Child health in rural Colombia: determinants and policy interventions (original) (raw)
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Food, sanitation, and the socioeconomic determinants of child growth in Colombia
American Journal of Public Health, 1981
To describe the causes of growth failure in a developing country, we studied family food availability, anthropometric measurements of preschool children, and family and neighborhood socioeconomic conditions in a stratified random sample of Cali, Colombia families. The influences on preschool child growth of food availability, neighborhood socioeconomic conditions, and family socioeconomic conditions were separated statistically. Neither food availability nor other family factors were related directly to growth, but neighborhood factors did have a strong relationship to growth. Children decreased progressively from 97.5 percent of expected weight in the top one-sixth of neighborhoods we studied to 89 per cent in the botton one-sixth. Food availability, although not related to growth, was strongly related to family factors. The top one-sixth of families had 115 percent of FAO (Food and Agricultural Organization) protein allowances, while the bottom one-sixth had only 75 per cent. Thes...
2004
In this paper we evaluate the effect of a large nutrition programme in rural Colombia on children nutritional status, school achievement and female labour supply. We find that the programme has very large and positive impacts. Dealing with the endogeneity of treatment is crucial, as the poorest children tend to select into the programme. Methods like Propensity Score Matching would even yield negative estimates of the impact of the program. Our results are robust to the use of instruments that do not depend on individual household choices. We also validate our evaluation strategy by considering the effect of the program on pre-intervention variables. Further, we explore the heterogeneity of the impact of the programme. Children from the poorest backgrounds are the ones that benefit the most. JEL: C21, I12, I38 * We are very grateful to
Determinants of child mortality, health, and nutrition in a developing country* 1
Journal of Development Economics, 1982
status are important determinants of adult productivities and earnings; and, thus, are an important channel of intergenerational socioeconomic mobility. Building upon economic models of household behavior, we investigate the determinants of child mortality and health and nutrition status in regions defined by the degree of urbanization in the developing country of Nicaragua, and offer some policy suggestions. Our estunates suggest that: determinants differ signilicantly across regions, income is not an important factor, there is an inverse relation with number of sib!.ngs, and there are positive associations with calorie intake. schooling (except in the relatively low-ina me rural areas), the availability of refrigeration, and the quality of sewage systems. :fh B.L. Wolfe and J.R. Bchrmaw. Child worfalit?;, hcwlth und nutrition in (I DC ' ! Under the aswmphw that the conditions exist k i a maximization.
2010
This paper analyses the determinants of child anthropometrics using the data of a sample of children aged 0 to 36 months derived from the Cameroonian household survey (ECAMII). In particular, we assess the impact of household consumption on the nutritional status of children as measured by height-forage (HAZ), weight-forage (WAZ), and weight-for-height (WHZ) Z-scores, while controlling for other correlates. The methodology used in this study encompasses the ordinary least squares (OLS), 2stage least squares (2SLS), and the control function approach The endogeneity of household consumption is taken into consideration through four different categories of instruments, including land ownership, educational level, the formal sector employment, and the dependence ratio. The control function approach stands out as the most appropriate estimation strategy as it purges the structural parameters of potential econometric problems such as the endogeneity and heterogeneity of unobservable variables. Household consumption expenditure is significantly and positively associated with nutritional status of children (HAZ, WAZ, and WHZ), which suggest that policies aiming to ensure adequate resource availability to households should figure high on the agenda of decision-makers. The significance of this impact varies by gender of the household head. Male headed households income seem to play a more decisive role in financing child health than their female counterparts. This result could be considered as including the unobservable income contributions of their spouses, given that this effect is likely to be the result of joint financing when it comes to child health care.
Determinants of child mortality, health, and nutrition in a developing country
Journal of Development Economics, 1982
status are important determinants of adult productivities and earnings; and, thus, are an important channel of intergenerational socioeconomic mobility. Building upon economic models of household behavior, we investigate the determinants of child mortality and health and nutrition status in regions defined by the degree of urbanization in the developing country of Nicaragua, and offer some policy suggestions. Our estunates suggest that: determinants differ signilicantly across regions, income is not an important factor, there is an inverse relation with number of sib!.ngs, and there are positive associations with calorie intake. schooling (except in the relatively low-ina me rural areas), the availability of refrigeration, and the quality of sewage systems. :fh B.L. Wolfe and J.R. Bchrmaw. Child worfalit?;, hcwlth und nutrition in (I DC ' ! Under the aswmphw that the conditions exist k i a maximization.
2005
Child health, particularly long-term nutritional status, is closely related to the characteristics of families, communities and children, including level of education and access to public services,. Public policy has a crucial role in increasing the likelihood that a child can access high quality health-care and other services that affect health status. Access to these public services, however, may have different effects depending on community and family characteristics, particularly the education level of the mother or caregiver. In Peru, despite a dramatic increase in investment in health during the last decade, there is still a large degree of inequality of access. This paper uses Young Lives data to explore the interaction of private assets, such as education, with public services, provided at the community and household level. The authors explore the ways in which maternal education levels interact with access to clean water and sewage, availability and quality of health facili...
SSRN Electronic Journal, 2000
Contextual effects on child health have been investigated extensively in previous research. However, few studies have considered the interplay between community characteristics and individual-level variables. This study examines the influence of community education and family socioeconomic characteristics on child health (as measured by height and weight-forage Z-scores), as well as their interactions. We adapted the Commission on Social Determinants of Health (CSDH) framework to the context of child health. Using data from the 2010 Colombian Demographic and Health Survey (DHS), weighted multilevel models are fitted since the data are not selfweighting. The results show a positive impact of the level of education of other women in the community on child health, even after controlling for individual and family socioeconomic characteristics. Different pathways through which community education can substitute for the effect of family characteristics on child nutrition are found. The interaction terms highlight the importance of community education as a moderator of the impact of the mother's own education and autonomy, on child health. In addition, the results reveal differences between height and weight-forage indicators in their responsiveness to individual and contextual factors. Our findings suggest that community intervention programmes may have differential effects on child health. Therefore, their identification can contribute to a better targeting of child care policies.
Decomposing the Intraurban Malnutrition Gap Between Poor and Non-poor Children in Colombia
Journal of Urban Health-bulletin of The New York Academy of Medicine, 2022
In Colombia, although it can be said that, on average children living in urban areas have better quality of life than their rural peers, it is also true that within cities, there are high levels of socioeconomic inequality. Our objective is to identify the contribution of the factors that explain the gap in stunting and excess weight between poor and non-poor children under 5 years of age in urban areas of Colombia. We use data from the 2015 National Nutritional Status Survey, and two nonlinear decomposition techniques based on the classical decomposition method developed by Blinder-Oaxaca. With a sample of 6877 observations, the results show that the intraurban gap of stunting between poor and non-poor children in urban areas is 4.8 percentage points. Its main determinants are the mother's educational level (46.5%), affiliation to the health system by the mother (19.4%), and assisted delivery in a medical institution (16.6%). For excess weight, the gap is − 2.1 percentage points, and its main determinants are the mother's educational level (39.2%) and birth attended by a physician (21.8%). This study suggests the coexistence of a double burden of malnutrition (DBM) in children under 5 years of age living in urban areas of Colombia. Stunting is associated with low-income levels while excess weight is associated with higher income levels. The identification of the main determinants of DBM and its relative importance, constitutes a contribution for public policy makers aimed at reducing socioeconomic gaps.
The determinants of the health status in a developing country: results form the colombian case
2004
This paper tries to find empirical evidence of the health determinants, as a measure of health capital in a developing country after a deep reform of its health-care sector. It follows the Grossman model (1972) and also takes, besides individual and socioeconomic variables, institutional factors of the health sector. Two surveys from 1997 and 2000 in Colombia, with a subjective (self-report) health status of the individuals, and information about the health system affiliation type, were used. The estimation method is an order probit model. At the end, the results show an important connection between individual, institutional and socioeconomic variables with the health status of a person in Colombia. The effect of the type of access to medical care strengths the inequities in health outcome.
The Determinants of The Health Status in a Developing Country: results from the Colombian Case
2005
This paper tries to find empirical evidence of the health determinants, as a measure of health capital in a developing country after a deep reform of its health-care sector. It follows the Grossman model (1972) and also takes, besides individual and socioeconomic variables, institutional factors of the health sector. Two surveys from 1997 and 2000 in Colombia, with a subjective (self-report) health status of the individuals, and information about the health system affiliation type, were used. The estimation method is an order probit model. At the end, the results show an important connection between individual, institutional and socioeconomic variables with the health status of a person in Colombia. The effect of the type of access to medical care strengths the inequities in health outcome.