Socioeconomic Status, Anthropometric Status and Developmental Outcomes of East-African Children



The aim of the current review is to critically evaluate existing evidence on the relationship between socio-economic status, anthropometry and child development. We observed that socio-economic variables (e.g. maternal and paternal educational level, occupation and income, and wealth index, which is a composite of various wealth indicators) were positively associated with anthropometric status. Additionally, it was observed that children who had poor anthropometric status (i.e. stunted or underweight) performed more poorly on measures of child development compared to peers with proper growth. Relationships between SES and developmental outcomes are consistently found; with some studies reporting a direct and others an indirect relationship. We propose a mediation model in which SES has an influence on developmental outcomes through various more proximal variables, such as maternal caring capacity, anthropometric status, and ill-health. Potential pathways of the influence of SES on anthropometric status include inadequate food intake, ill health and sub-optimal parenting behaviour. Anthropometric status also influences developmental outcomes through multiple pathways, such as potential brain damage and lowered activity levels. It is concluded that parental SES influences child’s physical growth which in turn affects their developmental outcomes. Implementing intervention measures to improve the anthropometric status of children living in poverty can be expected to improve developmental outcomes.


Human Immunodeficiency Virus Developmental Outcome Cognitive Outcome Cognitive Test Score Family Asset 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Bayley Scales of Infant Development




Height-for-Age Z-scores


Human Immunodeficiency Virus


Kenya Demographic and Health Survey


Kilifi Developmental Inventory


Millennium Development Goals


Structural Equation Modelling


Socio-Economic Status


Sub-Saharan Africa


United Nations Children’s Fund


Weight-for-age Z-scores


Weight-for-height Z-scores


  1. Aboud FE, Alemu T. Nutrition, maternal responsiveness and mental development of Ethiopian children. Soc Sci Med. 1995;41:725–32.PubMedCrossRefGoogle Scholar
  2. Abubakar A. Infant-toddler development in a multiple risk environment. Ridderkerk: Ridderprint; 2008.Google Scholar
  3. Abubakar A, Holding P, Newton CR, van Baar A, van de Vijver FJR. The role of weight for age and disease stage in poor psychomotor outcome of HIV-infected children in Kilifi, Kenya. Dev Med Child Neurol. 2009;51:968–73, Online Early 21 May.PubMedCrossRefGoogle Scholar
  4. Abubakar A, Van Vijver FJR, Van Baar AL, Kalu R, Mbonani L, Newton CJR, Holding PA. Socioeconomic status, anthropometric status and psychomotor development in a resource limited setting in Kenya: A path analytic study. Early Hum Dev. 2008;84:613–21.PubMedCrossRefGoogle Scholar
  5. Bhargava A. Modeling the effects of maternal nutritional status and socioeconomic variables on the anthropometric and psychological indicators of Kenyan infants from age 0-6 months. Am J Phys Anthropol. 2000;111:89–104.PubMedCrossRefGoogle Scholar
  6. Bhargava A, Fox-Kean M. The effects of maternal education versus cognitive test scores on child nutrition in Kenya. Econ Hum Biol. 2003;1:309–19.PubMedCrossRefGoogle Scholar
  7. Bhargava A, Jukes M, Ngorosho D, Khilma C, Bundy DAP. Modelling the effects of health status and the educational infrastructure on the cognitive development of Tanzanian schoolchildren. Am J Hum Biol. 2005;17:280–92.PubMedCrossRefGoogle Scholar
  8. Bloss E, Wainaina F, Bailey RC. Prevalence and predictors of underweight, stunting, and wasting among children aged 5 and under in western Kenya. J Trop Pediatr. 2004;50:260–70.PubMedCrossRefGoogle Scholar
  9. Bradley RH, Corwyn RF. Life at home: Same time, different places. Early Dev Parent. 1996;5:251–69.CrossRefGoogle Scholar
  10. Bradley RH, Corwyn RF. Socioeconomic status and child development. Annu Rev Psychol. 2002;53:371–99.PubMedCrossRefGoogle Scholar
  11. Central Bureau of Statistics. Kenya demographic health survey 2003. MA: Carverlton; 2004.Google Scholar
  12. Chesire EJ, Orago AS, Oteba LP, Echoka E. Determinants of under nutrition among school age children in a Nairobi peri-urban slum. East Afr Med J. 2008;85:471–9.PubMedGoogle Scholar
  13. de Onis M, Blossner M, Borghi E, Frongillo EA, Morris R. Estimates of global prevalence of childhood underweight in 1990 and 2015. JAMA. 2004;291:2600–6.PubMedCrossRefGoogle Scholar
  14. De Vries MW. Kids in context: temperament in cross-cultural perspective. In: Carey WB, Mcdevitt SC, editors. Prevention and early Intervention. New York: Bruner/Mazel; 1994.Google Scholar
  15. De Vries MW. Babies, brains and culture: optimizing neurodevelopment on the savannah. Acta Paediatr Suppl. 1999;88:43–8.PubMedCrossRefGoogle Scholar
  16. Drewett R, Wolke D, Asefa M, Kaba M, Tessema F. Malnutrition and mental development: is there a sensitive period? A nested case-control study. J Child Psychol Psychiatr. 2001;42:181–7.CrossRefGoogle Scholar
  17. Frongillo Jr EA, de Onis M, Hanson KMP. Socioeconomic and demographic factors are associated with worldwide patterns of stunting and wasting of children. J Nutrition. 1997;127:2302–9.Google Scholar
  18. Grantham-McGregor S. Linear growth and cognition. Lancet. 2002;359:542.PubMedCrossRefGoogle Scholar
  19. Grantham-McGregor SM, Powell CA, Walker SP, Himes JH. Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: the Jamaican Study. Lancet. 1991;338:1–5.PubMedCrossRefGoogle Scholar
  20. Greenfield PM. You can’t take it with you: Why ability assessments don’t cross cultures. Am Psychol. 1997;52:1115–24.CrossRefGoogle Scholar
  21. Jukes MC, Nokes CA, Alcock KJ, Lambo JK, Kihamia C, Ngorosho N, Mbise A, Lorri W, Yona E, Mwanri L, Baddeley AD, Hall A, Bundy DA. Heavy schistosomiasis associated with poor short-term memory and slower reaction times in Tanzanian schoolchildren. Trop Med Int Health. 2002;7:104–17.PubMedCrossRefGoogle Scholar
  22. Kamau-Thuita F, Omwega AM, Muita JW. Child care practices and nutritional status of children aged 0-2 years in Thika, Kenya. East Afr Med J. 2002;79:524–9.PubMedGoogle Scholar
  23. Kihara M, Carter JA, Newton CR. The effect of Plasmodium falciparum on cognition: a systematic review. Trop Med Int Health. 2006;11:386–97.PubMedCrossRefGoogle Scholar
  24. Kikafunda JK, Tumwine JK. Diet and socio-economic factors and their association with the nutritional status of pre-school children in a low income suburb of Kampala City, Uganda. East Afr Med J. 2006;83:565–74.PubMedGoogle Scholar
  25. Kikafunda JK, Walker AF, Collett D, Tumwine JK. Risk factors for early childhood malnutrition in Uganda. Pediatrics. 1998;102:E45.PubMedCrossRefGoogle Scholar
  26. Kogi-Makau W. Risk indicators of nutritional status of household of a Kenyan semi-arid population. East Afr Med J. 1992;69:560–2.PubMedGoogle Scholar
  27. Kulwa KB, Kinabo JL, Modest B. Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania. Food Nutr Bull. 2006;27:236–44.PubMedGoogle Scholar
  28. Kwena AM, Terlouw DJ, de Vlas SJ, Phillips-Howard PA, Hawley WA, Friedman JF, Vulule JM, Nahlen BL, Sauerwein RW, ter Kuile FO. Prevalence and severity of malnutrition in pre-school children in a rural area of western Kenya. Am J Trop Med Hyg. 2003;68:94–9.PubMedGoogle Scholar
  29. Levitsky DA, Strupp BJ. Malnutrition and the brain: changing concepts, changing concerns. J Nutr. 1995;125:2212S–20.PubMedGoogle Scholar
  30. Malda M, van de Vijver F. Assessing cognition in nutrition intervention trials across cultures. In: Voster HH, Blaauw R, Dhansay MA, Kuzwayo Pmn, Moeng L Wentzel-Viljoen E, editors. Proceedings of the 18th Congress of Nutrition. Durban: ICC; 2005.Google Scholar
  31. Mulenga K, Ahonen T, Aro M. Performance of Zambian Children on the NEPSY: A pilot study. Dev Neuropsy. 2001;20:375–83.CrossRefGoogle Scholar
  32. Nyakeriga AM, Troye-Blomberg M, Chemtai AK, Marsh K, Williams TN. Malaria and nutritional status in children living on the coast of Kenya. Am J Clin Nutr. 2004;80:1604–10.PubMedGoogle Scholar
  33. Nyaruhucha CN, Msuya JM, Mamiro PS, Kerengi AJ. Nutritional status and feeding practices of under-five children in Simanjiro District, Tanzania. Tanzan Health Res Bull. 2006;8:162–7.PubMedGoogle Scholar
  34. Ogden CL. Urban malnutrition, maternal activities and child nutrition in Kigali, Rwanda. New York: Cornell University; 1993.Google Scholar
  35. Olney DK, Kariger PK, Stoltzfus RJ, Khalfan SS, Ali NS, Tielsch JM, Sazawal S, Black R, Allen LH, Pollitt E. Development of nutritionally at-risk young children is predicted by malaria, anemia, and stunting in Pemba, Zanzibar. J Nutr. 2009;139:763–72.PubMedCrossRefGoogle Scholar
  36. Sigman M, Neumann C, Carter E, Cattle DJ, D’Souza S, Bwibo N. Prediction of cognitive competence in Kenyan children from Toddler nutrition, family characteristics and abilities. Child Dev. 1988;59:1251–61.CrossRefGoogle Scholar
  37. Sigman M, Neumann C, Baksh M, Bwibo N, McDonald MA. Relationship between nutrition and development in Kenyan toddlers. J Pediatr. 1989a;115:357–64.PubMedCrossRefGoogle Scholar
  38. Sigman M, Neumann C, Jansen AA, Bwibo N. Cognitive abilities of Kenyan children in relation to nutrition, family characteristics and education. Child Dev. 1989b;60:1463–74.PubMedCrossRefGoogle Scholar
  39. Sigman M, McDonald MA, Neumann C, Bwibo N. Prediction of Cognitive Competence in Kenyan Children from Toddler Nutrition, Family Characteristics and Abilities. J Child Psychol Psychiatr. 1991;32:307–20.CrossRefGoogle Scholar
  40. Sonke CJ, Poortinga YP, de Kuijer JHJ. Cultural differences on cognitive task performance: The influence of task familiarity. In: Lonner WJ, Dinnel Dl, Forgays DK Hayes SA, editors. Merging past, present, and future in cross-cultural psychology. Lisse: Swets and Zeitlinger; 1999.Google Scholar
  41. Stephenson LS, Latham MC, Ottesen EA. Global malnutrition. Parasitology. 2000;121:S5–22.PubMedCrossRefGoogle Scholar
  42. Stoltzfus RJ, Albonico M, Tielsch JM, Chwaya HM, Savioli L. Linear growth retardation in Zanzibari school children. J Nutr. 1997;127:1099–05.PubMedGoogle Scholar
  43. Tumwine JK, Barugahare W. Nutrition status of children in Kasese district at the Uganda-Congo border. East Afr Med J. 2002;79:427–34.PubMedGoogle Scholar
  44. Vella V, Tomkins A, Borghesi A, Migliori GB, Adriko BC, Crevatin E. Determinants of child nutrition and mortality in north-west Uganda. Bull World Health Organ. 1992;70:637–43.PubMedGoogle Scholar
  45. Vella V, Tomkins A, Nviku J, Marshall T. Determinants of nutritional status in south-west Uganda. J Trop Pediatr. 1995;41:89–98.PubMedGoogle Scholar
  46. Van de Vijver FJR. Appl Psychol Int Rev. 2002;51: 545–66.CrossRefGoogle Scholar
  47. Wachs TD. Multiple influences on children’s nutritional deficiencies: a systems perspective. Physiol Behav. 2008;94: 48–60.PubMedCrossRefGoogle Scholar
  48. Walka H, Pollitt E. A preliminary test of a developmental model for the study of undernourished children in Indonesia. Eur J Clin Nutr. 2000;54:S21–7.PubMedGoogle Scholar
  49. Walker SP, Chang SM, Powell C, Grantham-McGregory SM. Effects of early childhood psychosocial stimulation and nutritional supplementation on cognition and education in growth-stunted Jamaican children: Prospective cohort study. Lancet. 2005;19:1804–7.CrossRefGoogle Scholar
  50. Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145–57.PubMedCrossRefGoogle Scholar
  51. Whaley SE, Sigman M, Espinosa MP, Neumann CG. Infant predictors of cognitive development in an undernourished Kenyan population. J Dev Behav Pediatr. 1998;19:169–77.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PsychologyTilburg UniversityTilburgThe Netherlands

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