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UWA Business School
The UN Food and Agriculture Organisation's (FAO) latest report shows that hunger levels have fallen in the last year. Despite this, 925 million people around the world remain hungry, many of them children from the most disadvantaged regions of the world.

Associate Professor Anu Rammohan, from The University of Western Australia Business School, says child malnutrition is a problem that needs to be addressed urgently. In an attempt to better understand the factors causing child malnutrition, the health economist has conducted studies in Bangladesh and Nepal.

Using the 2004 Bangladesh Demographic Health Survey and the 2006 Nepal Demographic Health Survey, Professor Rammohan and her team conducted analyses of dozens of variables. These variables were compared to each child's height-for-age (or stunting, which gives an indication of long-term nutrition) and weight-for-height (which gives an indication of short-term nutrition).

The findings were complex, with many of the variables interacting to influence the levels of child malnutrition. The most important factor proved to be household wealth. In households from the wealthiest quintile of Nepalese society, boys were 3½ times less likely to be stunted, while girls were 2½ times less likely to be stunted.

In a related finding, the researchers ascertained that parents' level of education also affected child nutrition. In Nepal, children's weight-for-height was significantly improved if the father had a secondary education and was engaged in professional employment. In both studies, higher levels of maternal education also had a positive impact on child health.

Levels of maternal education are related to the next variable - maternal autonomy. ‘Maternal autonomy is found to be a crucial factor in improving child nutrition and health outcomes,' says Professor Rammohan. ‘An improvement in maternal autonomy improves her ability to make decisions regarding her children's health, nutrition and education and a more autonomous woman is also likely to have greater access to resources.'

Unfortunately for child nutrition rates, Professor Rammohan's surveys showed maternal autonomy in Nepal to be extremely low. Just 44% of mothers had the final say on their own healthcare, and only 46% had the final say on large household purchases, while 61% of mothers had no formal education. These measurements were complicated by the multitude of variables that affected female autonomy: education, labour force participation, material assets, religion, and influence in the domestic sphere were just some of these variables.

Other factors to influence child nutrition included the child's gender, birth order, and whether the sibling immediately older than them had died due to miscarriage, still birth, or infant mortality.

In recent years, progress has been made in the area of child nutrition. In Bangladesh, the proportion of underweight children has dropped from 66% in 1990 to 48% in 2004. Over the same period, the proportion of stunted children dropped from 65% to 43%. The figures are similar in Nepal, with the UN estimating that in 2005, 48% of Nepalese pre-school age children were underweight and 57% underheight.

Despite this progress, child malnutrition still remains a significant problem. ‘Being currently malnourished increases the vulnerability of children to diseases and raises their risk of child mortality, while also having other adverse effects on their physical, cognitive and mental development,' explains Professor Rammohan. That's why, she stresses, four of the United Nation's eight Millennium Development goals are specifically directed towards improving child health outcomes in developing nations.

Professor Rammohan's studies have shown that some family and household variables have a clear impact on child nutrition in developing countries. For example, the impact of household wealth reinforces the need to fight poverty. However, many others factors interact, making it difficult to fully measure or understand their impact on child health. What we do know is that millions of people, including children, still suffer from hunger. It's a problem we have to keep fighting.

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Heather Merritt
Director, External Relations
UWA Business School
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Verity Chia
Communications Officer
UWA Business School
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