Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa

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dc.contributor.authorAlaba, Olufunke A
dc.contributor.authorHongoro, Charles
dc.contributor.authorThulare, Aquina
dc.contributor.authorLukwa, Akim Tafadzwa
dc.date.accessioned2021-10-11T09:53:49Z
dc.date.available2021-10-11T09:53:49Z
dc.date.issued2021-07-02
dc.date.updated2021-07-08T14:23:37Z
dc.description.abstractBackground: The United Nations’ 2030 Agenda for Sustainable Development argues for the combating of health inequalities within and among countries, advocating for “leaving no one behind”. However, child mortality in developing countries is still high and mainly driven by lack of immunization, food insecurity and nutritional deficiency. The confounding problem is the existence of socioeconomic inequalities among the richest and poorest. Thus, comparing South Africa’s and India’s Demographic and Health Surveys (DHS) of 2015/16, this study examines socioeconomic inequalities in under-five children’s health and its associated factors using three child health indications: full immunization coverage, food insecurity and malnutrition. Methods: Erreygers Normalized concentration indices were computed to show how immunization coverage, food insecurity and malnutrition in children varied across socioeconomic groups (household wealth). Concentration curves were plotted to show the cumulative share of immunization coverage, food insecurity and malnutrition against the cumulative share of children ranked from poorest to richest. Subsequent decomposition analysis identified vital factors underpinning the observed socioeconomic inequalities. Results: The results confirm a strong socioeconomic gradient in food security and malnutrition in India and South Africa. However, while full childhood immunization in South Africa was pro-poor (−0.0236), in India, it was pro-rich (0.1640). Decomposed results reported socioeconomic status, residence, mother’s education, and mother’s age as primary drivers of health inequalities in full immunization, food security and nutrition among children in both countries. Conclusions: The main drivers of the socioeconomic inequalities in both countries across the child health outcomes (full immunization, food insecurity and malnutrition) are socioeconomic status, residence, mother’s education, and mother’s age. In conclusion, if socioeconomic inequalities in children’s health especially food insecurity and malnutrition in South Africa; food insecurity, malnutrition and immunization in India are not addressed then definitely “some under-five children will be left behind”.en_US
dc.identifierdoi: 10.3390/ijerph18137114
dc.identifier.apacitationAlaba, O. A., Hongoro, C., Thulare, A., & Lukwa, A. T. (2021). Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa. <i>International Journal of Environmental Research and Public Health</i>, 18(13), 7114. http://hdl.handle.net/11427/35158en_ZA
dc.identifier.chicagocitationAlaba, Olufunke A, Charles Hongoro, Aquina Thulare, and Akim Tafadzwa Lukwa "Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa." <i>International Journal of Environmental Research and Public Health</i> 18, 13. (2021): 7114. http://hdl.handle.net/11427/35158en_ZA
dc.identifier.citationAlaba, O.A., Hongoro, C., Thulare, A. & Lukwa, A.T. 2021. Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa. <i>International Journal of Environmental Research and Public Health.</i> 18(13):7114. http://hdl.handle.net/11427/35158en_ZA
dc.identifier.ris TY - Journal Article AU - Alaba, Olufunke A AU - Hongoro, Charles AU - Thulare, Aquina AU - Lukwa, Akim Tafadzwa AB - Background: The United Nations’ 2030 Agenda for Sustainable Development argues for the combating of health inequalities within and among countries, advocating for “leaving no one behind”. However, child mortality in developing countries is still high and mainly driven by lack of immunization, food insecurity and nutritional deficiency. The confounding problem is the existence of socioeconomic inequalities among the richest and poorest. Thus, comparing South Africa’s and India’s Demographic and Health Surveys (DHS) of 2015/16, this study examines socioeconomic inequalities in under-five children’s health and its associated factors using three child health indications: full immunization coverage, food insecurity and malnutrition. Methods: Erreygers Normalized concentration indices were computed to show how immunization coverage, food insecurity and malnutrition in children varied across socioeconomic groups (household wealth). Concentration curves were plotted to show the cumulative share of immunization coverage, food insecurity and malnutrition against the cumulative share of children ranked from poorest to richest. Subsequent decomposition analysis identified vital factors underpinning the observed socioeconomic inequalities. Results: The results confirm a strong socioeconomic gradient in food security and malnutrition in India and South Africa. However, while full childhood immunization in South Africa was pro-poor (−0.0236), in India, it was pro-rich (0.1640). Decomposed results reported socioeconomic status, residence, mother’s education, and mother’s age as primary drivers of health inequalities in full immunization, food security and nutrition among children in both countries. Conclusions: The main drivers of the socioeconomic inequalities in both countries across the child health outcomes (full immunization, food insecurity and malnutrition) are socioeconomic status, residence, mother’s education, and mother’s age. In conclusion, if socioeconomic inequalities in children’s health especially food insecurity and malnutrition in South Africa; food insecurity, malnutrition and immunization in India are not addressed then definitely “some under-five children will be left behind”. DA - 2021-07-02 DB - OpenUCT DP - University of Cape Town IS - 13 J1 - International Journal of Environmental Research and Public Health LK - https://open.uct.ac.za PY - 2021 T1 - Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa TI - Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa UR - http://hdl.handle.net/11427/35158 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35158
dc.identifier.vancouvercitationAlaba OA, Hongoro C, Thulare A, Lukwa AT. Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa. International Journal of Environmental Research and Public Health. 2021;18(13):7114. http://hdl.handle.net/11427/35158.en_ZA
dc.language.isoenen_US
dc.publisher.departmentDepartment of Public Health and Family Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceInternational Journal of Environmental Research and Public Healthen_US
dc.source.journalissue13en_US
dc.source.journalvolume18en_US
dc.source.pagination7114en_US
dc.source.urihttps://www.mdpi.com/journal/ijerph
dc.titleLeaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africaen_US
dc.typeJournal Articleen_US
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