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CHILD NUTRITIONAL STATUS IN EGYPT: A COMPREHENSIVE ANALYSIS OF SOCIOECONOMIC DETERMINANTS USING A QUANTILE REGRESSION APPROACH

Published online by Cambridge University Press:  10 January 2018

Mesbah Fathy Sharaf*
Affiliation:
Department of Economics, University of Alberta, Edmonton, Canada Department of Economics, Damanhour University, Damanhour, Egypt
Elhussien Ibrahim Mansour
Affiliation:
Department of Economics, The New School for Social Research, New York, USA
Ahmed Shoukry Rashad
Affiliation:
Department of Economics, Frankfurt School of Finance & Management, Germany
*
1Corresponding author. Email: sharaf@ualberta.ca

Summary

This study examined the underlying demographic and socioeconomic determinants of child nutritional status in Egypt using data from the most recent round of the Demographic and Health Survey. The height-for-age Z-score (HAZ) was used as a measure of child growth. A quantile regression approach was used to allow for a heterogeneous effect of each determinant along different percentiles of the conditional distribution of the HAZ. A nationally representative sample of 13,682 children aged 0–4 years was drawn from the 2014 Egypt DHS. The multivariate analyses included a set of HAZ determinants commonly used in the literature. The conditional and unconditional analyses revealed a socioeconomic gradient in child nutritional status, in which children of low income/education households have a worse HAZ than those from high income/education households. The results also showed significant disparities in child nutritional status by demographic and social characteristics. The quantile regression results showed that the association between the demographic and socioeconomic factors and HAZ differed along the conditional HAZ distribution. Intervention measures need to consider the heterogeneous effect of the determinants of child nutritional status along the different percentiles of the HAZ distribution. There is no one-size-fits-all policy to combat child malnutrition; a multifaceted approach and targeted policy interventions are required to address this problem effectively.

Type
Research Article
Copyright
© Cambridge University Press, 2018 

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References

Akee, R., Simeonova, E., Copeland, W., Angold, A. & Costello, J. E. (2013) Young adult obesity and household income: effects of unconditional cash transfers. American Economic Journal: Applied Economics 5(2), 128.Google Scholar
Bassolé, L. (2007) Child malnutrition in Senegal: does access to public infrastructure really matter? A quantile regression analysis. Paper presented at the African Economic Conference: Opportunities and Challenges of Development for Africa in the Global Arena, Addis Ababa, Ethiopia, November 2007, Vol. 1517.Google Scholar
Bomela, N. J. (2009) Social, economic, health and environmental determinants of child nutritional status in three Central Asian Republics. Public Health Nutrition 12(10), 18711877.Google Scholar
Cawley, J. & Liu, F. (2012) Maternal employment and childhood obesity: a search for mechanisms in time use data. Economics & Human Biology 10(4), 352364.Google Scholar
Chen, Y. & Li, H. (2009) Mother’s education and child health: is there a nurturing effect? Journal of Health Economics 28(2), 413426.Google Scholar
De Haen, H., Klasen, S. & Qaim, M. (2011) What do we really know? Metrics for food insecurity and undernutrition. Food Policy 36(6), 760769.Google Scholar
Fenske, N., Burns, J., Hothorn, T. & Rehfuess, E. A. (2013) Understanding child stunting in India: a comprehensive analysis of socio-economic, nutritional and environmental determinants using additive quantile regression. PloS One 8(11), e78692.Google Scholar
Kabubo-Mariara, J., Ndenge, G. K. & Mwabu, D. K. (2009) Determinants of children’s nutritional status in Kenya: evidence from Demographic and Health Surveys. Journal of African Economies 18(3), 363387.Google Scholar
Lakdawalla, D. & Philipson, T. (2009) The growth of obesity and technological change. Economics & Human Biology 7(3), 283293.Google Scholar
Liu, H., Fang, H. & Zhao, Z. (2013) Urban–rural disparities of child health and nutritional status in China from 1989 to 2006. Economics & Human Biology 11(3), 294309.Google Scholar
Mazumdar, S. (2010) Determinants of inequality in child malnutrition in India: the poverty–undernutrition linkage. Asian Population Studies 6(3), 307333.Google Scholar
Ministry of Health and Population, El-Zanaty and Associates & ICF International. (2015) Egypt Demographic and Health Survey 2014. Ministry of Health and Population, Cairo, Egypt, and ICF International, Rockville, MD, USA.Google Scholar
O’Donnell, O. A., Wagstaff, A. et al. (2008) Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and their Implementation. World Bank Publications, Washington, DC.Google Scholar
Philipson, T. J. & Posner, R. A. (2003) The Long-run growth in obesity as a function of technological change. Perspectives in Biology and Medicine 46(3), S87S107.Google Scholar
Rashad, A. S. & Sharaf, M. F. (2016) Economic growth and child malnutrition in Egypt? New evidence from national Demographic and Health Survey. Social Indicators Research, doi: 10.1007/s11205-016-1515-y.Google Scholar
Rashad, A. & Sharaf, M. (2017) Does maternal employment affect child nutrition status? New evidence from Egypt. University of Alberta Working Paper No. 2017-7.Google Scholar
Rashad, A. S. & Sharaf, M. F. (2015a) Catastrophic and impoverishing effects of out-of-pocket health expenditure: new evidence from Egypt. American Journal of Economics 5(5), 526533.Google Scholar
Rashad, A. S. & Sharaf, M. F. (2015b) Catastrophic economic consequences of healthcare payments: effects on poverty estimates in Egypt, Jordan, and Palestine. Economies 3(4), 216234.Google Scholar
Sharaf, M. F. & Rashad, A. S. (2016) Regional inequalities in child malnutrition in Egypt, Jordan, and Yemen: a Blinder–Oaxaca decomposition analysis. Health Economics Review 6(1), 23.Google Scholar
Sharaf, M. F. & Rashad, A. S (2017) Socioeconomic inequalities in infant mortality in Egypt: analyzing trends between 1995 and 2014. Social Indicators Research, doi.org/ 10.1007/s11205-017-1631-3.Google Scholar
Sweeney, S., Davenport, F. & Grace, K. (2013) Combining insights from quantile and ordinal regression: child malnutrition in Guatemala. Economics & Human Biology 11(2), 164177.Google Scholar
United Nations Children’s Fund. (2013) Improving Child Nutrition: The Achievable Imperative for Global Progress. UNICEF, New York.Google Scholar
United Nations Children’s Fund, WHO & The World Bank. (2012) World Bank Joint Child Malnutrition Estimates. UNICEF, New York, WHO, Geneva, and World Bank, Washington, DC.Google Scholar
Wamani, H., Åstrøm, A., Peterson, S., Tumwine, J. K. & Tylleskär, T. (2007) Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatrics 7(1), 1.Google Scholar