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Evidence of Between- and Within-Household Child Nutrition Inequality in Malawi: Does the Gender of the Household Head Matter?

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Abstract

This paper uses a variance decomposition approach to investigate inter- and intra-household inequalities in under-five children’s nutritional status in Malawi and distinguish between explained and unexplained variance. The adopted linear random effect model is based on a version of the conceptual framework by UNICEF, and the adopted dataset is from the Malawian Endline Survey 2014. The selected impact variable is child stunting. The explanatory variables are representative of the underlying and basic causes of this nutritional status. This study adds to the literature by providing an estimate by the gender of the household head and up-to-date evidence on the case of Malawi, where the prevalence of child malnutrition is rampant. The results reveal that between-household inequalities, especially those unexplained by the adopted model, mostly drive the long-term child nutritional inequalities. Policy suggestions for the design of nutritional and redistributive policies aimed at achieving the Sustainable Development Goals (SDGs) and the country’s growth and development strategy are provided.

Résumé

Cet article utilise une approche de décomposition de la variance pour étudier les inégalités entre les ménages et au sein des ménages quant à l’état nutritionnel des enfants de moins de cinq ans au Malawi, et pour faire la distinction entre la variance expliquée et non expliquée. Le modèle linéaire à effets aléatoires adopté est basé sur une version du cadre conceptuel de l’UNICEF et l’ensemble des données utilisées provient de l’évaluation finale des OMD au Malawi en 2014. La variable d’impact sélectionnée est le retard de croissance chez l’enfant. Les variables explicatives sont représentatives des causes sous-jacentes et fondamentales de cet état nutritionnel. Cette étude vient ajouter à la littérature existante l’analyse par sexe du chef de ménage et une mise à jour des preuves sur le cas malawien où la prévalence de la malnutrition infantile est endémique. Les résultats révèlent que ce sont essentiellement les inégalités entre les ménages, en particulier celles qui ne sont pas expliquées par le modèle adopté, qui sont à l’origine des inégalités à long terme concernant l’état nutritionnel des enfants. Ils fournissent des suggestions de politiques publiques pour appuyer la conception de politiques nutritionnelles et redistributives visant à atteindre les ODD et la stratégie de croissance et de développement du pays.

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References

  • Akombi, B.J., K.E. Agho, D. Merom, J.J. Hall, and A.M. Renzaho. 2017. Multilevel analysis of factors associated with wasting and underweight among children under-five years in Nigeria. Nutrients 9 (1): 44.

    Google Scholar 

  • Blumberg, R.L. 1991. Gender, family, and economy: The triple overlap. Newbury Park, CA: Sage.

    Google Scholar 

  • Briones-Alonso, E. 2015. The impact of culture, religion and traditional knowledge on food and nutrition security in developing countries. Working paper no. 30. Montreal: FoodSecure.

  • Brown, C., M. Ravallion, and D. van de Walle. 2017. Are poor individuals mainly found in poor households? Evidence using nutrition data for Africa. Policy research working paper 8001. Washington, DC: The World Bank.

  • Chikhungu, L.C., N.J. Madise, and S.S. Padmadas. 2014. How important are community characteristics in influencing children’s nutritional status? Evidence from Malawi population-based household and community surveys. Health & Place 30: 187–195.

    Google Scholar 

  • Chirande, L., D. Charwe, H. Mbwana, R. Victor, S. Kimboka, A.I. Issaka, and K.E. Agho. 2015. Determinants of stunting and severe stunting among under-fives in Tanzania: Evidence from the 2010 cross-sectional household survey. BMC Pediatrics 15: 165.

    Google Scholar 

  • Chirwa, E.W., and H.P. Ngalawa. 2008. Determinants of child nutrition in Malawi. South African Journal of Economics 76 (4): 628–640.

    Google Scholar 

  • Cornia, G.A., L. Deotti, and M. Sassi. 2016. Sources of food price volatility and child malnutrition in Niger and Malawi. Food Policy 60: 20–30.

    Google Scholar 

  • Cornia, G.A., and B. Martorano. 2017. The dynamics of income inequality in a dualistic economy: Malawi over 1990-2011. In Income inequality trends in sub-Saharan Africa divergence, determinants and consequences, ed. A. Odusola, G.A. Cornia, H. Bhorat, and P. Conceição. New York: United Nations Development Programme Regional Bureau for Africa.

    Google Scholar 

  • De Vreyer, P., and S. Lambert. 2016. Intra-household inequalities and poverty in Senegal. Paris School of Economics: Mimeo.

    Google Scholar 

  • Dwyer, D., and J. Bruce. 1988. A home divided: Women and income in the third world. Stanford, CA: Stanford University Press.

    Google Scholar 

  • Fentaw, R., A. Bogale, and D. Abebaw. 2013. Prevalence of child malnutrition in agro-pastoral households in Afar regional state of Ethiopia. Nutrition Research and Practice 7 (2): 122–131.

    Google Scholar 

  • Griffiths, P., N. Madise, A. Whitworth, and Z. Matthews. 2004. A tale of two continents: A multilevel comparison of the determinants of child nutritional status from selected African and Indian regions. Health and Place 10: 183–199.

    Google Scholar 

  • Haddad, L., C. Peña, C. Nishida, A. Quisumbing, and A. Slack. 1996. Food security and nutrition implications of intrahousehold bias: A review of literature. FCND discussion paper no. 19. Washington, DC: Food Consumption and Nutrition Division International Food Policy Research Institute.

  • Horton, S. 1988. Birth order and child nutritional status: Evidence from the Philippines. Economic Development and Cultural Change 36 (2): 341–354.

    Google Scholar 

  • Kabubo-Mariara, J., G.K. Ndenge, and D.K. Mwabu. 2009. Determinants of children’s nutritional status in Kenya: Evidence from demographic and health surveys. Journal of African Economies 18 (3): 363–387.

    Google Scholar 

  • Kassie, M., S. Ndiritu, and S. Stage. 2014. What determines gender inequality in household food security in Kenya? Application of exogenous switching treatment regression. World Development 56: 153–171.

    Google Scholar 

  • Khattak, U.K., S.P. Iqbal, and H. Ghazanfar. 2017. The role of parents’ literacy in malnutrition of children under the age of five years in a semi-urban community of Pakistan: A case-control study. Cureus 9 (6): e1316.

    Google Scholar 

  • Kuchenbecker, J., I. Jordan, A. Reinbott, J. Herrmann, T. Jeremias, G. Kennedy, E. Muehlhoff, B. Mtimuni, and M.B. Krawinkel. 2015. Exclusive breastfeeding and its effect on growth of Malawian infants: Results from a cross-sectional study. Paediatrics and International Child Health 35 (1): 14–23.

    Google Scholar 

  • Louat, F., E.G. Margaret, and J. Van Der Gaag. 1993. Welfare implications of female headship in Jamaican households. Living Standards Measurement Study working paper, no. 96. Washington, DC: The World Bank.

  • Madise, N., Z. Matthews, and B. Margetts. 1999. Heterogeneity of child nutritional status between households: A comparison of six sub-Saharan African countries. Population Studies 53 (3): 331–343.

    Google Scholar 

  • Makoka, D. 2013. The impact of maternal education on child nutrition: Evidence from Malawi, Tanzania, and Zimbabwe. DHS working papers. Washington, DC: USAID.

  • Malawi Government. 2017. The Malawi growth and development strategy (MGDs) III. file:///C:/Users/maria/Downloads/Malawi%20Growth%20and%20Development%20Strategy%20III.pdf.

  • Malawi National Vulnerability Assessment Committee. 2005. Malawi baseline livelihood profile. http://pdf.usaid.gov/pdf_docs/PNADG538.pdf. Accessed 3 Apr 2019.

  • Mallik, D., and M. Rafi. 2010. Are female-headed households more food insecure? Evidence from Bangladesh. World Development 38 (4): 593–605.

    Google Scholar 

  • Maxwell, S. 1998. Food security: A post modern perspective. Working paper no. 9. London: Institute of Development Studies.

  • Meyer-Rochow, V.B. 2009. Food taboos: Their origins and purposes. Journal of Ethnobiology and Ethnomedicine 5: 18.

    Google Scholar 

  • Mussa, R. 2011. Explaining urban rural malnutrition inequality in Malawi. Paper prepared for the special IARIW-SSA conference on measuring national income, wealth, poverty, and inequality in African countries Cape Town, South Africa, September 28–October 1, 2011.

  • Mussa, R. 2015. Intrahousehold and interhousehold child nutrition inequality in Malawi. South African Journal of Economics 83 (1): 140–153.

    Google Scholar 

  • National Statistical Office of Malawi ICF. 2017. Malawi demographic and health survey 2015-16. Zomba, Malawi, and Rockville. Zomba, Malawi: NSO and ICF.

    Google Scholar 

  • National Statistical Office of Malawi. 2015. Malawi MDG endline survey 2014. Zomba, Malawi: National Statistical Office.

    Google Scholar 

  • Osumanu, I.K. 2007. Household environmental and behavioural determinants of childhood diarrhoea morbidity in the Tamale Metropolitan area (TMA) Ghana. Geografisk Tidsskrift-Danish Journal of Geography 107 (1): 59–68.

    Google Scholar 

  • Pahl, J. 1983. The allocation of money within marriage. Sociological Review 31: 237–262.

    Google Scholar 

  • Picard, N., and F.C. Wolff. 2010. Measuring educational inequalities: A method and an application to Albania. Journal of Population Economics 23 (3): 989–1023.

    Google Scholar 

  • Pongou, R., M. Ezzati, and J.A. Salomon. 2006. Household and community socioeconomic and environmental determinants of child nutritional status in Cameroon. BMC Public Health 6: 98.

    Google Scholar 

  • Sahn, D.E., and D.C. Stifel. 2002. Robust comparisons of malnutrition in developing countries. American Journal of Agriculture Economics 84: 716–735.

    Google Scholar 

  • Sassi, M. 2018. Understanding food insecurity. Key features, indicators, and response design. Cham: Springer.

    Google Scholar 

  • Sassi, M. 2015a. Seasonality and trends in child malnutrition: Time-series analysis of health clinic data from the Dowa District of Malawi. The Journal of Development Studies 51 (12): 1667–1682.

    Google Scholar 

  • Sassi, M. 2015b. The welfare cost of maize price volatility in Malawi. Bio-based and Applied Economics 4 (1): 77–100.

    Google Scholar 

  • Sassi, M. 2014. Economic and health determinants of child nutritional status in the Malawian District of Salima. European Journal of Development Research 26 (5): 761–782.

    Google Scholar 

  • Sassi, M. 2012. Short-term determinants of malnutrition among children in Malawi. Food Security 4 (4): 593–606.

    Google Scholar 

  • Schnell-Anzola, B., M.L. Rowe, and R.A. LeVine. 2005. Literacy as a pathway between schooling and health-related communication skills: A study of Venezuelan mothers. International Journal of Educational Development 25 (1): 19–37.

    Google Scholar 

  • Skinner, C.J., D. Holt, and T.M.F. Smith. 1989. Analysis of complex surveys. Chichester, UK: Wiley.

    Google Scholar 

  • Smith, L.C., M.T. Ruel, and A. Ndiaye. 2004. Why is child malnutrition lower in urban than rural areas? Evidence from 36 developing countries. FCND discussion paper no. 176. Washington, DC: International Food Policy Research Institute.

  • UN Economic Commission for Africa, World Food Programme. 2015. The cost of hunger in Africa: The economic and social impact of child undernutrition. Addis Ababa: UN Economic Commission for Africa.

    Google Scholar 

  • UNICEF. 1998. The state of the world’s children 1998. New York: Oxford University Press.

    Google Scholar 

  • UNICEF, LSTM. 2011. Gender influences on child survival, health and nutrition: A narrative review. New York: UNICEF.

    Google Scholar 

  • Van de Meerendonk, A., N. Cunha, F. Juergens, and L. Pellerano. 2016. Towards a Malawian social protection floor: Assessment of social protection programmes in Malawi. Geneva: ILO.

    Google Scholar 

  • Vollmer, S., C. Bommer, A. Krishna, K. Harttgen, and S. Subramanian. 2016. The association of parental education with childhood undernutrition in low- and middle-income countries: Comparing the role of paternal and maternal education. International Journal of Epidemiology 46 (1): 312–323.

    Google Scholar 

  • Water and Sanitation Programme. 2012. Economic impacts of poor sanitation in Africa, Malawi loses MWK8.8 billion annually due to poor sanitation. Geneva: Water and Sanitation Programme.

    Google Scholar 

  • Weisz, A., G. Meuli, C. Thakwalakwa, I. Trehan, K. Maleta, and M. Manary. 2011. The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6–18 months. Nutrition Journal 10 (1): 25.

    Google Scholar 

  • WFP. 2012. Comprehensive food security and vulnerability analysis (CFSVA) and nutrition assessment Malawi. Rome: WFP.

    Google Scholar 

  • WHO. 1995. Physical status: The use and interpretation of anthropometry. WHO technical report series 854. Geneva, Switzerland: WHO.

  • WHO, UNICEF. 2009. WHO child growth standards and the identification of severe acute malnutrition in infants and children. Geneva: World Health Organization.

    Google Scholar 

  • World Bank. 2007. Malawi—Poverty and vulnerability assessment; investing in our future. Washington, DC: World Bank.

    Google Scholar 

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  1. Department of Economics and Management, University of Pavia, Pavia, Italy

    Maria Sassi

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Sassi, M. Evidence of Between- and Within-Household Child Nutrition Inequality in Malawi: Does the Gender of the Household Head Matter?. Eur J Dev Res 32, 28–50 (2020). https://doi.org/10.1057/s41287-019-00220-8

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