Inequalities in stunting among under-five children in Tanzania: Decomposing the Concentration Indexes using Demographic Health Surveys from 2004/5 to 2015/6

Abstract

Background: Child stunting is a global health concern. It has consequences on child survival, growth, and development. The absolute level of stunting has been decreasing in Tanzania although the prevalence is still high (34%), varying across socioeconomic determinants with a larger burden among the disadvantaged group. Reduction of inequalities in stunting are very crucial as we aim to reduce stunting to 28% by 2021. Objectives: This study aimed to determine the trend, contributing factors and changes of inequalities in stunting among children aged 3 – 59 months from 2004 to 2016 Methodology: Data were drawn from the Tanzania Demographic and Health Surveys. The dependent variable was stunting. The concentration index was used to quantify the magnitude of inequalities in stunting for each year. In order to get the contribution of each determinant on the inequality in stunting, the concentration index was decomposed by using the Wagstaff and Watanabe decomposition methods of the concentration index. Results: Inequalities in stunting insignificantly declined from -0.019 (p<0.001) in 2004 to -0.018 (p<0.001) in 2010 and then to -0.0096 (p<0.001). Disparities in the distribution of wealth index (mean contribution > 84.7%) and maternal years of schooling (mean contribution > 22.4%) increased the levels of inequalities in stunting in all survey years. Rural-urban differences reduced inequalities in stunting although its contribution changed over time. Conclusion: Inequalities in stunting declined, differentials in wealth index and maternal education had increased contribution on the levels of inequalities. To significantly reduce the larder burden of stunting among the disadvantaged groups, initiatives should be embarked on distribution of social services like water, health infrastructures and education.

Urban-rural Disparities in the Healthy Aging Trajectory in China: a Population-based Study

“…A concentration curve and concentration index were applied to quantify the unequal distribution of healthy aging across the wealth asset index. The concentration index is a numerical representation of a concentration curve obtained by plotting the distribution of poor health on the x-axis against a distribution of a socioeconomic variable on the y-axis [29,30] In this study, the trajectory of the healthy aging score (3 classes) was used to assess health aging, while household per capita consumption was used to evaluate socioeconomic status. A negative concentration index indicates the concentration of unsuccessful aging at lower economic levels, and a positive concentration index indicates the concentration of unsuccessful aging among those who are more a uent.…”