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Open AccessArticle

Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa

Center for Food Science and Nutrition, Addis Ababa University, PO Box: 1176, Addis Ababa, Ethiopia
United Nations Children’s Fund (UNICEF), Addis Ababa, Ethiopia
Author to whom correspondence should be addressed.
Nutrients 2020, 12(1), 253;
Received: 18 December 2019 / Revised: 10 January 2020 / Accepted: 14 January 2020 / Published: 18 January 2020
Stunting in children less than five years of age is widespread in Sub-Saharan Africa. We aimed to: (i) evaluate how the prevalence of stunting has changed by socio-economic status and rural/urban residence, and (ii) assess inequalities in children’s diet quality and access to maternal and child health care. We used data from nationally representative demographic and health- and multiple indicator cluster-surveys (DHS and MICS) to disaggregate the stunting prevalence by wealth quintile and rural/urban residence. The composite coverage index (CCI) reflecting weighed coverage of eight preventive and curative Reproductive, Maternal, Neonatal, and Child Health (RMNCH) interventions was used as a proxy for access to health care, and Minimum Dietary Diversity Score (MDDS) was used as a proxy for child diet quality. Stunting significantly decreased over the past decade, and reductions were faster for the most disadvantaged groups (rural and poorest wealth quintile), but in only 50% of the countries studied. Progress in reducing stunting has not been accompanied by improved equity as inequalities in MDDS (p < 0.01) and CCI (p < 0.001) persist by wealth quintile and rural-urban residence. Aligning food- and health-systems’ interventions is needed to accelerate stunting reduction more equitably. View Full-Text
Keywords: stunting; inequities; sub-Saharan Africa; continuum of care stunting; inequities; sub-Saharan Africa; continuum of care
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Baye, K.; Laillou, A.; Chitweke, S. Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa. Nutrients 2020, 12, 253.

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