Socioeconomic inequality in malnutrition in developing countries
Ellen Van de Poel, Erasmus University Rotterdam,
Ahmad Reza Hosseinpoor, World Health Organization,
Niko Speybroeck, Institute for Tropical Medicine
Tom Van Ourti,
Jeanette Vega, World Health Organization,
Bulletin of the World Health Organization (BLT) - Volume 86, Number 4, April 2008, 241-320
Available online at: http://www.who.int/bulletin/volumes/86/4/07-044800/en/index.html
“…..Epidemiological evidence points to a small set of primary causes of child mortality that are the main killers of children aged less than 5 years: pneumonia, diarrhoea, low birth weight, asphyxia and, in some parts of the world, HIV and malaria. Malnutrition is the underlying cause of one out of every two such deaths.1,2 The evidence also shows that child death and malnutrition are not equally distributed throughout the world. They cluster in sub-Saharan Africa and south
Disparities in health outcomes between the poor and the rich are increasingly attracting attention from researchers and policy-makers, thereby fostering a substantial growth in the literature on health equity.5–8 “Socioeconomic inequality” in malnutrition refers to the degree to which childhood malnutrition rates differ between more and less socially and economically advantaged groups. This is different from “pure inequality”, which takes into account all factors influencing childhood malnutrition.
The available literature documenting socioeconomic inequality in malnutrition focuses mainly on individual countries or regions.9–14 At a more global level, Wagstaff and Watanabe15 provided evidence on socioeconomic inequality in malnutrition across 20 developing countries. Other relevant cross-country studies include those of Pradhan et al.,16 who describe total inequality, and Smith et al.,17 who describe inequalities between urban and rural populations. The latter two studies, however, provide no evidence on socioeconomic inequality within developing countries.
This paper contributes to the literature in several ways. First, it updates and enlarges the evidence base on average malnutrition and socioeconomic inequality in malnutrition using the most recent Demographic and Health Survey (DHS) data from 47 developing countries.
The inclusion of such a large number of countries makes it possible to obtain insights into the regional clustering of poor–rich malnutrition disparities in the developing world and into the association between the average level of malnutrition and socioeconomic inequality. Given the focus on average rates of malnutrition in international development targets, it is of interest to establish how countries compare in terms of average rates of malnutrition and inequality in malnutrition. In addition to quantifying the degree of socioeconomic inequality using a single index, this paper also illustrates the different patterns found for the distribution of malnutrition across socioeconomic groups….”
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