Yaya, Sanni, Uthman, Olalekan A., Kunnuji, Michael, Navaneetham, Kannan, Akinyemi, Joshua O., Kananura, Rornald Muhumuza, Adjiwanou, Visseho, Adetokunboh, Olatunji and Bishwajit, Ghose (2020) Does economic growth reduce childhood stunting? A multicountry analysis of 89 Demographic and Health Surveys in sub-Saharan Africa. BMJ Global Health, 5 (1). e002042. doi:10.1136/bmjgh-2019-002042

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Abstract

Background: There is mixed evidence and lack of consensus on the impact of economic development on stunting, and likewise there is a dearth of empirical studies on this relationship in the case of sub-Saharan Africa. Thus, this paper examines whether economic growth is associated with childhood stunting in low-income and middle-income sub-Saharan African countries.

Methods: We analysed data from 89 Demographic and Health Surveys conducted between 1987 and 2016 available as of October 2018 using multivariable multilevel logistic regression models to show the association between gross domestic product (GDP) per capita and stunting. We adjusted the models for child’s age, survey year, child’s sex, birth order and country random effect, and presented adjusted and unadjusted ORs.

Results: We included data from 490 526 children. We found that the prevalence of stunting decreased with increasing GDP per capita (correlation coefficient=−0.606, p<0.0001). In the unadjusted model for full sample, for every US$1000 increase in GDP per capita, the odds of stunting decreased by 23% (OR=0.77, 95% CI 0.76 to 0.78). The magnitude of the association between GDP per capita and stunting was stronger among children in the richest quintile. After adjustment was made, the association was not significant among children from the poorest quintile. However, the magnitude of the association was more pronounced among children from low-income countries, such that, in the model adjusted for child’s age, survey year, child’s sex, birth order and country random effect, the association between GDP per capita and stunting remained statistically significant; for every US$1000 increase in GDP per capita, the odds of stunting decreased by 12% (OR=0.88, 95% CI 0.87 to 0.90).

Conclusion: There was no significant association between economic growth and child nutritional status. The prevalence of stunting decreased with increasing GDP per capita. This was more pronounced among children from the richest quintile. The magnitude of the association was higher among children from low-income countries, suggesting that households in the poorest quintile were typically the least likely to benefit from economic gains. The findings could serve as a building block needed to modify current policy as per child nutrition-related programmes in Africa.

Item Type:	Journal Article
Subjects:	H Social Sciences > HB Economic Theory R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Children -- Mortality -- Africa, Sub-Saharan, Health surveys -- Statistical methods, Economic development -- Africa, Sub-Saharan
Journal or Publication Title:	BMJ Global Health
Publisher:	BMJ Publishing Group
ISSN:	2059-7908
Official Date:	23 January 2020
Dates:	Date Event 23 January 2020 Published 23 January 2020 Available 6 January 2020 Accepted
Date of first compliant deposit:	28 January 2020
Volume:	5
Number:	1
Article Number:	e002042
DOI:	10.1136/bmjgh-2019-002042
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access

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