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Socioeconomic inequalities in child malnutrition in the developing world

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  • Wagstaff, Adam
  • Watanabe, Naoko

Abstract

Among the conclusions the authors reach about malnutrition rates, among different economic groups: 1) inequalities in malnutrition almost disfavor the poor; 2) it's not just that the poor have higher rates of malnutrition. The rate of malnutrition declines continuously with rising living standards; 3) the tendency of poorer children to have higher rates of stunting, and underweight, is not due to chance, or sampling variability. Inequalities in stunting, and underweight, as measured by the concentration index, are statistically significant in almost countries; 4) inequalities in underweight tend to be larger than inequalities in stunting, which tend to be larger than inequalities in wasting; 5) in most cases, whatever the malnutrition indicator, differences in inequality between countries are not statistically significant; 6) even if attention is restricted to the cross-country differences in inequality that are statistically significant, interesting conclusions emerge, Egypt, and Vietnam have the most equal distributions of malnutrition, and Nicaragua, Peru, and, to a lesser extent, Morocco, have highly unequal distributions; 7) some countries (such as Egypt and Romania) do well in terms of both the average (the prevalence of malnutrition) and the distribution (equality). Others do badly on both counts. Peru, for example, has a higher average level of stunting than Egypt, and higher poor-non-poor inequality. But many countries do well on one count, and badly on the other. Brazil, for example, has a far lower (less than 20 percent) stunting rate overall, than Bangladesh (more than 50 percent), but has four times as much inequality (as measured by the concentration index); 8) use of an achievement index that captures both the average level, and the inequality of malnutrition, leads to some interesting rank reversals in the country league table. With stunting, for example, focusing on the achievement index moves Egypt (a low-inequality country) from sixth position to fourth, higher than Brazil and Russia (two countries with high inequality).

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Bibliographic Info

Paper provided by The World Bank in its series Policy Research Working Paper Series with number 2434.

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Date of creation: 30 Sep 2000
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Handle: RePEc:wbk:wbrwps:2434

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Related research

Keywords: Early Childhood Development; Early Child and Children's Health; Public Health Promotion; Health Monitoring&Evaluation; Disease Control&Prevention; Early Child and Children's Health; Health Monitoring&Evaluation; Early Childhood Development; Child Labor; Child Labor Law;

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Citations

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Cited by:
  1. Wagstaff, Adam, 2002. "Inequalities in health in developing countries - swimming against the tide?," Policy Research Working Paper Series 2795, The World Bank.
  2. ERREYGERS, Guido, 2006. "Correcting the Concentration Index," Working Papers 2006027, University of Antwerp, Faculty of Applied Economics.
  3. Niño-Zarazúa, Miguel, 2011. "Mexico’s Progresa-Oportunidades and the emergence of social assistance in Latin America," MPRA Paper 29639, University Library of Munich, Germany.
  4. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890.
  5. Narayan Sastry, 2002. "Trends in Socioeconomic Inequalities in Under-Five Mortality: Evidence from Sao Paulo, Brazil, 1970-1991," Working Papers, RAND Corporation Publications Department 02-15, RAND Corporation Publications Department.
  6. Allendorf, Keera, 2007. "Do Women's Land Rights Promote Empowerment and Child Health in Nepal?," World Development, Elsevier, Elsevier, vol. 35(11), pages 1975-1988, November.
  7. Carlos Larrea & Pedro Montalvo & Ana María Ricaurte, 2005. "Child Malnutrition, Social Development and Health Services in the Andean Region," Research Department Publications, Inter-American Development Bank, Research Department 3189, Inter-American Development Bank, Research Department.
  8. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, Elsevier, vol. 21(4), pages 627-641, July.
  9. Ellen van de Poel & Owen O'Donnell & Eddy van Doorslaer, 2007. "Are Urban Children really healthier?," Tinbergen Institute Discussion Papers 07-035/3, Tinbergen Institute.
  10. 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, Elsevier, vol. 112(1), pages 207-223, January.
  11. Singh, Ashish, 2010. "Inequality of opportunity in Indian children: the case of immunization and nutrition," MPRA Paper 32505, University Library of Munich, Germany.
  12. Barrientos, Armando & Niño-Zarazúa, Miguel, 2011. "Social transfers and chronic poverty: objectives, design, reach and impact," MPRA Paper 30465, University Library of Munich, Germany.
  13. Sanjeev Gupta & Marijn Verhoeven & Erwin R. Tiongson, 2003. "Public spending on health care and the poor," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 685-696.
  14. Omilola, Babatunde, 2010. "Patterns and trends of child and maternal nutrition inequalities in Nigeria," IFPRI discussion papers, International Food Policy Research Institute (IFPRI) 968, International Food Policy Research Institute (IFPRI).

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