Socioeconomic inequality in the double burden of child malnutrition in the Eastern and Southern African Region

Socioeconomic inequalities in the double burden of child malnutrition threatens global nutrition targets 2025, especially in Eastern and Southern Africa. We aimed to quantify these inequalities from nationally representative household surveys in 13 Eastern and Southern African countries between 2000 and 2018. 13 of the latest Demographic and Health Surveys including 72,231 children under five year olds were studied. Prevalence of stunting, wasting and overweight (including obesity) were disagregated by wealth quintiles, maternal education categories and urban-rural residence for visual inspection of inequalities, and the slope index of inequality (SII) and the relative index of inequality (RII) were estimated for each country. Country-specific estimates were pooled using random-effects meta-analyses. Regional stunting and wasting prevalence was higher among children living in the poorest households, with mothers with the lowest educational level and in rural areas. In contrast, regional overweight (including obesity) prevalence was higher among children living in the richest households, with mothers with the highest educational level and urban areas. Tackling social inequalities in the distribution of the double burden of malnutrition among children in the Eastern and Southern African region will require strategies that address the reasons socially disadvantaged children become more exposed to stunting or wasting.