Are boys still short? : a study on sex differences in stunting prevalence over socio-economic status among children in Sub-Saharan Africa

Background: Over 150 million children worldwide are stunted. In Sub-Saharan Africa alone more than 1 in every 3 children is stunted due to insufficient food intake, boys being the most vulnerable according to prior research. Although UN has accentuated the negative impact of stunting and included it as part of the Sustainable Development Goal #2 ―End hunger‖, the decline in stunting prevalence is slow partly due to the poverty trap cycle of stunting. The economic costs of stunting are considerable as it precludes economic growth, which is especially damaging for developing countries where stunting prevalence is substantial, resulting in reinforcement of inequality. Objective: The aim of this thesis is to explore possible determinants of nutritional status and examine if the main significant variables identified can explain the gender gap of stunting prevalence, both current status and development over time, in Sub-Saharan Africa. Method: Student t-test and multiple logistic regression were employed to test for determinants of nutritional status, the existence of sex differences in stunting and how that differed controlling for socio-economic status proxied by several independent variables. Demographic and Health surveys from 35 Sub-Saharan African countries conducted between 1986 and 2016 provided data for the analysis. Results: The pooled results display that boys are 1.18 times more likely to become stunted than girls. Country specific results confirms the gender difference is in 33 of 35 countries (OR > 1, 95% CI) indicating a higher risk for boys. We found that wealth, mother’s education, polygamous households, mother’s age at first birth are important factors in determining children’s nutritional status. Although the observed determinants have significant impact, none of the tested variables can explain the gender gap in stunting prevalence. Conclusion: Our study confirms the gender gap indicated by smaller scale studies and hereby sets an updated benchmark for the region. The study did not find that the exposed moderating factors are playing a significant role in explaining the gender difference in stunting prevalence. Future research should therefore focus on investigating new potential explanations for the gender gap.nhhma