Changes in Height-for-Age of Children 1995 to 2014

Malnutrition is currently one of the largest threats to public health, with three million children dying worldwide per year as a result. This paper examines the determinants of children’s nutritional status in Egypt over time using an anthropometric index, height for age z score (HAZ), to assess children’s nutritional status. Over the last two decades, the HAZ distribution and the stunting rates in Egypt have changed markedly. However, what factors led to changes in the HAZ distribution in Egypt over time remains unknown. Using data from Egypt’s Demographic and Health Survey (EDHS) for the years 1995, 2003 and 2014, I identify factors that are correlated with the change in the height of children aged 2-4. I use a semi-parametric approach proposed by Dinardo, Fortin and Lemieux (DFL,1996) that decomposes the changes in the HAZ distribution and stunting rates between 1995 and 2003, 2003 and 2014, and 1995 and 2014 into differences that could potentially be explained by differences in covariates and/or return to covariates. The covariates include child characteristics, maternal characteristics, household socioeconomic status and access to health care. The results indicate that the variation in HAZ distribution and stunting rates in Egypt over time are driven mainly by a change in the return to covariates. There is suggestive evidence that the change in the return to mother’s height and weight over time had a positive impact on the change of the child’s height.  Additionally, health inequality exists across households with different income. Better policies targeted at increasing household income, mother’s employment and education can help reduce stunting rates by reducing illness and malnutrition.