Are the poor getting worse off? A decomposition of inequality in under-five malnutrition over time and space in Ghana

Abstract

The study used two rounds of Demographic and Health Survey data from Ghana (2003 and 2014) to estimate levels and changes in inequality in under-five malnutrition, and examine factors that explain levels and changes in inequality. The results suggest that though under-five malnutrition reduced by 24%, with household assets (household wealth) increasing by over 200% between 2003 and 2014, inequality in under-five malnutrition increased by 19.2%. Consistent with prior studies, the results also suggest that socioeconomic welfare, regional-related resource disparities, women and their partners’ education, household size and access to and availability of health services are key factors explaining the levels and changes in under-five malnutrition inequality over time, both at the national and sub-national levels. The study suggests the need for policy on inclusive cross-sectoral interventions that can lead to fairer distribution of opportunities and consequently access to social services in other to reduce inequality in under-five malnutrition. In this regard, existing social protection programmes in Ghana that have implications for the nutrition of children (e.g. LEAP, School Feeding Programme, National Health Insurance) should be tweaked to target poorer households for the purposes of reducing inequality in under-five malnutrition