The consequences of childhood malnutrition throughout the globe are widespread and devastating.
The burden and costs that it places both on individuals and on society are enormous, making it imperative that actions be taken to reduce the high numbers of malnourished children. 167 million children under five years old were underweight in developing countries in 1995, with South Asia having the highest prevalence at 50 percent of the developing-country total (Gabriele & Schettino, 2008). Child stunting (low length-for-age) and wasting (low weight-for-height), as well as overnutrition, are all public health problems faced by developing countries. These factors vary greatly among rural and urban areas as a direct result of a multitude of complex factors related to socioeconomic status (Gabriele & Schettino, 2008). Moreover, rapid urbanization has created a larger heterogeneity of poverty and malnutrition (Ortiz et al., 2013). The need for effective interventions and policies adapted to rural and urban areas has thus increased drastically, necessitating a deeper understanding of the factors affecting the distribution of childhood malnutrition in rural and urban areas.
Little evidence of the factors that play into the urban-rural difference can be found, and much is lacking on the association these factors have with malnutrition. An analysis and comparison of the key determinants of malnutrition among children of urban and rural areas in Ecuador will thus be undertaken in order to determine appropriate strategies to address this issue. A study by Smith et al.
(2005) found that child nutritional status was significantly better in urban areas. The authors believe that urban malnutrition is lower due to favorable socioeconomic conditions leading to better-caring practices for children. But while food insecurity and malnutrition differ greatly, the nature of the determinants and the magnitudes of their effects were found to be nearly the same among rural and urban regions (Garrett & Ruel, 1999). Specifically, income, food prices, maternal education, and demographics, such as household size, affected malnutrition in both rural and urban areas (Garrett & Ruel, 1999). Research completed in different areas of Kenya determined that geographic variability between urban and rural centers was evident, with underweight children “tending to cluster in rural areas” (Pawloski et al.
, 2012). Herrador et al. (2014) noted that stunting was significantly higher in rural areas of Ethiopia, due to the number of children living in the house, years of schooling of the caretaker, consumption of food from animal sources, and literacy of head of household. Similarly, the urban-rural gap could be traced back to parental education and better household economic status of urban children in Malawi, and poor household wealth, family size, and sub-optimal feeding practices after birth in Eastern Uganda (Engebretsen et al.; 2008, Mussa, 2014).
The findings from each of these studies imply that in order to reduce the gap between malnutrition in rural and urban areas, a focus should be placed on improving the socioeconomic status in rural areas.Despite evidence of this geographical difference, child growth and nutrition in rural South Africa was found to be “shifting towards an urban-like profile,” but persisting prevalence of rural malnutrition suggests there have been “inadequate interventions to address food insecurity and undernutrition” (Kimani-Murage et al., 2010). Key areas for intervention to reduce malnutrition in rural and urban areas must be identified, and administrators “need not abandon the conceptual frameworks and toolkits they have developed for rural areas but can bring them along as they move to work in the city” (Garrett & Ruel, 1999). Both of these sources suggest both the continued use of intervention in rural areas as well as further implementation of policies in the growing urban population.Fifty percent of child mortality results from undernourishment, which is a direct result of socioeconomic status (Victora et al., 2003). Anyamele (2009) looked at the different socioeconomic determinants of child mortality in sub-Saharan Africa.
The study examined differences between urban and rural areas, finding that wealth and literacy were both significant factors explaining child mortality, thus contributing to child malnutrition.Considering this, Fotso et al. (2006) extensively explored the difference in malnutrition based on geographical location, finding that urban-rural differentials can be mainly explained by socioeconomic status; these socioeconomic inequalities are more pronounced in urban regions. Moreover, Fotso (2007) examined correlations between socioeconomic status and malnutrition in urban and rural sub-Saharan African regions. Factors affecting the distribution of malnutrition were documented, showing immense socioeconomic and cultural diversity between the countries.
In order to determine whether the rural-urban difference in stunting could be explained by socioeconomic factors; maternal education, household wealth, and community socioeconomic status were examined. Results indicated that rates of malnutrition declined with increasing socioeconomic status and that malnutrition was lower in urban than rural areas. Additionally, urban-rural stunting differences were abolished when socioeconomic status was controlled. An analytical paper will be composed using the data from Demographic and Health Surveys of countries in the sub-Saharan region of Africa. In the report, factors affecting the difference in malnutrition in urban and rural areas of sub-Saharan Africa will be discussed and compared to current data on malnutrition and its determinants. In other words, the rates of child malnutrition will be compared to the statistics of specific urban-rural differentials of malnutrition that have been found following a review of the literature.
Determinants will include community socioeconomic status, household wealth, mother’s education, and father’s education. Statistics regarding the socioeconomic determinants of malnutrition will be sourced from the United Nations Development Programme (UNDP) Human Development Report 2002, as well as the United Nation’s Department of Economic and Social Affair’s report World Urbanization Prospects: The 2003 Revision. I will use the World Health Organization Joint Child Malnutrition Estimates 2017 for data on current malnutrition rates. Through a comparison of current data and recent literature, it is the purpose of this paper to improve the understanding of determinants of child malnutrition and to further our knowledge on the strength of association of specific determinants with undernutrition in urban and rural areas. An analysis of the determinants that contribute to the urban-rural gap will be undertaken in order adequately address malnutrition in rural and urban sub-Saharan Africa.