Determinants of Inequality in Stunting among Children Aged Between 0-23 Months in Tanzania

Abstract

Globally, approximately 149 million children suffer from stunting, a condition linked to long-term health, economic, and cognitive disadvantages. In Tanzania, despite a 4% reduction in stunting rates between 2015 and 2022, disparities persist, particularly among socioeconomically disadvantaged groups. This study explores the determinants of stunting inequality among aged 0-23 months using data from the 2022 Tanzania Demographic and Health Survey (TDHS). A secondary analysis of 2,158 children revealed a concentration index of -0.0348 (95% CI: -0.0573, -0.0123), indicating stunting disproportionately affects the poor. Decomposition analysis, using concentration curves, highlighted key factors: children aged 18-23 months were 2.40 times more likely to be stunted than those aged 0-5 months, while second-to-fourth-born children were 37% less likely than firstborns. Maternal primary education increased stunting odds by 39% compared to no education, and unimproved toilet facilities raised the risk by 51%. Protective factors included normal birth weight (25.76% contribution), breastfeeding (-7.78%), and vaccination (2.19%). These findings underscore the need for targeted interventions addressing sanitation, maternal education, and early nutrition to reduce stunting disparities.