IDEAS home Printed from https://ideas.repec.org/p/fpr/fcnddp/176.html
   My bibliography  Save this paper

Why is child malnutrition lower in urban than rural areas?

Author

Listed:
  • Smith, Lisa C.
  • Ruel, Marie T.
  • Ndiaye, Aida

Abstract

"While ample evidence documents that urban children generally have better nutritional status than their rural counterparts, recent research suggests that urban malnutrition is on the rise. The environment, choices, and opportunities of urbanites differ greatly from those of rural dwellers' from employment conditions to social and family networks to access to health care and other services. Given these differences, understanding the relative importance of the various determinants of child malnutrition in urban and rural areas and especially whether they differ is key to designing context-relevant, effective program and policy responses for stemming malnutrition. This study uses Demographic and Health Survey data from 36 developing countries to address the question of whether the socioeconomic determinants of child nutritional status differ across urban and rural areas. The purpose is to answer the broader question of why child malnutrition rates are lower in urban areas. The socioeconomic determinants examined are women's education, women's status, access to safe water and sanitation, and household economic status. The analysis finds little evidence of differences in the nature of the socioeconomic determinants or in the strength of their associations with child nutritional status across urban and rural areas. As expected, however, it documents marked differences in the levels of these determinants in favor of urban areas. Large gaps in favor of urban areas are also found in the levels of key proximate determinants of child nutritional status, especially maternal prenatal and birthing care, quality of complementary feeding, and immunization of children. The conclusion is that better nutritional status of urban children is probably due to the cumulative effect of a series of more favorable socioeconomic conditions, which, in turn, seems to lead to better caring practices for children and their mothers. Given that the nature of the determinants of child nutritional status is largely the same across urban and rural areas, the same program and policy framework can be used to stem malnutrition in both. Efforts to alleviate the most critical socioeconomic constraints specific to the different environments should continue to be prioritized." Authors' Abstract

Suggested Citation

  • Smith, Lisa C. & Ruel, Marie T. & Ndiaye, Aida, 2004. "Why is child malnutrition lower in urban than rural areas?," FCND discussion papers 176, International Food Policy Research Institute (IFPRI).
    • Handle: RePEc:fpr:fcnddp:176
    as

    Download full text from publisher

    File URL: https://www.ifpri.org/cdmref/p15738coll2/id/63532/filename/63533.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Ruel, Marie T. & Haddad, Lawrence & Garrett, James L., 1999. "Some Urban Facts of Life: Implications for Research and Policy," World Development, Elsevier, vol. 27(11), pages 1917-1938, November.
    2. Garrett, James L. & Ruel, Marie T., 1999. "Are Determinants of Rural and Urban Food Security and Nutritional Status Different? Some Insights from Mozambique," World Development, Elsevier, vol. 27(11), pages 1955-1975, November.
    3. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
    4. Arimond, Mary & Ruel, Marie T., 2002. "Progress in developing an infant and child feeding index," FCND discussion papers 143, International Food Policy Research Institute (IFPRI).
    5. Armar-Klemesu, Margaret & Ruel, Marie T. & Maxwell, Daniel G. & Levin, Carol E. & Morris, Saul Sutkover, 2000. "The constraints to good child care practices in Accra," FCND briefs 81, International Food Policy Research Institute (IFPRI).
    6. Engle, Patrice L. & Menon, Purnima & Haddad, Lawrence James, 1996. "Care and nutrition," FCND discussion papers 18, International Food Policy Research Institute (IFPRI).
    7. Cleland, John G. & van Ginneken, Jerome K., 1988. "Maternal education and child survival in developing countries: The search for pathways of influence," Social Science & Medicine, Elsevier, vol. 27(12), pages 1357-1368, January.
    8. Haddad, Lawrence James & Adato, Michelle, 2001. "How effectively do public works programs transfer benefits to the poor?," FCND discussion papers 108, International Food Policy Research Institute (IFPRI).
    9. Haddad, Lawrence & Ruel, Marie T. & Garrett, James L., 1999. "Are Urban Poverty and Undernutrition Growing? Some Newly Assembled Evidence," World Development, Elsevier, vol. 27(11), pages 1891-1904, November.
    10. Garrett, James L. & Ruel, Marie T., 1999. "Are determinants of rural and urban food security and nutritional status different?," FCND discussion papers 65, International Food Policy Research Institute (IFPRI).
    11. Ruel, Marie T. & Garrett, James L. & Morris, Saul Sutkover & Maxwell, Daniel G. & Oshaug, Arne & Engle, Patrice L. & Menon, Purnima & Slack, Alison T. & Haddad, Lawrence James, 1998. "Urban challenges to food and nutrition security," FCND discussion papers 51, International Food Policy Research Institute (IFPRI).
    12. Ruel, Marie T. & de la Briere, Benedicte & Hallman, Kelly & Quisumbing, Agnes R. & Coj, Nora, 2002. "Does subsidized childcare help poor working women in urban areas?," FCND briefs 131, International Food Policy Research Institute (IFPRI).
    13. Engle, Patrice L. & Menon, Purnima & Haddad, Lawrence, 1999. "Care and Nutrition: Concepts and Measurement," World Development, Elsevier, vol. 27(8), pages 1309-1337, August.
    14. Menon, Purnima & Ruel, Marie T. & Morris, Saul Sutkover, 2000. "Socio-economic differentials in child stunting are consistently larger in urban than rural areas," FCND briefs 97, International Food Policy Research Institute (IFPRI).
    15. Morris, Saul S. & Levin, Carol E. & Armar-Klemesu, Margaret & Maxwell, Daniel & Ruel, Marie T., 1999. "Does Geographic Targeting of Nutrition Interventions Make Sense in Cities? Evidence from Abidjan and Accra," World Development, Elsevier, vol. 27(11), pages 2011-2019, November.
    16. Smith, Lisa C. & Ramakrishnan, Usha & Ndiaye, Aida & Haddad, Lawrence James & Martorell, Reynaldo, 2003. "The importance of women's status for child nutrition in developing countries:," Research reports 131, International Food Policy Research Institute (IFPRI).
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Cruz-Garcia, Gisella S. & Sachet, Erwan & Vanegas, Martha & Piispanen, Kyle, 2016. "Are the major imperatives of food security missing in ecosystem services research?," Ecosystem Services, Elsevier, vol. 19(C), pages 19-31.
    2. Derek Headey & David Stifel & Liangzhi You & Zhe Guo, 2018. "Remoteness, urbanization, and child nutrition in sub‐Saharan Africa," Agricultural Economics, International Association of Agricultural Economists, vol. 49(6), pages 765-775, November.
    3. José Cuesta & Suzanne Duryea & Fidel Jaramillo & Marcos Robles, 2010. "Distributive impacts of the food price crisis in the Andean region," Journal of International Development, John Wiley & Sons, Ltd., vol. 22(7), pages 846-865.
    4. Patrick GUILLAUMONT & Christopher GRIGORIOU, 2008. "Child Mortality Reacts to Relative Prices," Working Papers 200814, CERDI.
    5. Bhagowalia, Priya & Headey, Derek D. & Kadiyala, Suneetha, 2012. "Agriculture, Income, and Nutrition Linkages in India: Insights from a Nationally Representative Survey:," IFPRI discussion papers 1195, International Food Policy Research Institute (IFPRI).
    6. Ecker, Olivier & Mabiso, Athur & Kennedy, Adam & Diao, Xinshen 22905, 2011. "Making agriculture pro-nutrition: Opportunities in Tanzania," IFPRI discussion papers 1124, International Food Policy Research Institute (IFPRI).
    7. Richard Longhurst & Inka Barnett & Nabeela Ahmed, 2015. "Determinants of Child Undernutrition in Bangladesh: Literature Review," Working Papers id:7910, eSocialSciences.
    8. Headey, Derek & Chiu, Alice & Kadiyala, Suneetha, 2011. "Agriculture's role in the Indian enigma: Help or hindrance to the undernutrition crisis?," IFPRI discussion papers 1085, International Food Policy Research Institute (IFPRI).
    9. Rudra Narayan Mishra, 2006. "Dynamics of caste-based deprivation in child under-nutrition in India," Centre for Development Studies, Trivendrum Working Papers 380, Centre for Development Studies, Trivendrum, India.
    10. Fanaye Tadesse & Headey, Derek, 2011. "Urbanization and Fertility Rates in Ethiopia," Ethiopian Journal of Economics, Ethiopian Economics Association, vol. 19(2), November.
    11. Ulimwengu, John M. & Roberts, Cleo & Randriamamonjy, Josee, 2012. "Resource-Rich Yet Malnourished: Analysis of the demand for food nutrients in the Democratic Republic of Congo," IFPRI discussion papers 1154, International Food Policy Research Institute (IFPRI).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Smith, Lisa C. & Ruel, Marie T. & Ndiaye, Aida, 2005. "Why Is Child Malnutrition Lower in Urban Than in Rural Areas? Evidence from 36 Developing Countries," World Development, Elsevier, vol. 33(8), pages 1285-1305, August.
    2. Fatma El-Hamidi & Ragui Assaad & Ahmed Akhter, 2000. "The Determinants of Employment Status in Egypt," Working Paper 269, Department of Economics, University of Pittsburgh, revised Sep 2006.
    3. Ruel, Marie T. & Menon, Purnima, 2002. "Creating a child feeding index using the demographic and health surveys," FCND briefs 130, International Food Policy Research Institute (IFPRI).
    4. Gutner, Tammi, 1999. "The political economy of Food subsidy reform in Egypt," FCND briefs 1, International Food Policy Research Institute (IFPRI).
    5. Marie T. Ruel & James L. Garrett, 2004. "Features of Urban Food and Nutrition Security and Considerations for Successful Urban Programming," The Electronic Journal of Agricultural and Development Economics, Food and Agriculture Organization of the United Nations, vol. 1(2), pages 242-271.
    6. Ruel, Marie T. & Levin, Carol E. & Armar-Klemesu, Margaret & Maxwell, Daniel & Morris, Saul S., 1999. "Good Care Practices Can Mitigate the Negative Effects of Poverty and Low Maternal Schooling on Children's Nutritional Status: Evidence from Accra," World Development, Elsevier, vol. 27(11), pages 1993-2009, November.
    7. Ruel, Marie T. & Levin, Carol E. & Armar-Klemesu, Margaret & Maxwell, Daniel G. & Morris, Saul Sutkover, 1999. "Good care practices can mitigate the negative effects of poverty and low maternal schooling on children's nutritional status," FCND discussion papers 62, International Food Policy Research Institute (IFPRI).
    8. Ruel, Marie T. & Armar-Klemesu, Margaret & Arimond, Mary, 2001. "A multiple-method approach to studying childcare in an urban environment," FCND discussion papers 116, International Food Policy Research Institute (IFPRI).
    9. Rafael de Sousa Camelo & Priscilla Albuquerque Tavares & Carlos César Santejo Saiani, 2009. "Alimentação, Nutrição e Saúde em Programas de Transferência de Renda: Evidências para o Programa Bolsa Família," Economia, ANPEC - Associação Nacional dos Centros de Pós-Graduação em Economia [Brazilian Association of Graduate Programs in Economics], vol. 10(4), pages 685-713.
    10. Ruel, Marie T. & Haddad, Lawrence James & Garrett, James L., 1999. "Some urban facts of life," FCND discussion papers 64, International Food Policy Research Institute (IFPRI).
    11. Richard Mussa, 2014. "A matching decomposition of the rural–urban difference in malnutrition in Malawi," Health Economics Review, Springer, vol. 4(1), pages 1-10, December.
    12. Mulubrhan Amare & Channing Arndt & Kibrom A Abay & Todd Benson, 2020. "Urbanization and Child Nutritional Outcomes," The World Bank Economic Review, World Bank, vol. 34(1), pages 63-74.
    13. Mesbah Fathy Sharaf & Ahmed Shoukry Rashad, 2016. "Regional inequalities in child malnutrition in Egypt, Jordan, and Yemen: a Blinder-Oaxaca decomposition analysis," Health Economics Review, Springer, vol. 6(1), pages 1-11, December.
    14. Jean-Pierre Lachaud, 2004. "Urbanisation, malnutrition des enfants et sexe au Burkina Faso : une analyse économétrique spatiale," Revue d’économie du développement, De Boeck Université, vol. 12(1), pages 35-70.
    15. Ecker, Olivier & Mabiso, Athur & Kennedy, Adam & Diao, Xinshen 22905, 2011. "Making agriculture pro-nutrition: Opportunities in Tanzania," IFPRI discussion papers 1124, International Food Policy Research Institute (IFPRI).
    16. Ellen van de Poel & Owen O'Donnell & Eddy van Doorslaer, 2007. "Are Urban Children really healthier?," Tinbergen Institute Discussion Papers 07-035/3, Tinbergen Institute.
    17. Floro, Maria Sagrario & Bali Swain, Ranjula, 2013. "Food Security, Gender, and Occupational Choice among Urban Low-Income Households," World Development, Elsevier, vol. 42(C), pages 89-99.
    18. Engle, Patrice L. & Menon, Purnima & Garrett, James L. & Slack, Alison T., 1997. "Developing a research and action agenda for examining urbanization and caregiving," FCND discussion papers 28, International Food Policy Research Institute (IFPRI).
    19. Wiesmann, Doris, 2006. "A global hunger index: measurement concept, ranking of countries, and trends," FCND discussion papers 212, International Food Policy Research Institute (IFPRI).
    20. Van de Poel, Ellen & O'Donnell, Owen & Van Doorslaer, Eddy, 2007. "Are urban children really healthier? Evidence from 47 developing countries," Social Science & Medicine, Elsevier, vol. 65(10), pages 1986-2003, November.

    More about this item

    Keywords

    malnutrition ; Demographic and Health Survey ;

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:fpr:fcnddp:176. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/ifprius.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.