Children's stunting in sub-Saharan Africa: Is there an externality effect of high fertility?

Kravdal, Øystein; Kodzi, Ivy

doi:10.4054/demres.2011.25.18

Cited by 15 publications

(14 citation statements)

References 48 publications

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“…In the present study, although the highest OR for stunting correspond to children belonging to families with six or more children the same was not confirmed in the multiple analysis after adjustment by other factors. These results are contrary to other studies [9,22,29,30], which observed a significant relationship between stunting and number of under five children in a household.…”

Section: Discussioncontrasting

confidence: 99%

Factors associated with stunting among children below five years of age in Zambia: evidence from the 2014 Zambia demographic and health survey

Mzumara¹,

Bwembya²,

Halwiindi³

et al. 2018

BMC Nutr

101

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Background: Stunting continues to be a major public health problem globally. Stunting is a manifestation of many factors including inadequate food intake and poor health conditions. However, poor quality nutritional diets during pregnancy, infancy and early childhood lead to inadequate nutrient intake. The prevalence of stunting in Zambia has been over 40% and remains unacceptably high. There is limited information on factors associated with stunting in Zambia. Thus to better understand factors contributing to the high stunting levels, the 2013/14 Zambia Demographic and Health Survey (ZDHS) data was analysed. Methods: Data was extracted using a data extraction tool and analysed using Stata version 13. Sample data of 12, 328 children aged 0-59 months was analysed. The analysis involved simple and multiple logistic regression to find associations between independent variables and stunting. Results: The prevalence of stunting among under five children in Zambia is 40%. From the 4937 children who were stunted, stunting was higher among male children as compared to female children (42.4 and 37.6% respectively). Additional analysis revealed that children whose source of drinking water was improved (33.7%) were less likely to be stunted compared to children whose source of drinking water was poor (47.7%). Stunting was associated with sex and age of a child; mother's age and education; residence; wealth and duration of breastfeeding. For instance, children whose mothers had higher education showed a 75% reduction of odds compared to children whose mothers had no education (AOR = 0.35, 95%CI: 0.22, 0.54; p < 0.05). Similarly, wealth status showed an inverse relationship. Children who came from rich households showed a 32% reduction of odds compared to children who came from poor households (AOR = 0.68, 95%CI: 0.57, 0.82; p < 0.05). Conclusion:The study established that the major predictors of stunting among children under 5 years old in Zambia were sex and age of the child; mother's age and level of education; wealth status; improved source of drinking water; duration of breastfeeding and residence. Therefore, multiple measures targeted at reducing child stunting should be taken in a bid to influence policy and conceiving of programmes.

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Section: Discussioncontrasting

confidence: 99%

Factors associated with stunting among children below five years of age in Zambia: evidence from the 2014 Zambia demographic and health survey

Mzumara¹,

Bwembya²,

Halwiindi³

et al. 2018

BMC Nutr

101

View full text Add to dashboard Cite

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“…The ages of the older siblings represent another example. Mothers with high fertility desires space their children more closely, perhaps creating more resource competition (e.g., time spent caring for a toddler affects the survival of the infant) or a higher probability of spreading of diseases between children (Kravdal & Kodzi 2011). These confounding factors may cause a larger survival disadvantage for later-born children of mothers with a large ideal family size than for the children of equal parity born to mothers with a lower desired family size, of whom a larger share is undesired.…”

Section: Regression Discontinuitymentioning

confidence: 99%

The Differential Mortality of Undesired Infants in Sub-Saharan Africa

Flatø

2018

Demography

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With high rates of infant mortality in sub-Saharan Africa, investments in infant health are subject to tough prioritizations within the household, in which maternal preferences may play a part. How these preferences will affect infant mortality as African women have ever-lower fertility is still uncertain, as increased female empowerment and increased difficulty in achieving a desired gender composition within a smaller family pull in potentially different directions. I study how being born at a parity or of a gender undesired by the mother relates to infant mortality in sub-Saharan Africa and how such differential mortality varies between women at different stages of the demographic transition. Using data from 79 Demographic and Health Surveys, I find that a child being undesired according to the mother is associated with a differential mortality that is not due to constant maternal factors, family composition, or factors that are correlated with maternal preferences and vary continuously across siblings. As a share of overall infant mortality, the excess mortality of undesired children amounts to 3.3 % of male and 4 % of female infant mortality. Undesiredness can explain a larger share of infant mortality among mothers with lower fertility desires and a larger share of female than male infant mortality for children of women who desire 1-3 children. Undesired gender composition is more important for infant mortality than undesired childbearing and may also lead couples to increase family size beyond the maternal desire, in which case infants of the surplus gender are particularly vulnerable.

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“…Giroux () and Kravdal and Kodzi () examined the effect of fertility and the number of siblings on child stunting sub‐Saharan Africa. While they found a strong association at the aggregate level, their estimates of the effect size are quite small at the household level.…”

Section: Calibrationmentioning

confidence: 99%

“…We therefore take an indirect approach to calibrate our estimate for θ H , which captures the impact of fertility on child health and health human capital (as proxied by adult height), by first examining the effect of fertility on child height and stunting, then inferring this effect on adult height, and finally estimating the effect of adult height on worker productivity and wages. Giroux (2008) and Kravdal and Kodzi (2011) examined the effect of fertility and the number of siblings on child stunting sub-Saharan Africa. While they found a strong association at the aggregate level, their estimates of the effect size are quite small at the household level.…”

Section: Labor Allocation Across Sectorsmentioning

confidence: 99%

The Effect of Fertility Decline on Economic Growth in Africa: A Macrosimulation Model

Karra¹,

Canning²,

Wilde³

2017

Population & Development Rev

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Children's stunting in sub-Saharan Africa: Is there an externality effect of high fertility?

Cited by 15 publications

References 48 publications

Factors associated with stunting among children below five years of age in Zambia: evidence from the 2014 Zambia demographic and health survey

Factors associated with stunting among children below five years of age in Zambia: evidence from the 2014 Zambia demographic and health survey

The Differential Mortality of Undesired Infants in Sub-Saharan Africa

The Effect of Fertility Decline on Economic Growth in Africa: A Macrosimulation Model

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