212-223, May.
    34. Harold Alderman & Jere R. Behrman & Victor Lavy & Rekha Menon, 2001. "Child Health and School Enrollment: A Longitudinal Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 36(1), pages 185-205.
    35. Lawrence Haddad & Harold Alderman & Simon Appleton & Lina Song & Yisehac Yohannes, 2003. "Reducing Child Malnutrition: How Far Does Income Growth Take Us?," The World Bank Economic Review, World Bank, vol. 17(1), pages 107-131, June.
    36. Cebu Study Team, 1992. "A child health production function estimated from longitudinal data," Journal of Development Economics, Elsevier, vol. 38(2), pages 323-351, April.
    37. Paul Glewwe, 1999. "Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 124-159.
    38. Brockerhoff, Martin & Derose, Laurie F., 1996. "Child survival in East Africa: The impact of preventive health care," World Development, Elsevier, vol. 24(12), pages 1841-1857, December.
    39. Sahn, David E., 1990. "The impact of export crop production on nutritional status in Cote d'Ivoire," World Development, Elsevier, vol. 18(12), pages 1635-1653, December.
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    2. Jul Indra & Khoirunurrofik Khoirunurrofik, 2022. "Understanding the role of village fund and administrative capacity in stunting reduction: Empirical evidence from Indonesia," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-12, January.
    3. Tri Mulyaningsih & Itismita Mohanty & Tesfaye Alemayehu Gebremedhin & Riyana Miranti & Vitri Widyaningsih, 2023. "Does access to water, sanitation, and hygiene improve children's health? An empirical analysis in Indonesia," Development Policy Review, Overseas Development Institute, vol. 41(5), September.
    4. Thiede, Brian C. & Gray, Clark, 2020. "Climate exposures and child undernutrition: Evidence from Indonesia," Social Science & Medicine, Elsevier, vol. 265(C).
    5. Kofinti, Raymond Elikplim & Koomson, Isaac & Paintsil, Jones Arkoh & Ameyaw, Edward Kwabena, 2022. "Reducing children's malnutrition by increasing mothers' health insurance coverage: A focus on stunting and underweight across 32 sub-Saharan African countries," Economic Modelling, Elsevier, vol. 117(C).
    6. AMAGHOUSS, Jabrane & IBOURK, Aomar, 2020. "Socio-Economic Determinants Of The Prevalence Of Disability In Morocco: Empirical Evidence From Spatial Data," Regional and Sectoral Economic Studies, Euro-American Association of Economic Development, vol. 20(2), pages 79-96.
    7. Egla Mansi & Eglantina Hysa & Mirela Panait & Marian Catalin Voica, 2020. "Poverty—A Challenge for Economic Development? Evidences from Western Balkan Countries and the European Union," Sustainability, MDPI, vol. 12(18), pages 1-24, September.

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    More about this item

    Keywords

    Child nutrition; Malnutrition; Stunting; Quantile regression; Indonesia.;
    All these keywords.

    JEL classification:

    • D01 - Microeconomics - - General - - - Microeconomic Behavior: Underlying Principles
    • D1 - Microeconomics - - Household Behavior
    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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