Dynamic modeling of child malnutrition and morbidity: Evidence from Nairobi’s slums

This paper contributes to the analysis of the relation between child malnutrition and morbidity by providing a comprehensive assessment of the mutual impacts of the two phenomena. We investigate the synergistic relationship between malnutrition and morbidity among infants in Nairobi's poor urban settlements. We use data from 3,459 children enrolled in an ongoing Maternal and Child Health Longitudinal study of the Africa Population and Health Research Center (APHRC) in Korogocho and Viwandani slums of Nairobi. We consider a joint dynamic framework for our analysis. The dynamic framework allows accounting for persistence in a given nutritional or morbidity status. Beside the self dynamics patterns in malnutrition and morbidity, our analytical framework also account for dynamic cross-effects between the two phenomena. We address the econometric challenges associated to our analytical framework using a bivariate random effects dynamic probit model, a bivariate extension of Wooldridge (2005) approach. This paper contributes to the literature in two ways. First, we propose an analytical framework that examines both dynamics of malnutrition and morbidity and analyze the contamination process between them, which permits to investigate the interactions existing across the two problems. Second, we contribute to shed light on a very important empirical question: does malnutrition interact identically with all common forms of morbidity, or is its effects stronger for some types of morbidity than others? Answer to this question may have important policy implications.