Socioeconomic Inequalities Persist Despite Declining Stunting Prevalence in Low- and Middle-Income Countries |
Authors: |
da Silva ICM, França GV, Barros AJD, Amouzou A, Krasevec J, and Victora CG |
Source: |
Journal of Nutrition, 148(2):254-258; DOI: 10.1093/jn/nxx050. |
Topic(s): |
Inequality Nutrition
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Country: |
More than one region
Multiple Regions
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Published: |
FEB 2018 |
Abstract: |
Background:
Global stunting prevalence has been nearly halved between 1990 and 2016, but it remains unclear whether this decline has benefited poor and rural populations within low- and middle-income countries (LMICs).
Objective:
We assessed time trends in stunting among children <5 y of age (under-5) according to household wealth and place of residence in 67 LMICs.
Methods:
Stunting prevalence was analyzed in 217 nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 67 countries with =2 surveys between 1993 and 2014. National estimates were stratified by wealth and area of residence, comparing the poorest 40% with the wealthiest 60%, and those residing in urban and rural areas. Time trends were calculated for LMICs by using multilevel regression models weighted by under-5 population, with stratification by wealth and by residence. Trends in absolute (slope index of inequality; SII) and relative (concentration index; CIX) inequalities were calculated.
Results:
Mean prevalences in 1993 were 53.7% in low-income and 48.2% in middle-income countries, with annual average linear declines of 0.76 and 0.72 percentage points (pp), respectively. Although similar slopes of declines were observed for the poorest 40% and wealthiest 60% groups in all countries (0.78 and 0.74 pp, respectively), absolute and relative inequalities increased over time in low-income countries (SII increased from -19.3% in 1993 to -23.7% in 2014 and CIX increased from -6.2% to -10.8% in the same period). In middle-income countries, socioeconomic inequalities remained stable. Overall, stunting prevalence decreased more rapidly among rural than for urban children (0.78 and 0.55 pp, respectively).
Conclusions:
The prevalence of stunting is decreasing. Poor-rich gaps are stable in middle-income countries and slightly increasing in low-income countries. Rural-urban inequalities are decreasing over time. |
Web: |
https://academic.oup.com/jn/article/148/2/254/4913041 |
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