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Why is child malnutrition lower in urban than rural areas?

  • Smith, Lisa C.
  • Ruel, Marie T.
  • Ndiaye, Aida

"While ample evidence documents that urban children generally have better nutritional status than their rural counterparts, recent research suggests that urban malnutrition is on the rise. The environment, choices, and opportunities of urbanites differ greatly from those of rural dwellers' from employment conditions to social and family networks to access to health care and other services. Given these differences, understanding the relative importance of the various determinants of child malnutrition in urban and rural areas and especially whether they differ is key to designing context-relevant, effective program and policy responses for stemming malnutrition. This study uses Demographic and Health Survey data from 36 developing countries to address the question of whether the socioeconomic determinants of child nutritional status differ across urban and rural areas. The purpose is to answer the broader question of why child malnutrition rates are lower in urban areas. The socioeconomic determinants examined are women's education, women's status, access to safe water and sanitation, and household economic status. The analysis finds little evidence of differences in the nature of the socioeconomic determinants or in the strength of their associations with child nutritional status across urban and rural areas. As expected, however, it documents marked differences in the levels of these determinants in favor of urban areas. Large gaps in favor of urban areas are also found in the levels of key proximate determinants of child nutritional status, especially maternal prenatal and birthing care, quality of complementary feeding, and immunization of children. The conclusion is that better nutritional status of urban children is probably due to the cumulative effect of a series of more favorable socioeconomic conditions, which, in turn, seems to lead to better caring practices for children and their mothers. Given that the nature of the determinants of child nutritional status is largely the same across urban and rural areas, the same program and policy framework can be used to stem malnutrition in both. Efforts to alleviate the most critical socioeconomic constraints specific to the different environments should continue to be prioritized." Authors' Abstract

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Paper provided by International Food Policy Research Institute (IFPRI) in its series FCND briefs with number 176.

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Date of creation: 2004
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Handle: RePEc:fpr:fcndbr:176
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  1. Arimond, Mary & Ruel, Marie T., 2002. "Progress in developing an infant and child feeding index," FCND briefs 143, International Food Policy Research Institute (IFPRI).
  2. Menon, Purnima & Ruel, Marie T. & Morris, Saul Sutkover, 2000. "Socio-economic differentials in child stunting are consistently larger in urban than rural areas," FCND discussion papers 97, International Food Policy Research Institute (IFPRI).
  3. Engle, Patrice L. & Menon, Purnima & Haddad, Lawrence, 1999. "Care and Nutrition: Concepts and Measurement," World Development, Elsevier, vol. 27(8), pages 1309-1337, August.
  4. Cleland, John G. & van Ginneken, Jerome K., 1988. "Maternal education and child survival in developing countries: The search for pathways of influence," Social Science & Medicine, Elsevier, vol. 27(12), pages 1357-1368, January.
  5. Haddad, Lawrence James & Adato, Michelle, 2001. "How effectively do public works programs transfer benefits to the poor?," FCND briefs 108, International Food Policy Research Institute (IFPRI).
  6. Ruel, Marie T. & Garrett, James L. & Morris, Saul Sutkover & Maxwell, Daniel G. & Oshaug, Arne & Engle, Patrice L. & Menon, Purnima & Slack, Alison T. & Haddad, Lawrence James, 1998. "Urban challenges to food and nutrition security," FCND discussion papers 51, International Food Policy Research Institute (IFPRI).
  7. Smith, Lisa C. & Ramakrishnan, Usha & Ndiaye, Aida & Haddad, Lawrence James & Martorell, Reynaldo, 2003. "The importance of women's status for child nutrition in developing countries:," Research reports 131, International Food Policy Research Institute (IFPRI).
  8. Ruel, Marie T. & de la Briere, Benedicte & Hallman, Kelly & Quisumbing, Agnes R. & Coj, Nora, 2002. "Does subsidized childcare help poor working women in urban areas?," FCND briefs 131, International Food Policy Research Institute (IFPRI).
  9. Armar-Klemesu, Margaret & Ruel, Marie T. & Maxwell, Daniel G. & Levin, Carol E. & Morris, Saul Sutkover, 2000. "The constraints to good child care practices in Accra," FCND briefs 81, International Food Policy Research Institute (IFPRI).
  10. Morris, Saul S. & Levin, Carol E. & Armar-Klemesu, Margaret & Maxwell, Daniel & Ruel, Marie T., 1999. "Does Geographic Targeting of Nutrition Interventions Make Sense in Cities? Evidence from Abidjan and Accra," World Development, Elsevier, vol. 27(11), pages 2011-2019, November.
  11. Garrett, James L. & Ruel, Marie T., 1999. "Are determinants of rural and urban food security and nutritional status different?," FCND discussion papers 65, International Food Policy Research Institute (IFPRI).
  12. 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.
  13. Engle, Patrice L. & Menon, Purnima & Haddad, Lawrence James, 1996. "Care and nutrition," FCND discussion papers 18, International Food Policy Research Institute (IFPRI).
  14. Haddad, Lawrence & Ruel, Marie T. & Garrett, James L., 1999. "Are Urban Poverty and Undernutrition Growing? Some Newly Assembled Evidence," World Development, Elsevier, vol. 27(11), pages 1891-1904, November.
  15. Ruel, Marie T. & Haddad, Lawrence & Garrett, James L., 1999. "Some Urban Facts of Life: Implications for Research and Policy," World Development, Elsevier, vol. 27(11), pages 1917-1938, November.
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