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

The dynamics of the Inequality of Children’s Malnutrition in Africa. A Comparative Analysis of a Regression-based Decomposition 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 well as variations of these disparities in time, is proposed. This investigation, mobilizing for each country 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 relative socioeconomic 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 among the poor households, the inequality in stunting is higher in the cities, where it sometimes increased. Nevertheless, some disparities of situations prevail according to countries. In this context, the nutritional statute of the children is positively correlated on the standard of living of the families – apprehended by an index of assets of the households –, on the educational level of the mothers, and with the urban localization, and conversely dependent to the age of the children. On the other hand, the sex of the children, the age of the mothers, the size 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 of the height-for-age of the children expressed as a percentage of the median of reference, shows that the welfare disparities of the households and, to a lesser extent, their spatial localization, are the most significant factors which contribute to raise the level of the inequality of the children’s malnutrition. On the other hand, the age of the children has an opposite effect in all the countries and for the various periods, while other elements have a more 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 of the children suggests several comments. First of all, the total decomposition indicates that the variation of the standard of living of the households played a significant role, while reducing or by accentuating the disparities of malnutrition. This factor was reinforced by the variation of the net effect of the age of the children, and was counterbalanced by the impact of the spatial localization. Then, the Oaxaca-type decomposition shows that in two countries out of three – 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 into account. This general observation prevails especially for the standard of living, the spatial localization, the instruction of the mothers and the size of the households. Lastly, total differential decomposition reveals an impact relatively contrasted of the variation of the coefficients of regression, averages of the determinants of malnutrition, and inequality of the determinants of malnutrition, on the changes of the inequality in stunting of the children. In addition, as a whole, the decomposition suggests that the relative weight of the averages of the determinants 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 the determinants of malnutrition on the latter, and the possibility of conflict between a « growth effect » and a « distributive effect ». Mots-clés : Inégalité de la malnutrition des enfants ; retard de croissance ; décomposition de régression