Heterogeneity of child nutritional status between households: A comparison of six sub-Saharan African countries

Using cross-sectional data from Ghana, Malawi, Nigeria, Tanzania, Zambia, and Zimbabwe, a multilevel analysis was performed to determine the extent of correlation of nutritional status between children in the same family and geographical area. Weight-for-age z-scores were used as a measure of nutritional status for children up to three years of age. The percentage of children who were under-weight ranged from 16 in Zimbabwe up to 36 in Nigeria. The effects of socioeconomic factors and individual characteristics on nutritional status between countries varied. However in all six countries, the child's age was the most important factor associated with nutritional status. A clustering effect at the household level was found in all six countries, ranging from 24 per cent in Tanzania and Zimbabwe to 40 per cent in Malawi. There was also a significant, but smaller, clustering effect at community level for Malawi, Nigeria, Tanzania, and Zambia.