Paper short abstract:

Using data from Demographic and Health Surveys (2007-2014) conducted in three middle-income African countries, we examine inequalities in stunting levels. We find that stunting rates have declined, but inequalities in stunting have increased, particularly among the poorest and those in urban areas.

Paper long abstract:

Stunting is the most prominent form of malnutrition and affects close to a third of children in Africa. The causes of stunting include poverty, lack of food and disease. Thus, a reduction in stunting could be achieved through combined and cumulative progress in nutrition, health and improved socio-economic conditions. We use data from Demographic and Health Surveys conducted between 2007 and 2014 in Ghana, Kenya and Zambia to conduct a comparative assessment of stunting. These countries have transitioned from low income to middle-income status, due to increased economic growth, higher commodity prices and rebasing of the national accounts. Using concentration curves and indices, we examine inequalities in stunting rates across wealth quintiles, as well as geographical locations. Our analysis shows that stunting rates have reduced in the countries, but the biggest reductions have occurred in Ghana and Kenya where stunting declined by 9% points over a 6-year period, while Zambia's stunting rate fell by 5% points. However, despite these reductions, stunting rates are still high, particularly in Zambia where over 40% of children are affected. In all three countries, children living in the poorest wealth quintiles are most affected, as well as those in rural areas. Our analysis shows that inequalities in stunting have widened over time in all three countries especially in the poorest wealth quintiles and urban areas. Our results suggest the need for continued focus on improving socio-economic levels of poor households and targeted social protection programmes to reduce inequalities if children nutritional outcomes are to improve.