Socioeconomic inequalities in hidden hunger, undernutrition, and overweight among under-five children in 35 sub-Saharan Africa countries

• Published in: Journal of the Egyptian Public Health Association
• Main Authors: Michael Ekholuenetale, Godson Tudeme, Adeyinka Onikan, Charity E. Ekholuenetale
• Format: Article in Journal/Newspaper
• Language: English
• Published: SpringerOpen 2020
• Subjects: Anemia; Mortality; Overweight; Stunting; Underweight; Wasting; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doi.org/10.1186/s42506-019-0034-5; https://doaj.org/article/c7ffe109ba4d46dea3a87cb95c077516

Abstract Background Many underlying factors are assumed to contribute to the disparities in magnitude of childhood malnutrition. Notwithstanding, socioeconomic inequalities remain key measures to determine chronic and hidden hunger among under-five children. This study was undertaken to explore childhood malnutrition problems that are associated to household wealth-related and mother’s educational attainment in sub-Saharan Africa (SSA). Methods Secondary data from birth histories in 35 SSA countries was used. The Demographic and Health Survey (DHS) data of 384,747 births between 2008 and 2017 in 35 countries was analyzed. The outcome variables of interest were mainly indicators of malnutrition: stunting, underweight, wasting, overweight, anemia, and under-five children survival. Household wealth-related and mother’s educational level were the measures of socioeconomic status. Concentration index and Lorenz curves were the main tools used to determine inequalities for nutritional outcomes. The statistical significance level was determined at 5%. Results Based on the results, Burundi (54.6%) and Madagascar (48.4%) accounted for the highest prevalence of stunted children. Underweight children were 32.5% in Chad and 35.5% in Niger. Nigeria (16.6%) and Benin (16.4%) had the highest burdens of wasted children. Overall, overweight and under-five survival were significantly more in the higher household wealth, compared with the lower household wealth (Conc. Index = 0.0060; p < 0.001 and Conc. Index = 0.0041; p = 0.002 respectively). Conversely, stunting (Conc. Index = − 0.1032; p < 0.001), underweight (Conc. Index = − 0.1369; p < 0.001), wasting (Conc. Index = − 0.0711; p < 0.001), and anemia (Conc. Index = − 0.0402; p < 0.001) were significantly lower in the higher household wealth status, compared with the lower household wealth groups. Furthermore, under-five children survival was significantly more from mothers with higher educational attainment, compared with children from mothers with lower ...