Background: Despite increased economic growth and development, and existence of various policies and
interventions aimed at improving food security and nutrition, majority of countries in sub-Saharan Africa have very
high levels of child malnutrition. The prevalence of stunting, an indicator of chronic malnutrition, is especially high.
Methods: In this paper, we use Demographic and Health Survey datasets from three countries in the region that
obtained middle-income status over the last decade (Ghana, Kenya and Zambia), to provide a comparative
quantitative assessment of stunting levels, and examine patterns in stunting inequalities between 2007 and 2014.
Results: Our analyses reveal that stunting rates decreased in all three countries over the study period, but are still
high. In Zambia, 40% of under 5-year olds are stunted, compared to 26% in Kenya and 19% in Ghana. In all three
countries, male children and those living in the poorest households have significantly higher levels of stunting. We also
observe stark inequalities across socio-economic status, and show that these inequalities have increased over time.
Conclusions: Our results reveal that even with economic gains at the national level, there is need for continued focus
on improving the socio-economic levels of the poorest households, if child nutritional outcomes are to improve.
Keywords: Inequality, Stunting, Children, Malnutrition, Sub-Saharan Africa, Concentration indices, Concentration curves,Middle-income, Ghana, Kenya, Zambia
In this report, we examine the determinants of child malnutrition using the Birth to Twenty data, a cohort study of children born in Soweto-Johannesburg in 1990. In particular, we focus on the causes of low height-for-age, or stunting, at age two, the measure most commonly used to capture chronic undernutrition in ...