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Socioeconomic and urban-rural inequalities in the population-level double burden of child malnutrition in the East and Southern African Region

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  • Rishi Caleyachetty
  • Niraj S Kumar
  • Hana Bekele
  • Semira Manaseki-Holland

Abstract

Socioeconomic and urban-rural inequalities in the population-level double burden of child malnutrition threatens global nutrition targets 2025, especially in East and Southern Africa. We aimed to quantify these inequalities from nationally representative household surveys in the East and Southern African region. 13 Demographic and Health Surveys between 2006 and 2018 including 72,231 children under five years old were studied. Prevalence of stunting, wasting and overweight (including obesity) were disaggregated by wealth quintiles, maternal education categories and urban-rural residence for visual inspection of inequalities. The slope index of inequality (SII) and the relative index of inequality (RII) were estimated for each country. Regional estimates of child malnutrition prevalence and socioeconomic and urban-rural inequalities were generated from pooling country-specific estimates using random-effects meta-analyses. Regional stunting and wasting prevalence were higher among children living in the poorest households, with mothers with the lowest educational level and in rural areas. In contrast, regional overweight (including obesity) prevalence was higher among children living in the richest households, with mothers with the highest educational level and urban areas. This study indicates pro-poor inequalities are present in child undernutrition and pro-rich inequalities are present in child overweight including obesity. These findings re-emphasise the need for an integrated approach to tackling the population-level double burden of child malnutrition in the region. Policy makers must target specific populations that are vulnerable to child malnutrition, to avoid further widening of socioeconomic and urban-rural inequalities.

Suggested Citation

  • Rishi Caleyachetty & Niraj S Kumar & Hana Bekele & Semira Manaseki-Holland, 2023. "Socioeconomic and urban-rural inequalities in the population-level double burden of child malnutrition in the East and Southern African Region," PLOS Global Public Health, Public Library of Science, vol. 3(4), pages 1-15, April.
    • Handle: RePEc:plo:pgph00:0000397
    DOI: 10.1371/journal.pgph.0000397
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    2. Aline Coudouel & Kathleen Beegle & Emma Monsalve, 2018. "Realizing the Full Potential of Social Safety Nets in Africa [Les filets sociaux en Afrique comment realiser pleinement leur potential?]," World Bank Publications - Books, The World Bank Group, number 29789, April.
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