Economic Growth and Childhood Malnutrition in Low- and Middle-Income Countries

Key Points Question To what extent is economic growth associated with reduced prevalence of childhood malnutrition, what are the most important contributing factors of malnutrition, and how are these contributing factors associated with economic growth? Findings This cross-sectional study of 1 138 568 children aged 0 to 35 months from 58 low- and middle-income countries found an ambiguous association between economic growth and the prevalence of childhood malnutrition. Moreover, while strong associations between several contributing factors and childhood malnutrition were identified, the associations between economic growth and these contributing factors themselves were often ambiguous. Meaning These findings suggest that to reduce childhood malnutrition, economic growth should be accompanied by targeted investments that improve contributing factors of malnutrition not necessarily affected by economic growth, such as maternal human capital.

BMI=body mass index (calculated as weight in kilograms divided by height in meters squared).
eTable 3. Adjusted Odds Ratios for Childhood Malnutrition Associated With the Log of Per-Head GDP Data for the per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey-year.
Standard errors are clustered at the primary sampling unit level.Odds ratios (ORs) for the log of per-head GDP represent the difference in odds associated with a 5% increase in per-head GDP.All specifications include country and survey-year fixed effects as well as household and child/mother control variables.All ORs are rounded to three decimal places; thus, an OR of 1•000 in the confidence interval (CI) does not necessarily imply that the value 1 is included in the CI.1990-2020 1990-2020 1990-2020 1990-2020 1990-2020 2005-2020 eTable 4. Association Between Economic Growth and Malnutrition-Sanity Tests    Data for the per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey year.All regressions are ordinary least squares, and the instrumental variable regressions are two-stage least squares.All specifications include country and survey-year fixed effects as well as household and child/mother control variables.SEs are clustered at the PSU level.Coefficients for the log of per-head GDP represent a 5% increase in per-head GDP.In the instrumental variable regressions, we used the variable share of gross capital formation at present purchasing power parity (investment share of GDP) from the Penn World Tables 10.0, with a 5-year lag as an instrument for the log of the per-head GDP.

Years
eTable 5. Association Between Determinants and Indicators of Malnutrition-Sanity Tests

Part 1
BMI=body mass index (calculated as weight in kilograms divided by height in meters squared).ORT=oral rehydration therapy.All regressions are ordinary least squares.All specifications are ordinary least squares and include country-fixed effects as well as household and child/mother control variables.SEs are clustered at the PSU level.

Trimmed
Delayed breastfeeding (SE) No ORT given with diarrhea (SE) No care sought for cough (SE) No access improved sanitation (SE) Unsatisfied family planning (SE) Part 2 BMI=body mass index (calculated as weight in kilograms divided by height in meters squared).ORT=oral rehydration therapy.All regressions are ordinary least squares.All specifications are ordinary least squares and include country-fixed effects as well as household and child/mother control variables.SEs are clustered at the PSU level.

Trimmed
Delayed breastfeeding (SE) No ORT given with diarrhea(SE) No care sought for cough (SE) High indoor pollution (SE) No access safe drinking water (SE) No access improved sanitation (SE) No skilled birth attendant (SE) Unsatisfied family planning(SE)

Part 1
ORT=oral rehydration therapy.Data for per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey year.All regressions are ordinary least squares, and the instrumental variable regressions are two-stage least squares.All specifications include country and survey-year fixed effects as well as household control variables.SEs are clustered at the PSU level.Coefficients for the log of per-head GDP represent a 5% increase in per-head GDP.In the instrumental variable regressions, we used the variable share of gross capital formation at present purchasing power parity (investment share of GDP) from the Penn World Tables 10.0, with a 5-year lag as an instrument for the log of the per-head GDP.
©     Part 2 BMI=body mass index (calculated as weight in kilograms divided by height in meters squared).Data for the per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey year.All regressions are ordinary least squares, and the instrumental variable regressions are two-stage least squares.All specifications include country and survey-year fixed effects as well as household control variables.SEs are clustered at the PSU level.Coefficients for the log of per-head GDP represent a 5% increase in per-head GDP.In the instrumental variable regressions, we used the variable share of gross capital formation at present purchasing power parity (investment share of GDP) from the Penn World Tables 10.0, with a 5-year lag as an instrument for the log of the perhead GDP.

Part 2
Each column refers to one regression decomposition.Data for the per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey year.All specifications include country and survey-year fixed effects as well as household control variables.

Figure 2 .
Figure 2. Association Between Determinants and Indicators of Malnutrition-Extended Model (18 Determinants) Stunting Overweight 001 Association Between Economic Growth and Determinants of Malnutrition-Sanity Tests © 2023 Büttner N et al.JAMA Network Open.eTable 6.
Each column refers to one regression decomposition.Data for the per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey year.All specifications include country and survey-year fixed effects as well as household and child/mother control variables.Each column refers to one regression decomposition.Data for the per-head gross domestic product (GDP) were merged with Demographic and Health Survey data by survey year.All specifications include country and survey-year fixed effects as well as household control variables.