Determinants of inequity in undernutrition, anemia and malaria in children under five (5) years in Uganda

Abstract

Inequities in health outcomes such as undernutrition (stunting, wasting and underweight), and morbidity (anemia and malaria) in children under five years continue to exist in Uganda amidst government interventions such as construction of more public hospitals and health centers, distribution of free and treated mosquito nets, diversifying funding for nutrition programmes MOH, (2017). This study sought to investigate the gap in undernutrition, anemia and malaria in children under five years. In addition, the study decomposes the determinants of inequities in health outcomes so as to explain the gap between the poor and non-poor children. The study uses secondary data from the Uganda Demographic and Health Survey (UDHS) 2016 and employs both the concentration curve and index to investigate the gap in health outcomes. The study further applies the Oaxaca decomposition technique to decompose determinants of inequities in health outcomes in order to explain the gap between the poor and non-poor children under five years in Uganda. The concentration curve and index results indicate that undernutrition, anemia and malaria are more in the poor since all curves are above the line of equality and all indices are negative. The Oaxaca decomposition results show that the gap between the non-poor and poor is positive for all the health outcomes, the gaps are 0.058, 0.033, 0.044, 0.141 and 0.279 for stunting, wasting, underweight, anaemia and malaria respectively. In addition, the significant factors in explaining the increase in the gap for all the outcome variables of the study are mother’s education, ethnicity, vitamin A intake, child’s age, safe water, bednet and residence. Mother working is significant in reducing the gap for malaria and anaemia while ethnicity and gender reduces the gap for stunting and wasting respectively. Over all, mother’s education is the major contributing factor in explaining the gap between the poor and non-poor among the outcome variables in this study followed by safe water and residence. The study suggests that more emphasis is required on the quality and levels of education of a girl child, equal coverage of clean water and sanitation and giving special attention when designing programs for rural areas in order to reduce undernutrition, anemia and malaria in children under five years.