Socio-Economic Inequalities in the Double Burden of Malnutrition among under-Five Children: Evidence from 10 Selected Sub-Saharan African Countries

Olufunke A Alaba; Plaxcedes Chiwire; Aggrey Siya; Oluremi A Saliu; Karen Nhakaniso; Emmanuella Nzeribe; Denis Okova; Akim Tafadzwa Lukwa

doi:10.3390/ijerph20085489

Socio-Economic Inequalities in the Double Burden of Malnutrition among under-Five Children: Evidence from 10 Selected Sub-Saharan African Countries

Int J Environ Res Public Health. 2023 Apr 12;20(8):5489. doi: 10.3390/ijerph20085489.

Authors

Olufunke A Alaba¹, Plaxcedes Chiwire^{2

3}, Aggrey Siya⁴, Oluremi A Saliu⁵, Karen Nhakaniso⁶, Emmanuella Nzeribe⁷, Denis Okova¹, Akim Tafadzwa Lukwa^{1

8}

Affiliations

¹ Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa.
² Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands.
³ Western Cape Department: Health, Western Cape Province, P.O. Box 2060, Cape Town 8000, South Africa.
⁴ College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala P.O. Box 7062, Uganda.
⁵ Department of Environmental Health Science, Faculty of Health Sciences, National Open University of Nigeria, Abuja 901101, Nigeria.
⁶ Business School, University of the People, 595 E Colorado Blvd Suite 623, Pasadena, CA 91101, USA.
⁷ Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi GPS AK-448-4944, Ghana.
⁸ DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Private Bag X1, Matieland, Stellenbosch 7602, South Africa.

Abstract

Background: Africa is unlikely to end hunger and all forms of malnutrition by 2030 due to public health problems such as the double burden of malnutrition (DBM). Thus, the aim of this study is to determine the prevalence of DBM and degree of socio-economic inequality in double burden of malnutrition among children under 5 years in sub-Saharan Africa.

Methods: This study used multi-country data collected by the Demographic and Health Surveys (DHS) Program. Data for this analysis were drawn from the DHS women's questionnaire focusing on children under 5 years. The outcome variable for this study was the double burden of malnutrition (DBM). This variable was computed from four indicators: stunting, wasting, underweight and overweight. Inequalities in DBM among children under 5 years were measured using concentration indices (CI).

Results: The total number of children included in this analysis was 55,285. DBM was highest in Burundi (26.74%) and lowest in Senegal (8.80%). The computed adjusted Erreygers Concentration Indices showed pro-poor socio-economic child health inequalities relative to the double burden of malnutrition. The DBM pro-poor inequalities were most intense in Zimbabwe (-0.0294) and least intense in Burundi (-0.2206).

Conclusions: This study has shown that across SSA, among under-five children, the poor suffer more from the DBM relative to the wealthy. If we are not to leave any child behind, we must address these socio-economic inequalities in sub-Saharan Africa.

Keywords: SES inequality; SSA; concentration indices; double burden of malnutrition; under 5 years.

MeSH terms

Africa South of the Sahara / epidemiology
Child
Child, Preschool
Female
Humans
Malnutrition* / epidemiology
Overweight / epidemiology
Prevalence
Socioeconomic Factors
Surveys and Questionnaires

Grants and funding

This research received no external funding; however, the International Journal of Environmental Research and Public Health (IJERPH) supported the study as they waived the APC charges for processing this manuscript.