[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
IDEAS home Printed from https://ideas.repec.org/p/mon/ceddtr/86.html
   My bibliography  Save this paper

La dynamique de l'inégalité de la malnutrition des enfants en Afrique. Une analyse comparative fondée sur une décomposition de régression

Author

Listed:
  • Jean-Pierre Lachaud

    (Groupe d'Economie du Développement Université Montesquieu Bordeaux IV)

Abstract
Une analyse comparative pour trois pays d'Afrique – Burkina Faso, Cameroun et Togo –des facteurs de l'inégalité socio-économique relative du retard de croissance des enfants, ainsi que des variations de ces disparités dans le temps, est proposée. Cette investigation, mobilisant pour chaque pays deux enquêtes démographiques et de santé relatives aux années 1990, suggère plusieurs conclusions. Premièrement, on observe une persistance, voire une aggravation, de l'incidence et/ou de l'inégalité socio-économique relative du retard de croissance des enfants de moins de 60 ou 36 mois. Par ailleurs, bien que la prévalence de la malnutrition des enfants soit plus forte dans les campagnes et parmi les ménages pauvres, l'inégalité du retard de croissance est plus élevée dans les villes, où elle s'est parfois accrue. Néanmoins, des disparités de situation prévalent selon les pays. Dans ce contexte, le statut nutritionnel des enfants est positivement corrélé au niveau de vie des familles – appréhendé à l'aide d'un indice d'actifs des ménages –, au niveau d'instruction des mères, et à la localisation urbaine, et inversement lié à l'âge des enfants. Par contre, le sexe des enfants, l'âge des mères, la taille du ménage et l'appartenance ethnique ont des effets contrastés selon les pays et la période considérés. Deuxièmement, la décomposition de l'indice de concentration de la taille des enfants en pourcentage de la médiane de référence, montre que les disparités de niveau de vie des ménages et, dans une moindre mesure, de leur localisation spatiale, sont les facteurs les plus importants qui contribuent à rehausser le niveau de l'inégalité de la malnutrition des enfants. Par contre, l'âge des enfants a un effet inverse dans tous les pays et pour les différentes périodes, tandis que d'autres éléments ont un rôle plus secondaire – sauf les disparités d'instruction des mères, ayant un fort impact inégalitaire au Cameroun. Troisièmement, l'examen de la dynamique de l'inégalité du retard de croissance des enfants suggère plusieurs commentaires. Tout d'abord, la décomposition totale indique que la variation du niveau de vie des ménages a joué un rôle de premier plan, en réduisant ou en accentuant les disparités de malnutrition. Ce facteur a été renforcé par la variation de l'effet net de l'âge des enfants, et contrebalancé par l'impact de la localisation spatiale. Ensuite, la décomposition de type Oaxaca montre que dans deux pays sur trois – Burkina Faso et Cameroun –, l'effet des élasticités l'emporte sur celui des inégalités –, bien que des situations contrastées soient observées selon les pays et les facteurs pris en compte. Ce constat général prévaut surtout pour le niveau de vie, la localisation spatiale, l'instruction des mères et la dimension des ménages. Enfin, la décomposition différentielle totale révèle un impact relativement contrasté de la variation des coefficients de régression, des moyennes des déterminants de la malnutrition, et de l'inégalité des déterminants de la malnutrition, sur les changements de l'inégalité du retard de croissance des enfants. Par ailleurs, dans l'ensemble, la décomposition montre que le poids relatif des moyennes des déterminants est plus fort que celui des coefficients des différentes sources d'inégalité. De plus, les résultats de la décomposition mettent en évidence la complexité des effets des déterminants de la malnutrition sur cette dernière, et la possibilité de conflit entre un « effet de croissance » et un « effet de distribution ». A comparative analysis for three countries of Africa – Burkina Faso, Cameroon and Togo– of the factors of the relative socioeconomic inequality in stunting of the children, as wellas variations of these disparities in time, is proposed. This investigation, mobilizing for eachcountry two demographic and health surveys relating to the 90s, suggests several conclusions. Firstly, one observes a persistence, even an aggravation, of the incidence and/or relativesocioeconomic inequality in stunting of the children of less than 60 or 36 months. In addition,although the prevalence of the children's malnutrition is stronger in the campaigns and amongthe poor households, the inequality in stunting is higher in the cities, where it sometimesincreased. Nevertheless, some disparities of situations prevail according to countries. In thiscontext, the nutritional statute of the children is positively correlated on the standard ofliving of the families – apprehended by an index of assets of the households –, on theeducational level of the mothers, and with the urban localization, and conversely dependent tothe age of the children. On the other hand, the sex of the children, the age of the mothers, thesize of the household and the ethnic membership have contrasted effects according to the countries and the period considered. Secondly, the decomposition of the concentration index ofthe height-for-age of the children expressed as a percentage of the median of reference, showsthat the welfare disparities of the households and, to a lesser extent, their spatiallocalization, are the most significant factors which contribute to raise the level of theinequality of the children's malnutrition. On the other hand, the age of the children has anopposite effect in all the countries and for the various periods, while other elements have amore secondary role – except the disparities in instruction of the mothers, having a strong uneven impact in Cameroon. Thirdly, the study of the dynamics of the inequality in stunting ofthe children suggestsseveral comments. First of all, the total decomposition indicates thatthe variation of thestandard of living of the households played a significant role, whilereducing or by accentuating the disparities of malnutrition. This factor was reinforced by thevariation of the net effect of the age of the children, and was counterbalanced by the impact ofthe spatial localization. Then, the Oaxaca-type decomposition shows that in two countries out ofthree – Burkina Faso and Cameroon –, the effect of elasticities exceeds that of the inequalities– although contrasted situations are observed according to the countries and factors taken intoaccount. This general observation prevails especially for the standard of living, the spatiallocalization, the instruction of the mothers and the size of the households. Lastly, totaldifferential decomposition reveals an impact relatively contrasted of the variation of thecoefficients of regression, averages of the determinants of malnutrition, and inequality of thedeterminants of malnutrition, on the changes of the inequality in stunting of the children. Inaddition, as a whole, the decomposition suggests that the relative weight of the averages of thedeterminants is stronger than that of the coefficients of the various sources of inequality.Moreover, the results of the decomposition highlight the complexity of the effects of thedeterminants of malnutrition on the latter, and the possibility of conflict between a « growth effect » and a « distributive effect». (Full text in French)

Suggested Citation

  • Jean-Pierre Lachaud, 2003. "La dynamique de l'inégalité de la malnutrition des enfants en Afrique. Une analyse comparative fondée sur une décomposition de régression," Documents de travail 86, Groupe d'Economie du Développement de l'Université Montesquieu Bordeaux IV.
  • Handle: RePEc:mon:ceddtr:86
    as

    Download full text from publisher

    To our knowledge, this item is not available for download. To find whether it is available, there are three options:
    1. Check below whether another version of this item is available online.
    2. Check on the provider's web page whether it is in fact available.
    3. Perform a search for a similarly titled item that would be available.

    References listed on IDEAS

    as
    1. Shorrocks, A F, 1980. "The Class of Additively Decomposable Inequality Measures," Econometrica, Econometric Society, vol. 48(3), pages 613-625, April.
    2. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
    3. Lee, Lung-fei & Rosenzweig, Mark R. & Pitt, Mark M., 1997. "The effects of improved nutrition, sanitation, and water quality on child health in high-mortality populations," Journal of Econometrics, Elsevier, vol. 77(1), pages 209-235, March.
    4. Wagstaff, Adam & Nga Nguyet Nguyen, 2002. "Poverty and survival prospects of Vietnamese children under Doi Moi," Policy Research Working Paper Series 2832, The World Bank.
    5. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    6. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    7. Barrera, Albino, 1990. "The role of maternal schooling and its interaction with public health programs in child health production," Journal of Development Economics, Elsevier, vol. 32(1), pages 69-91, January.
    8. Cotton, Jeremiah, 1988. "On the Decomposition of Wage Differentials," The Review of Economics and Statistics, MIT Press, vol. 70(2), pages 236-243, May.
    9. Reimers, Cordelia W, 1983. "Labor Market Discrimination against Hispanic and Black Men," The Review of Economics and Statistics, MIT Press, vol. 65(4), pages 570-579, November.
    10. Jean-Pierre Lachaud, 1996. "Pauvreté,vulnérabilité et marché du travail au Burkina Faso," Série de recherche 02, Groupe d'Economie du Développement de l'Université Montesquieu Bordeaux IV.
    11. Lerman, Robert I. & Yitzhaki, Shlomo, 1989. "Improving the accuracy of estimates of Gini coefficients," Journal of Econometrics, Elsevier, vol. 42(1), pages 43-47, September.
    12. repec:bla:revinw:v:46:y:2000:i:2:p:139-59 is not listed on IDEAS
    13. Gary S. Fields & Gyeongjoon Yoo, 2000. "Falling Labor Income Inequality In Korea'S Economic Growth: Patterns And Underlying Causes," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 46(2), pages 139-159, June.
    14. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Granlund , David & Chuc , NT & Phuc , HD & Lindholm, Lars, 2008. "Inequality in mortality in Vietnam: unravel the causes," Umeå Economic Studies 751, Umeå University, Department of Economics.
    2. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    3. González Álvarez, M Luz & Barranquero, Antonio Clavero, 2009. "Inequalities in health care utilization in Spain due to double insurance coverage: An Oaxaca-Ransom decomposition," Social Science & Medicine, Elsevier, vol. 69(5), pages 793-801, September.
    4. Wagstaff, Adam, 2002. "Inequalities in health in developing countries - swimming against the tide?," Policy Research Working Paper Series 2795, The World Bank.
    5. E. Xie, 2011. "Income-related inequalities of health and health care utilization," Frontiers of Economics in China, Springer;Higher Education Press, vol. 6(1), pages 131-156, March.
    6. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    7. Martin Siegel & Karl Mosler, 2014. "Semiparametric Modeling Of Age‐Specific Variations In Income Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 870-878, July.
    8. Hendrik Jürges, 2009. "Healthy Minds In Healthy Bodies: An International Comparison Of Education‐Related Inequality In Physical Health Among Older Adults," Scottish Journal of Political Economy, Scottish Economic Society, vol. 56(3), pages 296-320, July.
    9. David Cantarero & Marta Pascual & Jose Maria Sarabia, 2004. "Can income inequality contribute to understand inequalities in health? An empirical approach based on the European Community Household Panel," ERSA conference papers ersa04p230, European Regional Science Association.
    10. Pradhan, Jalandhar & Arokiasamy, Perianayagam, 2010. "Socio-economic inequalities in child survival in India: A decomposition analysis," Health Policy, Elsevier, vol. 98(2-3), pages 114-120, December.
    11. Granlund, David & Chuc, Nguyen T. & Phuc, Ho D. & Lindholm, Lars, 2010. "Inequality in mortality in Vietnam during a period of rapid transition," Social Science & Medicine, Elsevier, vol. 70(2), pages 232-239, January.
    12. Nesson, Erik T. & Robinson, Joshua J., 2019. "On the measurement of health and its effect on the measurement of health inequality," Economics & Human Biology, Elsevier, vol. 35(C), pages 207-221.
    13. Chen, Zhuo & Roy, Kakoli, 2009. "Calculating concentration index with repetitive values of indicators of economic welfare," Journal of Health Economics, Elsevier, vol. 28(1), pages 169-175, January.
    14. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375, March.
    15. Owen O’Donnell & Eddy van Doorslaer & Adam Wagstaff, 2012. "Decomposition of Inequalities in Health and Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 17, Edward Elgar Publishing.
    16. Wildman, John, 2003. "Income related inequalities in mental health in Great Britain: analysing the causes of health inequality over time," Journal of Health Economics, Elsevier, vol. 22(2), pages 295-312, March.
    17. Martins, Lurdes & Veiga, Paula, 2010. "Do inequalities in parents' education play an important role in PISA students' mathematics achievement test score disparities?," Economics of Education Review, Elsevier, vol. 29(6), pages 1016-1033, December.
    18. Heshmati, Almas, 2004. "Inequalities and Their Measurement," IZA Discussion Papers 1219, Institute of Labor Economics (IZA).
    19. Rassou R., 1993. "Statistical measurement of gender wage differentials," ILO Working Papers 992920693402676, International Labour Organization.
    20. M. Kamrul Islam & Ulf‐G. Gerdtham & Philip Clarke & Kristina Burström, 2010. "Does income‐related health inequality change as the population ages? Evidence from Swedish panel data," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 334-349, March.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:mon:ceddtr:86. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.