WHO | Socioeconomic inequality in malnutrition in developing countries

Epidemiological evidence points to a small set of primary causes of child mortality that are the main killers of children aged less than 5 years: pneumonia, diarrhoea, low birth weight, asphyxia and, in some parts of the world, HIV and malaria. Malnutrition is the underlying cause of one out of every two such deaths. The evidence also shows that child death and malnutrition are not equally distributed throughout the world. They cluster in sub-Saharan Africa and south Asia, and in poor communities within these regions. Disparities in health outcomes between the poor and the rich are increasingly attracting attention from researchers and policy-makers, thereby fostering a substantial growth in the literature on health equity. “Socioeconomic inequality” in malnutrition refers to the degree to which childhood malnutrition rates differ between more and less socially and economically advantaged groups. This is different from “pure inequality”, which takes into account all factors influencing childhood malnutrition. The available literature documenting socioeconomic inequality in malnutrition focuses mainly on individual countries or regions. At a more global level, Wagstaff and Watanabe provided evidence on socioeconomic inequality in malnutrition across 20 developing countries. Other relevant cross-country studies include those of Pradhan et al., who describe total inequality, and Smith et al., who describe inequalities between urban and rural populations. The latter two studies, however, provide no evidence on socioeconomic inequality within developing countries.