Fighting Undernutrition and Child Mortality in Sierra Leone

Abstract

This study has analysed the determinants of child undernutrition and mortality in Sierra Leone with the objective of identifying key predictors to advise policy. It utilises the country’s Demographic and Health Survey 2008. The estimation of the empirical model employs a seemingly unrelated regression (SUR) technique and probit framework. The predictors of undernutrition found most significant are: mothers’ education; housing environment measured by household density, accommodation capacity and sanitary condition; regional development differentials; having vegetables in the diet for mothers and children; and immunization. The predictors found significant for tackling mortality are: mothers’ education; household density; recognition of gendered differential needs for children; nutritional deficiency; micronutrient supplement; and postnatal care. The policy simulations demonstrate that focusing policy on these factors could
immensely help address child growth problems in the country. More particularly, the paper suggests the need for a greater focus on supporting mothers’ education and strengthening public health in childcare management. That, while modern medicine is always crucial, it can be perceived only as bolstering good natural practices in caring for children. It is noted that children that are chronically undernourished can resist episodic sources of undernutrition more strongly than those that have not been undernourished before. This supports the argument that while ‘vulnerability’ and ‘poverty’ are closely related concepts, they are separable from a static and dynamic point of view; the former measures the probability of becoming poor due to exposure to shocks even if one is currently better-off, or the probability of becoming poorer for those that are already poor. Child wasting appears closer to vulnerability than stunting, which is mainly noted with those already in poverty. Therefore, policies should target both urban and rural settlers—the former are characterised in this study by higher incidence of child wasting (acute undernutrition) while the latter are characterised by higher incidence of stunting (chronic undernutrition). The study does not find any strict linearity in the expectation of the distribution and dynamics of the effects of nutritional deficiency and morbid episodes across the socioeconomic groups analysed, thereby evincing the need for careful policy targeting. The four regions of the country should be evaluated carefully in policy targeting processes, given that there are urban poverty pockets as well as rural poverty pockets.

Keywords: Undernutrition, Childcare, Cognitive Capacity, Productivity