Menu ENN Search

Does economic growth reduce childhood undernutrition in Ethiopia?

Summary of research1

Location: Ethiopia

What we know: Rapid economic growth in developing countries has had a mixed effect on human development; the impact on reducing childhood undernutrition is not well understood.

What this article adds: A cross-sectional study of three rounds of data from the Demographic and Health Survey (DHS) in Ethiopia (2000, 2005 and 2010) was integrated with corresponding World Bank real per capital income (PCI) to examine the association between economic growth and childhood undernutrition in Ethiopia. Household PCI improved in the two sample period intervals by 18.85% and 43.14% respectively. Strong significant associations were found between PCI and child undernutrition, as measured by stunting, underweight and wasting (P<0.0001 for all measures) in 32,610 children aged 0 to 59 months. Results suggest a strong correlation between economic development and improved anthropometric nutritional status in Ethiopia.

Policy discussions and debates over the last couple of decades have emphasised the efficiency of development policies in terms of translating economic growth into human development. However, the literature shows that rapid economic growth has brought mixed results and the effect of economic growth on improving human nutrition remains inconclusive. In some countries, rapid economic growth has accompanied increased income inequality, while in others it has brought little or no substantial improvement in poverty and nutrition outcomes (DNEAP, 2010; O’Donnella et al, 2009).

For the past decade, Ethiopia has made economic progress, with a gross domestic product (GDP) growth rate of 11% per annum. Despite this achievement, the prevalence of micronutrient deficiencies remains high and infant and young child feeding practices remain sub-optimal. This study aimed to assess the interplay between economic growth and childhood undernutrition in Ethiopia.

Three rounds of cross-sectional data from the Ethiopian Demographic and Health Survey (DHS) (2000, 2005 and 2010) were used for the study. DHS involves multi-stage cluster sampling and collects standardised data from women of reproductive age regarding their socio-demographic characteristics and maternal and child health. Child nutritional status is assessed using standard anthropometric measures. A multi-level, mixed logistic regression model was used for analysis. The dependent variables were stunting, underweight and wasting in household children. The main independent variable was World Bank real per capita income (PCI) that was adjusted for purchasing power parity.

A total of 32,610 children aged 0 to 59 months was included in the pooled analysis, with 11,095 (34.02%); 9,861 (30.24%); and 11,654 (35.74%) samples from the 2000, 2005 and 2010 surveys respectively. Overall, 11,296 children (46.7%) [46.0%-47.3%] were stunted, 8,197 (33.8%) [33.2%-34.4%] were underweight and 3,175 (13.1%) [12.7%-13.5%] were wasted.2 Among respondents, 84.4% lived in rural areas, 83.9% were male-headed households, 89.9% were married, and 24.8% were in the lowest wealth quantile at the time of the survey. More than 15.1% of families used unimproved toilet facilities, 45.6% received improved water, 53.3% of respondents did not engage in paid work, while 22.1% (7,130) and 76.6% (24,673) of husbands were employed in paid jobs and agricultural activities respectively. The relevant PCI of the country data (2000: US$515, 2005: US$612 and 2010: US$876) demonstrated an improvement in PCI of households in Ethiopia in the two sample period intervals of 18.85% and 43.14%, respectively.

Analysis showed a strong correlation between prevalence of early childhood undernutrition outcomes and PCI. The proportions of stunting (r = -0.1207, p<0.0001), wasting (r = -0.0338, p<0.0001) and underweight (r = -0.1035, p<0.0001) from all children in the household were negatively correlated with the PCI. In the final model adjustment with all the covariates, economic growth was associated with a substantial reduction in the prevalence of stunting [β = -0.0016, SE = 0.00013, p<0.0001], underweight [β = -0.0014, SE = 0.0002, p<0.0001] and wasting [β = -0.0008, SE = 0.0002, p<0.0001] in the country over a decade. Results demonstrate that economic growth was strongly (negatively) correlated with undernutrition in Ethiopia. This confirms the hypothesis that economic development is associated with improved nutritional status as measured by prevalence of underweight, wasted and stunted children.

These results contribute to empirical findings that confirm the association of household income and nutrition in sub-Saharan African countries. Families in sub-Saharan Africa spend as much as 60% of their income on food-related expenditures and an improvement in wealth condition is often translated into better access to food and healthcare services. Since most of the sampled households were engaged in agriculture and this sector makes a significant contribution to overall GDP, improvement in agricultural productivity of the country over the last decades may have played a vital role in nutrition improvement.

In order to facilitate further reductions in undernutrition and achieve the sustainable development goals, investment to boost agricultural production, stabilisation of price volatilities and implementation of policies to increase household income are crucial. Evidence also shows that nutrition interventions have assured effects on child health and development (Ruel et al, 2013). There is therefore a need to continue to focus on both nutrition-sensitive and nutrition-specific interventions that can boost child health and nutritional status.


1Biadgilign S, Shumetie A, Yesigat H (2016) Does Economic Growth Reduce Childhood Undernutrition in Ethiopia? PLoS ONE 11(8): e0160050.

1Defined as less than two standard deviations (-2SD) below the median height-for-age (stunting), weight-for-age (underweight) and weight-for-height (wasting), according to 2006 WHO growth standards.


DNEAP: Poverty and Well Being in Mozambique: The Third National Assessment. National Directorate of Poverty Analysis and Studies, Ministry of Planning and Development, Maputo, Mozambique. 2010.

O’Donnella O, Nicolásb ÁL, Doorslaerc EV: Growing richer and taller: Explaining change in the distribution of child nutritional status during Vietnam’s economic boom. Journal of Development Economics 2009, 88(1):45–58.

Ruel M, Alderman H, Group MaCNS: Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 2013, 382(9891).


More like this

FEX: Impact of maternal mental health on recovery from severe acute malnutrition in Malawi

View this article as a pdf MSc summer project1 By Mphatso Nancy Chisala Mphatso Chisala is a medic by profession with an interest in the prevention and treatment of child...

FEX: Understanding sex differences in childhood malnutrition

View this article as a pdf This is a summary of the following paper: Thurstans S, Opondo C, Seal A, Wells J, Khara T, Dolan C et al (2021) Understanding sex differences in...

NEX: Association between economic growth and early childhood undernutrition: evidence from 121 demographic and health surveys from 36 low-income and middle-income countries

Sebastian Vollmer et al. Lancet Glob Health 2014; 2: e225-34 It is presumed that increased economic growth will lead to increases in average income, especially improving the...

FEX: Challenges in addressing undernutrition in India

By Ajay Kumar Sinha, Dolon Bhattacharyya and Raj Bhandari Ajay Kumar Sinha (left) is the Founder Secretary and Executive Director of FLAIR. He is an expert on public policy...

FEX: Ethiopia: Are children of employed mothers less stunted than those of unemployed mothers?

Kedir Mohammed is the Nutrition Cluster Coordinator of the Sub-National Emergency Nutrition Coordination Unit (ENCU), Semera, Afar Region, Ethiopia. Ibrahim Mohammed is a...

FEX: Feasibility and effectiveness of preventing child malnutrition with local foods in Kenya

Summary of research1 One of the researchers (Rebecca Ashton) weighs a child The findings of a study to establish the operational feasibility and effectiveness of using locally...

FEX: Is exposure to animal faeces harmful to child nutrition and health outcomes?

Summary of research1 Location: Ethiopia, Bangladesh and Vietnam What we know: Sub-clinical environmental enteric disorder (EED) is an important causal pathway from poor...

FEX: Evaluation of an integrated health-nutrition-WASH project to reduce malnutrition prevalence in children under two in Bangladesh

By Monsurul Hoq and John Brogan Monsurul Hoq was working as a Statistician Epidemiologist during the study. He has experience in monitoring and evaluation of community-based...

FEX: Review of food security and nutrition amongst urban poor

Summary of review1 Location: Kenya, Niger, Bangladesh What we know: A significant and increasing proportion of the world population resides in urban slums. Achieving food...

FEX: The Lancet Series on Maternal and Child Undernutrition Progress

View this article as a pdf Research snapshot1 Thirteen years after the first Lancet Series on Maternal and Child Undernutrition, the latest series on Maternal and Child...

FEX: Summary of Lancet Series on Maternal and Child Undernutrition

Below are short summaries of the recently launched Lancet series of papers on Maternal and Child Undernutrition1. This high profile series focuses on the disease burden...

FEX: The impact of intensive counselling and a mass media campaign on complementary feeding practices and child growth in Bangladesh

Summary of research* Location: Bangladesh. What we know: In Bangladesh there has been little to no progress in improving children's diets and little evidence available on...

FEX: Improving complementary feeding practices through smartphone-based maternal education in Iran

View this article as a pdf Research snapshot1 Mothers' poor nutrition-related knowledge, attitudes and practices are considered to be major causes of malnutrition in...

NEX: Maternal and Child Nutrition (MCN)

Special Issue: Promoting Healthy Growth and Preventing Childhood Stunting, September 2013 (Volume 9, Issue Supplement S2 Pages 1-149) Promoting healthy growth and preventing...

FEX: CMAM rollout in Ethiopia: the ‘way in’ to scale up nutrition

By Dr Ferew Lemma, Dr Tewoldeberhan Daniel, Dr Habtamu Fekadu and Emily Mates Dr Ferew Lemma is Senior Nutrition Advisor to the State Minister (Programs), Federal Ministry of...

FEX: Local spatial clustering of stunting and wasting among children under the age of five years

Summary of research* Location: Ethiopia What we know: The prevalence of stunting and wasting in Ethiopia has fallen but remains a considerable burden. Effective nutrition...

FEX: Tackling the double burden of malnutrition in low and middle-income countries: response of the international community

Research By Alexandra Rutishauser-Perera Alexandra Rutishauser-Perera is a Humanitarian Nutrition Adviser with Save the Children. She has ten years of experience of public...

FEX: A reflection on the 2021 Lancet Maternal & Child Nutrition Series through a WaSt lens

View this article as a pdf This article provides a summary of the Lancet Maternal & Child Nutrition Series to date, reflecting upon the 2021 series from the perspective of the...

FEX: An overview of REST’s implementation of the Productive Safety Net Programme

By The Relief Society of Tigray (REST) Mekelle Team The Relief Society of Tigray (REST) has been in existence in Ethiopia for over 30 years, starting out as a relatively small...

FEX: Early is best but it is not always too late. Young Lives evidence on nutrition and growth in Ethiopia, India, Peru and Vietnam

View this article as a pdf Summary of report Location: Ethiopia, India, Peru and Vietnam What this article is about: Anthropometric data, taken from 12,000 children across...


Reference this page

Does economic growth reduce childhood undernutrition in Ethiopia?. Field Exchange 55, July 2017. p25.



Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.