Child Malnutrition in Ethiopia: Can Maternal Knowledge Augment The Role of Income?

This paper explores the role of nutritional knowledge - and maternal education, in particular - as a strategy for reducing child malnutrition. It is part of the World Bank's Africa Region Working Paper Series of (as of this writing) over 100 publications. The study focuses on Ethiopia, a country with one of the highest malnutrition rates in Sub-Saharan Africa. Despite this fact, according to the authors, there is limited understanding of the causes of this health problem in Ethiopia.

The paper begins with an introductory section providing context and citing relevant research. One communication-related point to emerge is that mothers' health knowledge alone has been found to be a "crucial skill in improving children's nutritional status." A study cited here indicates that such knowledge is acquired outside the classroom, though its acquisition is facilitated by the numeracy and literacy skills obtained through formal education. The authors interpret this research as indicating that, even in communities where formal education is limited, it may be possible to impart nutritional knowledge through tailored child malnutrition education programmes.

A brief summary of the nutritional status of pre-school children in Ethiopia follows. In short, the authors find that malnutrition is: higher among boys than among girls, higher in rural areas than in urban ones, and higher among children in households with women who are less educated. They go on to outline the empirical approach which informed their research, which used individual-, household-, and community-level data from the 1995/6, the 1997, and the 1998 Welfare Monitoring Surveys (WMS), as well as data from the 1995/6 household income and expenditure survey (HICES) and the 1998 Health and Nutrition Survey (HNS).

The authors next provide a descriptive overview of the data. The key point to emerge is that "The importance of parental education is borne out in this study. Both female and male adult education have a large positive and statistically significant effect on the child's nutritional status, and the effect of female education is about twice as large as this of male education." In addition, community nutritional knowledge, proxied by mothers' capability to correctly assess their children's nutritional status, also emerges as an important factor in determining nutritional outcomes. "Maternal diagnostic ability of child growth performance not only reflects a care giver's nutritional knowledge in the abstract; a correct diagnosis is also a prerequisite for corrective action and would thus be positively associated with the child's nutritional status." The researchers also found that ownership of a radio and/or television facilitates the acquisition of nutritional information.

A discussion of policy simulations indicates that "Income growth alone will be insufficient to eliminate child malnutrition in Ethiopia. Bringing at least one female adult per household up to the primary education level would reduce stunting prevalence by 6 to 11 percent." The authors conclude that - if combined - income growth, increased female education, and improved nutritional knowledge would diminish the prevalence of child stunting in Ethiopia by 14% to 31%. They emphasise that, while it will take time before the effects of income growth (and, especially, increased female education) will affect child malnutrition, imparting nutritional knowledge would likely provide a timely and effective complementary intervention.