The consequencesof childhood malnutrition throughout the globe are widespread and devastating.The burden and costs that it places both on individuals and on society areenormous, making it imperative that actions be taken to reduce the high numbersof malnourished children. 167 million children under five years old wereunderweight in developing countries in 1995, with South Asia having the highestprevalence at 50 percent of the developing-country total (Gabriele &Schettino, 2008). Child stunting (low length-for-age) and wasting (lowweight-for-height), as well as overnutrition, are all public health problemsfaced by developing countries. These factors vary greatly among rural and urbanareas as a direct result of a multitude of complex factors related tosocioeconomic status (Gabriele & Schettino, 2008).

Moreover, rapidurbanization has created a larger heterogeneity of poverty and malnutrition(Ortiz et al., 2013). The need for effective interventions and policies adaptedto rural and urban areas has thus increased drastically, necessitating a deeperunderstanding of the factors affecting the distribution of childhoodmalnutrition in rural and urban areas.Little evidence ofthe factors that play into the urban-rural difference can be found, and much islacking on the association these factors have with malnutrition.

An analysisand comparison of the key determinants of malnutrition among children of urbanand rural areas in Ecuador will thus be undertaken in order to determineappropriate strategies to address this issue.A study by Smithet al. (2005) found that child nutritional status was significantly better inurban areas. The authors believe that urban malnutrition is lower due tofavorable socioeconomic conditions leading to better-caring practices forchildren.

But while food insecurity and malnutrition differ greatly, the natureof the determinants and the magnitudes of their effects were found to be nearlythe same among rural and urban regions (Garrett & Ruel, 1999).Specifically, income, food prices, maternal education, and demographics, suchas household size, affected malnutrition in both rural and urban areas (Garrett& Ruel, 1999).Research completedin different areas of Kenya determined that geographic variability betweenurban and rural centers was evident, with underweight children “tending tocluster in rural areas” (Pawloski et al., 2012). Herrador et al. (2014)noted that stunting was significantly higher in rural areas of Ethiopia, due tothe number of children living in the house, years of schooling of the caretaker,consumption of food from animal sources, and literacy of head of household.

Similarly, the urban-rural gap could be traced back to parental education andbetter household economic status of urban children in Malawi, and poorhousehold wealth, family size, and sub-optimal feeding practices after birth inEastern Uganda (Engebretsen et al.; 2008, Mussa, 2014). The findings from eachof these studies imply that in order to reduce the gap between malnutrition inrural and urban areas, a focus should be placed on improving the socioeconomicstatus in rural areas.Despite evidenceof this geographical difference, child growth and nutrition in rural SouthAfrica was found to be “shifting towards an urban-like profile,” butpersisting prevalence of rural malnutrition suggests there have been”inadequate interventions to address food insecurity andundernutrition” (Kimani-Murage et al.

, 2010). Key areas for interventionto reduce malnutrition in rural and urban areas must be identified, andadministrators “need not abandon the conceptual frameworks and toolkitsthey have developed for rural areas but can bring them along as they move towork in the city” (Garrett & Ruel, 1999). Both of these sourcessuggest both the continued use of intervention in rural areas as well as furtherimplementation of policies in the growing urban population.Fifty percent ofchild mortality results from undernourishment, which is a direct result ofsocioeconomic status (Victora et al., 2003). Anyamele (2009) looked at thedifferent socioeconomic determinants of child mortality in sub-Saharan Africa.

The study examined differences between urban and rural areas, finding thatwealth and literacy were both significant factors explaining child mortality,thus contributing to child malnutrition.Considering this,Fotso et al. (2006) extensively explored the difference in malnutrition basedon geographical location, finding that urban-rural differentials can be mainlyexplained by socioeconomic status; these socioeconomic inequalities are morepronounced in urban regions. Moreover, Fotso(2007) examined correlations between socioeconomic status and malnutrition inurban and rural sub-Saharan African regions. Factors affecting the distributionof malnutrition were documented, showing immense socioeconomic and culturaldiversity between the countries. In order to determine whether the rural-urbandifference in stunting could be explained by socioeconomic factors; maternaleducation, household wealth, and community socioeconomic status were examined.

Results indicated that rates of malnutrition declined with increasingsocioeconomic status and that malnutrition was lower in urban than rural areas.Additionally, urban-rural stunting differences were abolished whensocioeconomic status was controlled.An analyticalpaper will be composed using the data from Demographic and Health Surveys ofcountries in the sub-Saharan region of Africa. In the report, factors affectingthe difference in malnutrition in urban and rural areas of sub-Saharan Africawill be discussed and compared to current data on malnutrition and itsdeterminants. In other words, the rates of child malnutrition will be comparedto the statistics of specific urban-rural differentials of malnutrition thathave been found following a review of the literature. Determinants will includecommunity socioeconomic status, household wealth, mother’s education, andfather’s education.

Statistics regarding the socioeconomic determinants ofmalnutrition will be sourced from the United Nations Development Programme (UNDP)Human Development Report 2002, as well as the United Nation’s Department ofEconomic and Social Affair’s report World Urbanization Prospects: The 2003Revision. I will use the World Health Organization Joint Child MalnutritionEstimates 2017 for data on current malnutrition rates.Through acomparison of current data and recent literature, it is the purpose of thispaper to improve the understanding of determinants of child malnutrition and tofurther our knowledge on the strength of association of specific determinantswith undernutrition in urban and rural areas. An analysis of the determinantsthat contribute to the urban-rural gap will be undertaken in order adequatelyaddress malnutrition in rural and urban sub-Saharan Africa.


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