Household and community HIV/AIDS status and child malnutrition in sub-Saharan Africa: Evidence from the demographic and health surveys

Jul 7, 2011Social science & medicine (1982)

Household and Community HIV/AIDS Status Linked to Child Malnutrition in Sub-Saharan Africa

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Abstract

Children whose mothers are infected with HIV are significantly more likely to be stunted, wasted, or underweight compared to those whose mothers are not infected.

The analysis is based on data from 18 countries in sub-Saharan Africa collected between 2003 and 2008.
Child malnutrition was assessed through rates of stunting, wasting, and underweight.
Children under five with HIV-positive mothers show a higher likelihood of malnutrition than peers with non-infected mothers from similar backgrounds.
Nutritional status differences are not significant for paternal orphans or children in households with other HIV-positive adults.
Having other adults in the household who are HIV positive is linked to increased malnutrition in children under one year old.
The impact of a mother's HIV status on child underweight varies across communities, with less effect in areas with higher overall malnutrition.

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This paper examines the extent to which under five children in households or communities adversely affected by HIV/AIDS are disadvantaged, in comparison with other children in less affected households/communities. The study is based on secondary analysis of the Demographic and Health Survey (DHS) data collected during 2003-2008 from 18 countries in sub-Saharan Africa, where the DHS has included HIV test data for adults of reproductive age. We apply multilevel logistic regression models that take into account the effect of contextual community/country level HIV/AIDS factors on child malnutrition. The outcome variable of interest is child undernutrition: stunting, wasting and underweight. The results suggest that across countries in sub-Saharan Africa, children whose mothers are infected with HIV are significantly more likely to be stunted, wasted or underweight compared to their counterparts of similar demographic and socio-economic background whose mothers are not infected. However, the nutritional status of children who are paternal orphans or in households where other adults are HIV positive are not significantly different from non-orphaned children or those in households where no adult is infected with HIV. Other adult household members being HIV positive is, however, associated with higher malnutrition among younger children below the age of one. Further analysis reveals that the effect of mothers' HIV status on child nutritional status (underweight) varies significantly across communities within countries, the effect being lower in communities with generally higher levels of malnutrition. Overall, the findings have important implications for policy and programme efforts towards improved integration of HIV/AIDS and child nutrition services in affected communities and other sub-groups of the population made vulnerable by HIV/AIDS. In particular, children whose mothers are infected with HIV deserve special attention.

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Household and community HIV/AIDS status and child malnutrition in sub-Saharan Africa: Evidence from the demographic and health surveys

Abstract

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