Measuring poverty and child malnutrition with their determinants from household survey data.

Abstract

The eradication of poverty and malnutrition is the main objective of most societies and policy makers. But in most cases, developing a perfect or accurate poverty and malnutrition assessment tool to target the poor households and malnourished people is a challenge for applied policy research. The poverty of households and malnutrition of children under five years have been measured based to money metric and this approach has a number of problems especially in developing countries. Hence, in this study we developed an asset index from Demographic and Health Survey data as an alternative method to measure poverty of households and malnutrition and thereby examine different statistical methods that are suitable to identify the associated factors. Therefore, principal component analysis was used to create an asset index for each household which in turn served as response variable in case of poverty and explanatory (known as wealth quintile) variable in the case of malnutrition. In order to account for the complexity of sampling design and the ordering of outcome variable, a generalized linear mixed model approach was used to extend ordinal survey logistic regression to include random effects and therefore to account for the variability between the primary sampling units or villages. Further, a joint model was used to simultaneously measure the malnutrition on three anthropometric indicators and to examine the possible correlation between underweight, stunting and wasting. To account for spatial variability between the villages, we used spatial multivariate joint model under generalized linear mixed model. A quantile regression model was used in order to consider a complete picture of the relationship between the outcome variable (poverty index and weight-for-age index) and predictor variables to the desired quantiles. We have also used generalized additive mixed model (semiparametric) in order to relax the assumption of normality and linearity inherent in linear regression models, where categorical covariates were modeled by parametric model, continuous

covariates and interaction between the continuous and categorical variables by nonparametric models. A composite index from three anthropometric indices was created and used to identify the association of poverty and malnutrition as well as the factors associated with them. Each of these models has inherent strengths and weaknesses. Then, the choice of one depends on what a research is trying to accomplish and the type of data being used. The findings from this study revealed that the level of education of household head, gender of household head, age of household head, size of the household, place of residence and the province are the key determinants of poverty of households in Rwanda. It also revealed that the determinants of malnutrition of children under five years in Rwanda are: child age, birth order of the child, gender of the child, birth weight of the child, fever, multiple birth, mother’s level of education, mother’s age at the birth, anemia, marital status of the mother, body mass index of the mother, mother’s knowledge on nutrition, wealth index of the family, source of drinking water and province. Further, this study revealed a positive association between poverty of household and malnutrition of children under five years.