Stunted Too Early: Analysis of the Cambodia and Kenya 2014 Demographic and Health Survey Data

Abstract

Background: Child stunting reflects chronic under-nutrition, which often begins before birth and is almost irreversible after the second year of life. Globally, by 2018, an estimated 140 million children under the age of 5 years were stunted. Over one-third each lived in South East Asia (34.4%) and Eastern and South Africa (33.6%). This condition puts children at disadvantages due to partly irreversible physical and cognitive damage. This poorly nourished beginning has consequences that include persistent poverty, worsening inequality, higher health care costs and weaker national economies. Early detection of stunting is a key factor to any prevention strategy.

 Objective: To examine the relationship between child, maternal, household, and gender inequality characteristics with early onset of child stunting in Kenya and Cambodia.

 Methods: The study analyzed data from the 2014 Demographic and Health Surveys (DHS) in Kenya and Cambodia for children under age 2. Bivariate and logistic regression analyses were performed to find associations between the variables and child stunting.

 Results: The prevalence of stunting among children under age 2 in Kenya was 22%, and in Cambodia, 25%. Child’s age, perceived birth size, family wealth status, and region of residence were significantly associated with stunting. In both countries children from the richest households had 0.4 times lower odds of being stunted compared with those from the poorest households. In Kenya, female children had 0.6 times lower odds of being stunted compared with male children. In Cambodia, children from rural areas had 0.6 times lower odds of being stunted compared with those from urban areas, while children whose mothers were underweight had 1.7 times higher odds of being stunted than children whose mothers were not underweight. In both countries, there was general lack of a strong and significant relationship between the DHS indicators of gender inequality and child stunting.

 Conclusions: Children’s characteristics, household wealth and maternal underweight were more important in predicting stunting in these children under two years of age than factors related to gender inequality. A more extensive analysis of future DHS data that includes other aspects of gender inequality such as decisions on choice and preparation of food, purchase of household goods, as well as gender-based barriers to provision of child care might provide additional insights on that potential determinant of early stunting.