Socioeconomic Inequalities Persist Despite Declining Stunting Prevalence in Low- and Middle-Income Countries

The Journal of Nutrition
Inácio Crochemore M da SilvaCesar G Victora

Abstract

Global stunting prevalence has been nearly halved between 1990 and 2016, but it remains unclear whether this decline has benefited poor and rural populations within low- and middle-income countries (LMICs). We assessed time trends in stunting among children <5 y of age (under-5) according to household wealth and place of residence in 67 LMICs. Stunting prevalence was analyzed in 217 nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 67 countries with ≥2 surveys between 1993 and 2014. National estimates were stratified by wealth and area of residence, comparing the poorest 40% with the wealthiest 60%, and those residing in urban and rural areas. Time trends were calculated for LMICs by using multilevel regression models weighted by under-5 population, with stratification by wealth and by residence. Trends in absolute (slope index of inequality; SII) and relative (concentration index; CIX) inequalities were calculated. Mean prevalences in 1993 were 53.7% in low-income and 48.2% in middle-income countries, with annual average linear declines of 0.76 and 0.72 percentage points (pp), respectively. Although similar slopes of declines were observed for the poorest 40% and wealthiest 60...Continue Reading

References

Jan 22, 2008·Lancet·Cesar G VictoraUNKNOWN Maternal and Child Undernutrition Study Group
Feb 17, 2010·Pediatrics·Cesar Gomes VictoraRoger Shrimpton
May 13, 2011·Lancet·Cesar G VictoraCelia L Szwarcwald
Jun 12, 2013·Lancet·Robert E BlackUNKNOWN Maternal and Child Nutrition Study Group
Jun 12, 2013·Lancet·Zulfiqar A BhuttaUNKNOWN Lancet Nutrition Interventions Review Group, the Maternal and Child Nutrition Study Group
Dec 19, 2014·Public Health Nutrition·María Clara Restrepo-MéndezCesar G Victora
May 18, 2016·Maternal & Child Nutrition·Mercedes de Onis, Francesco Branca

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Citations

Mar 19, 2019·International Journal of Epidemiology·Helen GonçalvesUNKNOWN Pelotas Cohorts Study Group
Oct 19, 2019·European Journal of Clinical Nutrition·Seo Ah HongYoung-Ho Khang
Aug 30, 2020·The American Journal of Clinical Nutrition·Tyler VaivadaZulfiqar A Bhutta
May 22, 2019·BioMed Research International·Dang Van ChucPham Minh Khue
Apr 11, 2020·International Journal for Equity in Health·Giovanna Gatica-DomínguezCesar G Victora
Jan 23, 2020·Nutrients·Kaleab BayeStanley Chitweke
Sep 10, 2021·Public Health Nutrition·Eman Mohamed MahfouzTarek Ahmed Abdel Rahman
Nov 12, 2021·American Journal of Human Biology : the Official Journal of the Human Biology Council·Christiane Scheffler, Michael Hermanussen

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