Research

Malnutrition and the disproportional burden on the poor: the case of Ghana

Ellen Van de Poel^1,2 , Ahmad Reza Hosseinpoor³ , Caroline Jehu-Appiah⁴ , Jeanette Vega³ and Niko Speybroeck⁵

¹  Department of Applied Economics, Erasmus University Rotterdam, Burg. Oudlaan 50, 3000 DR Rotterdam, The Netherlands

²  The Faculty of Economics and Commerce, The University of Melbourne, Victoria 3010, Australia

³  Equity, Poverty and Social Determinants of Health, Evidence and Information for Policy, World Health Organization, Avenue Appia 20, CH - 1211 Geneva 27, Switzerland

⁴  Policy Planning Monitoring and Evaluation Division, Ghana Health Service, Private Mail Bag, Ministries, Accra, Ghana

⁵  Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium

author email corresponding author email

International Journal for Equity in Health 2007, 6:21doi:10.1186/1475-9276-6-21

Published:	28 November 2007

Abstract

Background

Malnutrition is a major public health and development concern in the developing world and in poor communities within these regions. Understanding the nature and determinants of socioeconomic inequality in malnutrition is essential in contemplating the health of populations in developing countries and in targeting resources appropriately to raise the health of the poor and most vulnerable groups.

Methods

This paper uses a concentration index to summarize inequality in children's height-for-age z-scores in Ghana across the entire socioeconomic distribution and decomposes this inequality into different contributing factors. Data is used from the Ghana 2003 Demographic and Health Survey.

Results

The results show that malnutrition is related to poverty, maternal education, health care and family planning and regional characteristics. Socioeconomic inequality in malnutrition is mainly associated with poverty, health care use and regional disparities. Although average malnutrition is higher using the new growth standards recently released by the World Health Organization, socioeconomic inequality and the associated factors are robust to the change of reference population.

Conclusion

Child malnutrition in Ghana is a multisectoral problem. The factors associated with average malnutrition rates are not necessarily the same as those associated with socioeconomic inequality in malnutrition.