Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis

Abstract Introduction Undernutrition, particularly stunting, and deficiency of micronutrients are prevalent nutrition-related problems in adolescent girls residing in low- and middle-income countries. The coexistence of both kinds of malnutrition typically impacts the most vulnerable people, such as...

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Main Authors: Tewodros Getaneh Alemu, Elsa Awoke Fentie, Daniel Gashaneh Belay, Desale Bihonegn Asmamaw, Ever Siyoum Shewarega, Wubshet Debebe Negash, Habitu Birhan Eshetu, Fantu Mamo Aragaw, Samrawit Mihret Fetene, Rediet Eristu Teklu
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21841-1
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author Tewodros Getaneh Alemu
Elsa Awoke Fentie
Daniel Gashaneh Belay
Desale Bihonegn Asmamaw
Ever Siyoum Shewarega
Wubshet Debebe Negash
Habitu Birhan Eshetu
Fantu Mamo Aragaw
Samrawit Mihret Fetene
Rediet Eristu Teklu
author_facet Tewodros Getaneh Alemu
Elsa Awoke Fentie
Daniel Gashaneh Belay
Desale Bihonegn Asmamaw
Ever Siyoum Shewarega
Wubshet Debebe Negash
Habitu Birhan Eshetu
Fantu Mamo Aragaw
Samrawit Mihret Fetene
Rediet Eristu Teklu
author_sort Tewodros Getaneh Alemu
collection DOAJ
description Abstract Introduction Undernutrition, particularly stunting, and deficiency of micronutrients are prevalent nutrition-related problems in adolescent girls residing in low- and middle-income countries. The coexistence of both kinds of malnutrition typically impacts the most vulnerable people, such as women of reproductive age, and it has a detrimental impact on maternal and child health. Besides, malnutrition and inequality form a vicious cycle that is hard to break without all-encompassing solutions that address every stage of the life cycle. Therefore, this study aimed to assess the presence of socioeconomic inequality in the co-occurrence of anemia and stunting and its contributors in sub-Saharan African countries. Methods A total of 39,712 weighted adolescent girl samples from DHS data SSA countries were included in the study. Erreygers normalized concentration index and its concentration curve were used to assess socioeconomic-related inequality in the co-occurrence of anemia and stunting. Decomposition analysis was performed to identify factors contributing to socioeconomic-related inequality. Results The weighted Erreygers normalized concentration index for co-occurrence of anemia and stunting was − 0.046 with Standard error = 0.0043 (P value < 0.0001); indicating that co-occurrence of anemia and stunting was disproportionately concentrated among the poor. The decomposition analysis revealed that wealth index, place of residency, adolescent educational level, and unimproved source of water were the major contributors to the pro-poor socioeconomic inequalities in the co-occurrence of anemia and stunting. Conclusion and recommendation In this study, there is a pro-poor inequality in the co-occurrence of anemia and stunting. Therefore, it’s vital to step up initiatives that improve access to education for adolescent girls, supply of safe water, and boost the economic standing of their country to enhance the level of living status of the population.
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spelling doaj-art-cb54e428b87f4de2b7dab0db5bfcc57b2025-08-20T02:13:15ZengBMCBMC Public Health1471-24582025-02-0125111010.1186/s12889-025-21841-1Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysisTewodros Getaneh Alemu0Elsa Awoke Fentie1Daniel Gashaneh Belay2Desale Bihonegn Asmamaw3Ever Siyoum Shewarega4Wubshet Debebe Negash5Habitu Birhan Eshetu6Fantu Mamo Aragaw7Samrawit Mihret Fetene8Rediet Eristu Teklu9Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of GondarDepartment of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Reproductive Health, School of Public Health, College of Medicine and Health Science, Dilla UniversityDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarAbstract Introduction Undernutrition, particularly stunting, and deficiency of micronutrients are prevalent nutrition-related problems in adolescent girls residing in low- and middle-income countries. The coexistence of both kinds of malnutrition typically impacts the most vulnerable people, such as women of reproductive age, and it has a detrimental impact on maternal and child health. Besides, malnutrition and inequality form a vicious cycle that is hard to break without all-encompassing solutions that address every stage of the life cycle. Therefore, this study aimed to assess the presence of socioeconomic inequality in the co-occurrence of anemia and stunting and its contributors in sub-Saharan African countries. Methods A total of 39,712 weighted adolescent girl samples from DHS data SSA countries were included in the study. Erreygers normalized concentration index and its concentration curve were used to assess socioeconomic-related inequality in the co-occurrence of anemia and stunting. Decomposition analysis was performed to identify factors contributing to socioeconomic-related inequality. Results The weighted Erreygers normalized concentration index for co-occurrence of anemia and stunting was − 0.046 with Standard error = 0.0043 (P value < 0.0001); indicating that co-occurrence of anemia and stunting was disproportionately concentrated among the poor. The decomposition analysis revealed that wealth index, place of residency, adolescent educational level, and unimproved source of water were the major contributors to the pro-poor socioeconomic inequalities in the co-occurrence of anemia and stunting. Conclusion and recommendation In this study, there is a pro-poor inequality in the co-occurrence of anemia and stunting. Therefore, it’s vital to step up initiatives that improve access to education for adolescent girls, supply of safe water, and boost the economic standing of their country to enhance the level of living status of the population.https://doi.org/10.1186/s12889-025-21841-1SocioeconomicInequalityCo-occurrenceAnemiaStuntingAdolescent girls
spellingShingle Tewodros Getaneh Alemu
Elsa Awoke Fentie
Daniel Gashaneh Belay
Desale Bihonegn Asmamaw
Ever Siyoum Shewarega
Wubshet Debebe Negash
Habitu Birhan Eshetu
Fantu Mamo Aragaw
Samrawit Mihret Fetene
Rediet Eristu Teklu
Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis
BMC Public Health
Socioeconomic
Inequality
Co-occurrence
Anemia
Stunting
Adolescent girls
title Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis
title_full Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis
title_fullStr Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis
title_full_unstemmed Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis
title_short Socioeconomic inequality in the co-occurrence of anemia and stunting among adolescent girls aged 15–19 years in Sub-Saharan African countries: a decomposition analysis
title_sort socioeconomic inequality in the co occurrence of anemia and stunting among adolescent girls aged 15 19 years in sub saharan african countries a decomposition analysis
topic Socioeconomic
Inequality
Co-occurrence
Anemia
Stunting
Adolescent girls
url https://doi.org/10.1186/s12889-025-21841-1
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