PHA-Exchange> Socioeconomic Inequalities in Child Malnutrition

[Claudio Schuftan]

>
> Socioeconomic Inequalities in Child Malnutrition in the Developing World
>
> Adam Wagstaff, Naoko Watanabe
> Poverty and Human Resources, Development  Research Group
> World Bank, September, 2000
>
> Available as PDF file [37p.] at: http://econ.worldbank.org/docs/1189.pdf
> <http://econ.worldbank.org/docs/1189.pdf>
>
>  ".... Despite the development community's shift in emphasis toward the
> poor, malnutrition, like other dimensions of poor health, is concentrated
> among the worst off. Yet targets are still defined in terms of population
> averages. Consider, then, this information about malnutrition rates among
> different economic groups in 20 developing countries.
>
> Among the conclusions Wagstaff and Watanabe reach about malnutrition rates
> among different economic groups:
>
>
> *       Inequalities in malnutrition almost always disfavor the poor.
>
> *       It's not just that the poor have higher rates of malnutrition. The
> rate of malnutrition declines continuously with rising living standards. ·
> The tendency of poorer children to have higher rates of stunting and
> underweight is not due to chance or sampling variability. Inequalities in
> stunting and underweight, as measured by the concentration index, are
> statistically significant in almost all countries.
>
> *       Inequalities in underweight tend to be larger than inequalities in
> stunting, which tend to be larger than inequalities in wasting.
>
> *       In most cases, whatever the malnutrition indicator, differences in
> inequality between countries are not statistically significant.
>
> *       Even if attention is restricted to the cross-country differences
in
> inequality that are statistically significant, interesting conclusions
> emerge. Egypt and Vietnam have the most equal distributions of
malnutrition,
> and Nicaragua, Peru, and, to a lesser extent, Morocco have highly unequal
> distributions.
>
> *       Some countries (such as Egypt and Romania) do well in terms of
both
> the average (the prevalence of malnutrition) and the distribution
> (equality). Others do badly on both counts. Peru, for example, has a
higher
> average level of stunting than Egypt and higher poor-nonpoor inequality.
But
> many countries do well on one count and badly on the other. Brazil, for
> example, has a far lower (less than 20 percent) stunting rate overall than
> Bangladesh (more than 50 percent) but has four times as much inequality
(as
> measured by the concentration index).
>
> *       Use of an achievement index that captures both the average level
and
> the inequality of malnutrition leads to some interesting rank reversals in
> the country league table. With stunting, for example, focusing on the
> achievement index moves Egypt (a low-inequality country) from sixth
position
> to fourth, higher than Brazil and Russia (two countries with high
> inequality)...."