Levels and trends in key socioeconomic inequalities in childhood undernutrition in Ethiopia: evidence from Ethiopia demographic and health surveys 2000-2019

Abstract

Introduction The global burden of childhood undernutrition is mainly concentrated in low-income and lower-middle-income countries. In Ethiopia, childhood undernutrition varies significantly across different population groups. The present study is aimed at examining the levels and trends in key socioeconomic inequalities in childhood undernutrition in Ethiopia. Methods This cross-sectional study was based on a total pooled sample of 48,782 under-five children drawn from five rounds of the Ethiopia Demographic and Health Surveys (2000–2019). We used multilevel binary logistic regression analysis to determine the key socioeconomic determinants of undernutrition among under five children. In addition, we applied concentration index and decomposition rate analysis techniques to explore the levels and trends in key socioeconomic inequalities in childhood undernutrition. Results Place of residence, household wealth status (approximated by asset-based wealth index), and maternal education, among others, were the key socioeconomic variables significantly associated (p < 0.001) with childhood undernutrition in Ethiopia. The level of inequality was the highest with children from rural areas, poor households and uneducated mothers. Absolute socioeconomic inequality in childhood undernutrition prevalence rate was declined by 9.72 during the study period (2000 to 2019). Conclusion Childhood undernutrition was unequally distributed among under-five children in Ethiopia, and largely concentrated among low socioeconomic status population groups. The identified key socioeconomic drivers of inequality in childhood undernutrition can be used to inform localized interventions and communication strategies to improve nutritional status of under-five children in Ethiopia. The study underscores development of poverty reduction strategies that directly address the existing challenges of the food insecurity and childhood undernutrition for the low-income population groups in the country.

Gender-specific disaggregated analysis of childhood undernutrition in Ethiopia: evidence from 2000–2016 nationwide survey

“…Although a limited number of studies have been conducted in Ethiopia on childhood stunting, wasting and underweight among Ethiopian children [ 19 , 21 , 23 , 29 , 55 – 58 ], investigation of the burden of undernutrition focusing on gender inequality has not been adequately addressed in scientific papers [ 37 , 59 , 60 ] and efforts to reduce this inequality are rarely seen. Moreover, inequality studies primary focus on socioeconomic inequality [ 32 – 34 , 37 ]. To our knowledge, our study is the first of its kind to assess the prevalence and factors associated with childhood undernutrition between boys and girls, using a nationally representative sample of children aged between 0 and 59 months in Ethiopia.…”

“…Another study by Wang et al [ 37 ] used a decomposition technique to evaluate the differences in nutritional outcomes by observable factors and socio-economic characteristics using the Ethiopia Demographic and Health Survey (EDHS) 2011. Apart from these two studies, past studies in Ethiopia have mainly focused on urban–rural inequalities [ 31 ], socioeconomic inequality [ 32 – 34 , 37 ], and many concentrated on the spatial analysis of one or more forms of undernutrition [ 19 , 23 , 38 – 40 , 40 , 41 ]. For example, although Negasi (2021) used the Ethiopia Socioeconomic Survey (ESS) to investigate inequalities in childhood undernutrition, their focus was on socioeconomic status [ 33 ], Jember et al (2021) [ 42 ], and Tesema et al [ 38 ] focused on geospatial inequality of anaemia among children.…”

The Food and Nutrition Policy Environment and Drivers of Changes in Key Food System Outcomes in Ethiopia

“…Food security is a prominent concern in Ethiopia. Despite improvements in several health and development indicators in recent years, Ethiopia remained one of the countries with the highest prevalence of maternal and child undernutrition (Negussie & Nigatu, 2023). Moreover, Ethiopia is one of the top ten food insecure countries in the world.…”