Inequality in child nutrition in Nepal: A decomposition analysis

Abstract

The nutrition outcomes vary across different regions in the developing countries, socioeconomic factors are drivers for inequality across urban and rural regions. Nepal is facing migration from from rural to urban by large and in recent times health facilities and nutrition intakes in two differently populated regions are varying. Nutrition intake and outcome leading to growth of human capital have different factors associated with them in these two regions. The nutrition outcomes measured in terms of height for age z scores and prevalence or stunting are often found to be concentrated among poor groups and household’s access to health and sanitation facilities. The concentration indices were drawn to show whether the inequality across rural and urban group of children prevailed. The logistic regression showed the likelihood of stunting, wasting and underweight across the different categories of dependent variables. The gap across nutritional outcomes were decomposed using linear decomposition technique and Oaxaca Blinder approach with Height for Age(HAZ), Weight for Age and Weight for Height(WHZ) as outcome variable. For outcome variables as Stunting, wasting and underweight we decomposed results with non-linear based Fairlie decomposition technique. The results showed that stunting and underweight have higher inequality in rural group and lower inequality for urban group. Logistic regression showed children belonging to Lumbini province were likely to suffer wasting and children from Karnali province had higher chances of stunting to children from other provinces. Similarly, the likelihood of stunting and underweight also remained significant among the poorer household group children. The likelihood of stunting and underweight is also significant for children belonging to household with no toilet facility. From linear based Oaxaca Blinder decomposition mother’s education contributes 38% and 36% to the endowment induced urban rural gap in HAZ and WAZ outcome. Wealth index also contributes to urban rural gap in HAZ and WAZ by 50%. Maternal autonomy contributes to endowment induced gap in urban rural HAZ by 24%, anemia only shows significant result at 1 %

however, in contribution to urban rural gap WAZ score. The non linear decomposition results showed anemia as major contributor to wasting outcomes and toilet facility to all nutritional undernutrition outcomes.