Spatial Inequality in Under-Five Children Undernutrition: Evidence From Ethiopia.

Abstract

Many developing countries are overburdened by child undernutrition, skewed towards poor and rural populations. This has long-lasting effects on adult livelihoods through reduced productivity and living standards, which vary across different countries and within countries. In that regard, we examined the spatial disparities in child undernutrition and its contributors in Ethiopia. Using 2019 Ethiopia Demographic Health Survey data and subnational boundaries as well as thematic maps and spatial autoregressive model at the cluster or kebele level, we found the presence of spatial disparities in child undernutrition, where children in the northern and northeast kebeles are more likely to have undernutrition than other kebeles. In addition, we found that aridity, precipitation, skilled health worker availability, geographical location and women's education significantly influence undernutrition. We also found positive and significant spillover effects in stunting, wasting and undernutrition between clusters, showing spatial dependence in Ethiopia. There is a need to focus on underserved regions to ensure that resources are allocated to those in need. Policymakers need to design better educational and economic strategies to increase food and nutrition security for children from poor and rural households, especially those in southern, northern, northeast and some eastern regions. Thus, there is a need to ensure targeted nutrition programmes in arid regions, climate-resilient agricultural interventions, expansion of maternal education programmes and strengthening rural health systems to improve nutrition outcomes for children under five.