Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis
Abstract Introduction Adolescent undernutrition is a key factor influencing health outcomes. An undernourished adolescent girl who begins pregnancy with inadequate nutrient reserves often delivers low birth weight or growth-restricted infants, who is more prone to metabolic disorders in adulthood an...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22807-z |
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| author | Ever Siyoum Shewarega Tsion Mulat Tebeje Makida Berhan Alem Mulugeta Lulie Assres Elsa Awoke Fentie |
| author_facet | Ever Siyoum Shewarega Tsion Mulat Tebeje Makida Berhan Alem Mulugeta Lulie Assres Elsa Awoke Fentie |
| author_sort | Ever Siyoum Shewarega |
| collection | DOAJ |
| description | Abstract Introduction Adolescent undernutrition is a key factor influencing health outcomes. An undernourished adolescent girl who begins pregnancy with inadequate nutrient reserves often delivers low birth weight or growth-restricted infants, who is more prone to metabolic disorders in adulthood and faces higher risks of infant mortality and lower chances of survival. There is limited information on socioeconomic inequality in undernutrition among late female adolescent girls in sub-Saharan Africa. Therefore, this study aimed to assess the presence of socioeconomic inequality in undernutrition and its contributors in sub-Saharan African countries. Methods This study was based on recent Demographic and Health Survey of 30 Sub-Saharan African countries from 2010 to 2020. A total weighted sample of 45,598 late female adolescents was included. The Erreygers normalized concentration index and its concentration curve were applied to assess socioeconomic-related inequality in undernutrition. Decomposition analysis was conducted to identify factors contributing to socioeconomic related inequality. Results The weighted Erreygers normalized concentration index for undernutrition was − 0.070 with Standard error = 0.0053 (P value < 0.0001); this revealed that undernutrition was disproportionately concentrated among the poor (pro-poor). The weighted ECI values for each country ranged from − 0.0356 in Liberia to -0.1981 in Burkina Faso, with Kenya (-0.1343), Namibia (-0.1207), and Nigeria (-0.1161) exhibiting the highest levels of inequality after Burkina Faso. The decomposition analysis revealed that wealth index (62.79%), educational level (55.84%), media exposure (40.53%) and place of residence (17.00%) were the major contributors for the pro-poor socioeconomic inequalities in undernutrition. Conclusion and recommendation This study revealed a small but statistically significant pro-poor inequality in undernutrition among late female adolescents. Therefore, interventions should be prioritized in countries with high pro-poor inequality in undernutrition, such as Burkina Faso, Kenya, Nigeria, Namibia, and Burundi. Targeting disadvantaged late female adolescents in these countries through measures like women’s economic empowerment and mass media awareness campaigns can help reduce these inequalities and contribute to achieving universal health coverage. |
| format | Article |
| id | doaj-art-5e07303f095641efb02ddce580932b84 |
| institution | OA Journals |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-5e07303f095641efb02ddce580932b842025-08-20T02:20:01ZengBMCBMC Public Health1471-24582025-04-0125111110.1186/s12889-025-22807-zSocioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysisEver Siyoum Shewarega0Tsion Mulat Tebeje1Makida Berhan Alem2Mulugeta Lulie Assres3Elsa Awoke Fentie4Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Dilla UniversitySchool of Public Health, College of Health Science and Medicine, Dilla UniversityDepartment of Reproductive, Maternal, child, Adolescent and youth program, Amref Health AfricaDepartment of internal medicine, Ras desta memorial hospitalDepartment of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of GondarAbstract Introduction Adolescent undernutrition is a key factor influencing health outcomes. An undernourished adolescent girl who begins pregnancy with inadequate nutrient reserves often delivers low birth weight or growth-restricted infants, who is more prone to metabolic disorders in adulthood and faces higher risks of infant mortality and lower chances of survival. There is limited information on socioeconomic inequality in undernutrition among late female adolescent girls in sub-Saharan Africa. Therefore, this study aimed to assess the presence of socioeconomic inequality in undernutrition and its contributors in sub-Saharan African countries. Methods This study was based on recent Demographic and Health Survey of 30 Sub-Saharan African countries from 2010 to 2020. A total weighted sample of 45,598 late female adolescents was included. The Erreygers normalized concentration index and its concentration curve were applied to assess socioeconomic-related inequality in undernutrition. Decomposition analysis was conducted to identify factors contributing to socioeconomic related inequality. Results The weighted Erreygers normalized concentration index for undernutrition was − 0.070 with Standard error = 0.0053 (P value < 0.0001); this revealed that undernutrition was disproportionately concentrated among the poor (pro-poor). The weighted ECI values for each country ranged from − 0.0356 in Liberia to -0.1981 in Burkina Faso, with Kenya (-0.1343), Namibia (-0.1207), and Nigeria (-0.1161) exhibiting the highest levels of inequality after Burkina Faso. The decomposition analysis revealed that wealth index (62.79%), educational level (55.84%), media exposure (40.53%) and place of residence (17.00%) were the major contributors for the pro-poor socioeconomic inequalities in undernutrition. Conclusion and recommendation This study revealed a small but statistically significant pro-poor inequality in undernutrition among late female adolescents. Therefore, interventions should be prioritized in countries with high pro-poor inequality in undernutrition, such as Burkina Faso, Kenya, Nigeria, Namibia, and Burundi. Targeting disadvantaged late female adolescents in these countries through measures like women’s economic empowerment and mass media awareness campaigns can help reduce these inequalities and contribute to achieving universal health coverage.https://doi.org/10.1186/s12889-025-22807-zUndernutritionSocioeconomic inequalityLate female adolescentSub-Saharan Africa |
| spellingShingle | Ever Siyoum Shewarega Tsion Mulat Tebeje Makida Berhan Alem Mulugeta Lulie Assres Elsa Awoke Fentie Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis BMC Public Health Undernutrition Socioeconomic inequality Late female adolescent Sub-Saharan Africa |
| title | Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis |
| title_full | Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis |
| title_fullStr | Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis |
| title_full_unstemmed | Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis |
| title_short | Socioeconomic inequality in undernutrition among late female adolescent in sub-Saharan African countries: a decomposition analysis |
| title_sort | socioeconomic inequality in undernutrition among late female adolescent in sub saharan african countries a decomposition analysis |
| topic | Undernutrition Socioeconomic inequality Late female adolescent Sub-Saharan Africa |
| url | https://doi.org/10.1186/s12889-025-22807-z |
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