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Abstract
While ample evidence documents that urban children generally have better
nutritional status than their rural counterparts, recent research suggests that urban
malnutrition is on the rise. The environment, choices, and opportunities of urbanites
differ greatly from those of rural dwellers--from employment conditions to social and
family networks to access to health care and other services. Given these differences,
understanding the relative importance of the various determinants of child malnutrition in
urban and rural areas--and especially whether they differ--is key to designing context-relevant,
effective program and policy responses for stemming malnutrition. This study
uses Demographic and Health Survey data from 36 developing countries to address the
question of whether the socioeconomic determinants of child nutritional status differ
across urban and rural areas. The purpose is to answer the broader question of why child
malnutrition rates are lower in urban areas. The socioeconomic determinants examined
are women's education, women's status, access to safe water and sanitation, and
household economic status. The analysis finds little evidence of differences in the nature
of the socioeconomic determinants or in the strength of their associations with child
nutritional status across urban and rural areas. As expected, however, it documents
marked differences in the levels of these determinants in favor of urban areas. Large
gaps in favor of urban areas are also found in the levels of key proximate determinants of
child nutritional status, especially maternal prenatal and birthing care, quality of
complementary feeding, and immunization of children. The conclusion is that better
nutritional status of urban children is probably due to the cumulative effect of a series of
more favorable socioeconomic conditions, which, in turn, seems to lead to better caring
practices for children and their mothers. Given that the nature of the determinants of
child nutritional status is largely the same across urban and rural areas, the same program
and policy framework can be used to stem malnutrition in both. Efforts to alleviate the
most critical socioeconomic constraints specific to the different environments should
continue to be prioritized.