Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)

Background: The double burden of malnutrition (DBM) in sub-Saharan Africa is a pressing public health issue, particularly among children under five years old. DBM encompasses both undernutrition (stunting) and overnutrition (overweight) within the same population, often shaped by socio-economic disp...

Full description

Saved in:
Bibliographic Details
Main Authors: Akim Tafadzwa Lukwa, Denis Okova, Paidamoyo Bodzo, Sikelela Charles Maseko, Melisa Bhebe, Folahanmi Tomiwa Akinsolu, Abodunrin Olunike, Emmanuella Nzeribe, Aggrey Siya, Admire Nyabunze, Charles Hongoro, Plaxcedes Chiwire
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2025-01-01
Series:Global Transitions
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2589791825000209
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849387110691241984
author Akim Tafadzwa Lukwa
Denis Okova
Paidamoyo Bodzo
Sikelela Charles Maseko
Melisa Bhebe
Folahanmi Tomiwa Akinsolu
Abodunrin Olunike
Emmanuella Nzeribe
Aggrey Siya
Admire Nyabunze
Charles Hongoro
Plaxcedes Chiwire
author_facet Akim Tafadzwa Lukwa
Denis Okova
Paidamoyo Bodzo
Sikelela Charles Maseko
Melisa Bhebe
Folahanmi Tomiwa Akinsolu
Abodunrin Olunike
Emmanuella Nzeribe
Aggrey Siya
Admire Nyabunze
Charles Hongoro
Plaxcedes Chiwire
author_sort Akim Tafadzwa Lukwa
collection DOAJ
description Background: The double burden of malnutrition (DBM) in sub-Saharan Africa is a pressing public health issue, particularly among children under five years old. DBM encompasses both undernutrition (stunting) and overnutrition (overweight) within the same population, often shaped by socio-economic disparities. Addressing DBM in early childhood is vital, as malnutrition can lead to long-term health, cognitive, and developmental challenges. Methods: Using nationally representative data from the Demographic and Health Surveys (DHS) across 20 sub-Saharan African countries, this study examines temporal socio-economic inequalities in DBM. Countries include Zimbabwe, Kenya, Nigeria, and Mozambique, among others. DBM was defined using anthropometric measures, while socio-economic status (SES) was categorized as poor, middle, or rich. Temporal trends were analyzed, and inequalities were quantified using Erreygers Normalized Concentration Indices (ENCI) and Theil indices to explore within- and between-group disparities by SES and urban/rural residence. Results: DBM prevalence across countries ranged from 0.2 % to 4.6 %. Declines were noted in Zimbabwe and Kenya. Socio-economic inequalities were significant, with overnutrition increasingly concentrated in wealthier households, while undernutrition remained prevalent among poorer populations. Theil index analyses revealed within-group disparities as the primary drivers of overall inequality, particularly in urban wealthier populations, though rural and low-SES groups also contributed significantly in countries like Senegal and Mali. Conclusion: DBM is still present in sub-Saharan Africa and is driven by socio-economic inequalities. Targeted interventions focusing on improving access to nutritious food, healthcare, and education for vulnerable populations, particularly in rural and low-SES groups, are essential to reduce malnutrition disparities.
format Article
id doaj-art-dec5f2b97b894e72b8495e234c034432
institution Kabale University
issn 2589-7918
language English
publishDate 2025-01-01
publisher KeAi Communications Co., Ltd.
record_format Article
series Global Transitions
spelling doaj-art-dec5f2b97b894e72b8495e234c0344322025-08-20T03:55:22ZengKeAi Communications Co., Ltd.Global Transitions2589-79182025-01-01726227510.1016/j.glt.2025.04.008Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)Akim Tafadzwa Lukwa0Denis Okova1Paidamoyo Bodzo2Sikelela Charles Maseko3Melisa Bhebe4Folahanmi Tomiwa Akinsolu5Abodunrin Olunike6Emmanuella Nzeribe7Aggrey Siya8Admire Nyabunze9Charles Hongoro10Plaxcedes Chiwire11Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Family Medicine, Family, Community and Emergency Care (FaCE), Faculty of Health Sciences, University of Cape Town, South Africa; Corresponding author. Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town. South Africa.Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Corresponding author.Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaHealth Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaHealth Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaCenter for Reproduction and Population Health Studies (CeRPHS), Nigerian Institute of Medical Research, Lagos, Nigeria; Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan, Oyo State, NigeriaCenter for Reproduction and Population Health Studies (CeRPHS), Nigerian Institute of Medical Research, Lagos, Nigeria; Department of Biostatistics and Epidemiology, Nanjing Medical University, Jiangning District, Nanjing, Jiangsu 211166, PR ChinaSydani Institute for research and Innovation, Sydani Group, Plot 1422 Independence Avenue, Central Business District, Abuja, NigeriaUganda Wildlife Research and Training Institute, P.O. Box 173, Kasese, Uganda; Makerere University School of Public Health, P.O. Box 7062, Kampala UgandaZimbabwe National Statistics Agency, Statistician (Macroeconomics Division), Kaguvi Building, Cnr Central Avenue/Fourth Street, Causeway, P.O. Box CY 342, Harare, ZimbabweDevelopmental, Capable and Ethical State, Human Sciences Research Council, Pretoria, 0001, Gauteng Province, South Africa; School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences, University of Pretoria, Pretoria, 0028, Gauteng Province, South AfricaWestern Cape Department: Health, Western Cape Province, P.O. Box 2060, Cape Town, 8000, South Africa; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, the NetherlandsBackground: The double burden of malnutrition (DBM) in sub-Saharan Africa is a pressing public health issue, particularly among children under five years old. DBM encompasses both undernutrition (stunting) and overnutrition (overweight) within the same population, often shaped by socio-economic disparities. Addressing DBM in early childhood is vital, as malnutrition can lead to long-term health, cognitive, and developmental challenges. Methods: Using nationally representative data from the Demographic and Health Surveys (DHS) across 20 sub-Saharan African countries, this study examines temporal socio-economic inequalities in DBM. Countries include Zimbabwe, Kenya, Nigeria, and Mozambique, among others. DBM was defined using anthropometric measures, while socio-economic status (SES) was categorized as poor, middle, or rich. Temporal trends were analyzed, and inequalities were quantified using Erreygers Normalized Concentration Indices (ENCI) and Theil indices to explore within- and between-group disparities by SES and urban/rural residence. Results: DBM prevalence across countries ranged from 0.2 % to 4.6 %. Declines were noted in Zimbabwe and Kenya. Socio-economic inequalities were significant, with overnutrition increasingly concentrated in wealthier households, while undernutrition remained prevalent among poorer populations. Theil index analyses revealed within-group disparities as the primary drivers of overall inequality, particularly in urban wealthier populations, though rural and low-SES groups also contributed significantly in countries like Senegal and Mali. Conclusion: DBM is still present in sub-Saharan Africa and is driven by socio-economic inequalities. Targeted interventions focusing on improving access to nutritious food, healthcare, and education for vulnerable populations, particularly in rural and low-SES groups, are essential to reduce malnutrition disparities.http://www.sciencedirect.com/science/article/pii/S2589791825000209Double burden of malnutrition (DBM)Socio-economic inequalitiesStuntingWastingOverweightUnder-five children
spellingShingle Akim Tafadzwa Lukwa
Denis Okova
Paidamoyo Bodzo
Sikelela Charles Maseko
Melisa Bhebe
Folahanmi Tomiwa Akinsolu
Abodunrin Olunike
Emmanuella Nzeribe
Aggrey Siya
Admire Nyabunze
Charles Hongoro
Plaxcedes Chiwire
Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)
Global Transitions
Double burden of malnutrition (DBM)
Socio-economic inequalities
Stunting
Wasting
Overweight
Under-five children
title Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)
title_full Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)
title_fullStr Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)
title_full_unstemmed Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)
title_short Temporal socio-economic inequalities in the double burden of malnutrition (DBM) among under-five Children: An analysis of within- and between-group disparities in 20 sub-Saharan African countries (2004–2024)
title_sort temporal socio economic inequalities in the double burden of malnutrition dbm among under five children an analysis of within and between group disparities in 20 sub saharan african countries 2004 2024
topic Double burden of malnutrition (DBM)
Socio-economic inequalities
Stunting
Wasting
Overweight
Under-five children
url http://www.sciencedirect.com/science/article/pii/S2589791825000209
work_keys_str_mv AT akimtafadzwalukwa temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT denisokova temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT paidamoyobodzo temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT sikelelacharlesmaseko temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT melisabhebe temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT folahanmitomiwaakinsolu temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT abodunrinolunike temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT emmanuellanzeribe temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT aggreysiya temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT admirenyabunze temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT charleshongoro temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024
AT plaxcedeschiwire temporalsocioeconomicinequalitiesinthedoubleburdenofmalnutritiondbmamongunderfivechildrenananalysisofwithinandbetweengroupdisparitiesin20subsaharanafricancountries20042024