Trends of Socioeconomic Disparities in the Kenyan Child Malnutrition Statistics: An analysis of the Demographic and Health Survey
Date:
Talk Summary:
Introduction: The burden of child malnutrition remains substantially high in Kenya despite commendable efforts in reducing its prevalence. Even though the country has recorded substantial economic advancements, there appears to be a disconnect between the rate of economic growth and health-related socioeconomic disparities.
Objective: To examine the trends of socioeconomic disparities in child malnutrition, determining factors, and the contributions of determinants towards socioeconomic inequalities of malnutrition in children under five years in Kenya between 2003 and 2014.
Methods: We used data from the Kenya Demographic and Health Survey (KDHS). Malnutrition determinants were analyzed using multiple logistic regression models with malnutrition indicators, stunting, underweight, and wasting used as the outcome variables. Concentration indices were used to quantify the socioeconomic inequalities in child malnutrition. Decomposition methods were used to explore the contributions of each determinant to the observed overall socioeconomic disparities in underweight and stunting.
Results: Socioeconomic inequalities in all child malnutrition indicators in Kenya worsened between 2003 and 2014. A child’s age (Adjusted Odds Ratio, AOR=1.12; 95%CI 1.11–1.13), lack of a religion (or irreligion) (AOR=1.33; 1.04–1.70), primary maternal education (AOR=1.43; 1.04–1.96), birth order (AOR=1.02; 1.01–1.04), and household poverty (AOR=1.82; 1.49–2.20) were substantial determinants of stunting whereas other religions (AOR=18.68; 4.00–87.32), a child’s age (AOR=1.07; 1.05–1.08), limited maternal education (AOR=2.68; 1.63–4.41), birth order (AOR=1.03; 1.01–1.05), mother’s age at first birth (AOR=1.02; 1.01–1.04), region (AOR=1.65; 1.19–2.29) and poverty (AOR=1.74; 1.33–2.27) were associated with increased risk of child underweight. Other religions (AOR=15.79; 3.44–72.53), no maternal education (AOR=5.72; 2.47–13.26), and being from the Rift Valley region (AOR=2.58; 1.50–4.43) were significant determinants of wasting. A household’s socioeconomic status was the largest significant contributor towards socioeconomic disparities in stunting and underweight. The contribution of a household’s socioeconomic status rose from 1.38% in 2003 to 1.51% in 2014 for stunting and from 1.55% in 2003 to 1.72% in 2014 for underweight.
Conclusion: The nutrition status of children from poor households has substantially worsened with most of this inequality attributable to poor socioeconomic status. To tackle these inequalities the Kenyan government may be required to employ a multi-layered approach with attention to reducing the disparities in wealth distribution.
Keywords: Child malnutrition, DHS, Stunting, Underweight, Wasting, Concentration Indices, Socio-economic inequities.