On the Decomposition and Dynamics of Inequality of Opportunities: A Special Focus on Early Childhood Health and Nutrition in Tunisia

It is widely recognized in the public health literature that health and nutrition during the early childhood period have important long-term and sometimes irreversible consequences on health and wellbeing later in life. In this paper, we attempt to analyze deeply the patterns of inequality of opportunity in health and nutrition outcomes among under-five children in Tunisia. In order to attain such objective, we use several tools, including comparison of the distributions of considered outcomes across a number of circumstances groups; computation of the Human Opportunity Index and estimation of the relative contributions of circumstances using the Shapley decomposition. The main finding reveal reasonable and low levels of inequality in access to all basic healthcare services and nutrition except access to improved water and sanitation. The parents' education, wealth and location of residence are key factors causing such low inequalities. Without more inclusive and pro-poor policy interventions, there are few chances for children belonging in poor families and living in marginalized rural areas to spring out of the poverty lived by their parents.