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Boys are more stunted than girls in Sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys

Wamani, Henry; Åstrøm, Anne Nordrehaug; Peterson, Stefan; Tumwine, James K.; Tylleskär, Thorkild
Peer reviewed, Journal article
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URI
https://hdl.handle.net/1956/2618
Date
2007-04-10
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  • Department of Global Public Health and Primary Care [1908]
Original version
https://doi.org/10.1186/1471-2431-7-17
Abstract
Background: Many studies in sub-Saharan Africa have occasionally reported a higher prevalence of stunting in male children compared to female children. This study examined whether there are systematic sex differences in stunting rates in children under-five years of age, and how the sex differences in stunting rates vary with household socio-economic status. Methods: Data from the most recent 16 demographic and health surveys (DHS) in 10 sub-Saharan countries were analysed. Two separate variables for household socio-economic status (SES) were created for each country based on asset ownership and mothers' education. Quintiles of SES were constructed using principal component analysis. Sex differentials with stunting were assessed using Student's t-test, chi square test and binary logistic regressions. Results: The prevalence and the mean z-scores of stunting were consistently lower amongst females than amongst males in all studies, with differences statistically significant in 11 and 12, respectively, out of the 16 studies. The pooled estimates for mean z-scores were -1.59 for boys and -1.46 for girls with the difference statistically significant (p < 0.001). The stunting prevalence was also higher in boys (40%) than in girls (36%) in pooled data analysis; crude odds ratio 1.16 (95% CI 1.12–1.20); child age and individual survey adjusted odds ratio 1.18 (95% CI 1.14–1.22). Male children in households of the poorest 40% were more likely to be stunted compared to females in the same group, but the pattern was not consistent in all studies, and evaluation of the SES/sex interaction term in relation to stunting was not significant for the surveys. Conclusion: In sub-Saharan Africa, male children under five years of age are more likely to become stunted than females, which might suggest that boys are more vulnerable to health inequalities than their female counterparts in the same age groups. In several of the surveys, sex differences in stunting were more pronounced in the lowest SES groups
Publisher
BioMed Central
Copyright
Copyright 2007 Wamani et al; licensee BioMed Central Ltd.

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