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Record Nr. |
UNINA9910968331403321 |
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Autore |
Skoufias Emmanuel |
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Titolo |
All Hands On Deck : : Reducing Stunting through Multisectoral Efforts in Sub-Saharan Africa / / Emmanuel Skoufias |
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Pubbl/distr/stampa |
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Washington, D.C. : , : The World Bank, , 2019 |
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ISBN |
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Edizione |
[1st ed.] |
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Descrizione fisica |
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1 online resource (192 pages) |
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Collana |
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Disciplina |
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Soggetti |
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Malnutrition - Africa, Sub-Saharan |
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Lingua di pubblicazione |
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Formato |
Materiale a stampa |
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Livello bibliografico |
Monografia |
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Nota di contenuto |
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Front Cover -- Contents -- Foreword -- Acknowledgments -- About the Authors -- Abbreviations -- Overview -- Motivation -- Design and Methods -- Results -- Policy Considerations -- Attention to the Incentive Structure -- Notes -- References -- Chapter 1 Introduction and Motivation -- Notes -- References -- Chapter 2 Methodology and Data -- The United Nations Children's Fund Conceptual Framework -- Caveats and the Contributions of This Study -- Notes -- References -- Chapter 3 Stunting in Sub-Saharan African Countries -- Note -- References -- Chapter 4 The Underlying Determinants of Nutrition -- Measures of Food Security and Child Care -- Measures of Water, Sanitation, and Hygiene -- Measures of Health -- Empirical Measures of the Underlying Determinants of Nutrition -- Access to Food and Care, Health, and WASH -- Simultaneous Access to the Underlying Determinants of Nutrition -- Notes -- References -- Chapter 5 Stunting and Access to the Underlying Determinants of Nutrition -- Stunting and Children's Simultaneous Access to the Drivers of Nutrition -- Stunting and the Underlying Determinants of Nutrition -- A Brief Summary of the Country-Specific Estimates -- Testing the Sensitivity of the Findings -- Notes -- References -- Chapter 6 An Application at the Country Level: The Case of Tanzania -- Stunting and the Underlying Determinants of Nutrition in Tanzania -- Correlation between Stunting and Access to the Drivers of Nutrition -- Monitoring Progress in Nutrition and Access to the Drivers of Nutrition -- Notes -- References |
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-- Chapter 7 Income Growth Is an Essential Element of a More Effective Multisectoral Approach -- Average Income -- Variability of Income -- Notes -- References -- Chapter 8 How Can a Multisectoral Strategy to Reducing Stunting Produce the Desired Results? -- The Joint Targeting of Interventions by Different Sectors. |
Attention to the Incentive Structure -- Notes -- References -- Appendix A Exploring the Relationship between Height-for-Age and the Three Drivers of Nutrition -- Appendix B In Search of Synergies -- Appendix C Stunting and the Three Drivers of Nutrition: Country-Specific Estimates -- Appendix D Stunting and the Three Drivers of Nutrition: Subpopulation-Specific Estimates -- Boxes -- Box 1.1 Nutrition-Specific and Nutrition-Sensitive Interventions -- Box 4.1 Additional Questions in Surveys for Better Adequacy Measures -- Box 4.2 Access to and Utilization of Health Facilities -- Box 5.1 Tariffs, Trade, and Child Stunting -- Box 7.1 Agricultural Chemicals and Child Nutrition -- Figures -- Figure O.1 Differences in Access to Adequate Food and Care, Sub-Saharan Africa -- Figure O.2 Differences in Access to Adequate WASH, Sub-Saharan Africa -- Figure O.3 Differences in Access to Adequate Health, Sub-Saharan Africa -- Figure O.4 Children's Access to the Three Determinants of Nutrition in Sub-Saharan Africa -- Figure O.5 Prevalence of Stunting in Sub-Saharan Africa, Based on Children's Access to the Three Determinants of Nutrition -- Figure O.6 Prevalence of Stunting in Sub-Saharan Africa, Based on Children's Access to Zero, One, Two, or Three Determinants of Nutrition -- Figure O.7 Marginal Effects on the Probability of Stunting, Based on Children's Access to Combinations of the Three Determinants of Nutrition -- Figure O.8 The Relationship between Height-for-Age Z-scores and Wealth by Percentile of Household Wealth among Older and Younger Children -- Figure 1.1 Causes, Correlates, and Consequences of Stunting -- Figure 2.1 Determinants of Child Malnutrition -- Figure 2.2 Framework for Actions to Achieve Optimum Fetal and Child Nutrition and Development -- Figure 3.1 Stunting Prevalence among Younger (0-23 Months) and Older (24-59 Months) Children. |
Figure 3.2 Growth Faltering (Children 0-59 Months) -- Figure 3.3 Growth Faltering, by Socioeconomic Characteristics (Children 0-59 Months) -- Figure 3.4 Distribution of Height-for-Age for Different Populations -- Figure 3.5 Stunting Prevalence, by Country (Children 0-23 Months) -- Figure 3.6 Stunting Prevalence in Urban and Rural Areas within Each Country (Children 0-23 Months) -- Figure 3.7 Stunting Prevalence among Boys and Girls within Each Country (Children 0-23 Months) -- Figure 3.8 Stunting Prevalence, by Wealth Quintile within Each Country (Children 0-23 Months) -- Figure 3.9 Stunting Prevalence, by Mother's Education within Each Country (Children 0-23 Months) -- Figure B4.2.1 The Nonrandom Allocation of High- and Low-Quality Health Facilities, Nigeria -- Figure 4.1 Percentage of Children with Access to Adequate Food and Care within Each Country (Children 0-23 Months) -- Figure 4.2 Inequities in Access to Adequate Food and Care within Each Country (Children 0-23 Months) -- Figure 4.3 Percentage of Children with Access to Adequate WASH within Each Country (Children 0-23 Months) -- Figure 4.4 Inequities in Access to Adequate WASH within Each Country (Children 0-23 Months) -- Figure 4.5 Percentage of Children with Access to Adequate Health within Each Country (Children 0-23 Months) -- Figure 4.6 Inequities in Access to Adequate Health within Each Country (Children 0-23 Months) -- Figure 4.7 Inequities in Joint Access to the Underlying Drivers of Nutrition within Each Country (Children 0-23 Months) -- Figure 4.8 Inequities in Joint Access to the Underlying Drivers of Nutrition within Each Country, |
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Urban versus Rural Areas (Children 0-23 Months) -- Figure 4.9 Inequities in Simultaneous Access to the Underlying Drivers of Nutrition within Each Country, B20 versus T20 (Children 0-23 Months). |
Figure 5.1 The Cumulative Distribution of Height-for-Age Z-Scores (Children 0-23 Months) -- Figure 5.2 Access to No Drivers versus Access to One Driver of Nutrition and the Prevalence of Stunting (Children 0-23 Months) -- Figure 5.3 Access to One versus Access to Two Drivers of Nutrition and the Prevalence of Stunting (Children 0-23 Months) -- Figure 5.4 Access to Two versus Access to Three Drivers of Nutrition and the Prevalence of Stunting (Children 0-23 Months) -- Figure 5.5 Access to No Drivers versus Access to Three Drivers of Nutrition and the Prevalence of Stunting (Children 0-23 Months) -- Figure 5.6 Access to No Drivers versus Access to One or More Drivers of Nutrition and the Prevalence of Stunting (Children 0-23 Months) -- Figure 5.7 The Effect of Simultaneous Access to One or More of the Drivers of Nutrition at the Lower Quantiles of the HAZ Distribution -- Figure 5.8 The Effects of Access to Combinations of the Three Drivers of Nutrition at the Lower Quantiles of the HAZ Distribution -- Figure 6.1 Growth Faltering in Tanzania, by Socioeconomic Characteristics (Children 0-59 Months) -- Figure 6.2 Stunting Prevalence among Children under 24 Months -- Figure 6.3 Access to the Different Components of Food/Care, WASH, and Health (Children under 24 Months) -- Figure 6.4 Access to No Drivers versus Access to One or More Drivers of Nutrition and the Prevalence of Stunting (Children 0-23 Months) -- Figure 6.5 Fraction of Increase in Mean HAZ between 2005 and 2016 Attributable to Explained Factors, Tanzania (Children 0-23 Months) -- Figure 6.6 Decomposing the Contribution of Access to the Drivers of Nutrition to the Increase in Mean HAZ between 2005 and 2016, Tanzania (Children 0-23 Months). |
Figure 6.7 Decomposing the Contribution of Access to the Drivers of Nutrition to the Increase in Mean HAZ (with Restrictions Imposed), Tanzania (Children 0-23 Months) -- Figure 7.1 The Relationship between Height-for-Age Z-Scores and Wealth Percentiles by Wealth Deciles among Older and Younger Children -- Figure 7.2 Differences in the Relationship between Height-for-Age Z-Scores and Wealth Percentiles by Wealth Deciles between Some Key Basic Determinants of Nutrition -- Figure 7.3 Differences in the Relationship between Height-for-Age Z-Scores and Wealth Percentiles by Wealth Deciles between Groups of Countries -- Figure 7.4 Country-Specific Estimates of the Relationship between Median Height-for-Age Z-Scores and Household Wealth Index Percentile -- Map -- Map 6.1 Tanzania: Regional Stunting Rates and Access to Health and WASH -- Tables -- Table 2.1 Characterization of Countries Included in the Study -- Table 4.1 Components of Food Security Measured -- Table 4.2 Components of Care -- Table 4.3 Components of WASH -- Table 4.4 Components of Health -- Table 4.5 Inclusion of Select Health and WASH Components -- Table 5.1 Percentage of Children with Adequate Access in Each Group/Category -- Table 5.2 Changes in the Stunting Rate for Groups of Children with Simultaneous Access to One or More of the Drivers of Nutrition, National-Level Estimates -- Table 5.3 Marginal Effects on the Probability of Stunting of Simultaneous Access to One or More of the Drivers of Nutrition, Child-Level Estimates -- Table 5.4 Marginal Effects on the Probability of Stunting of Simultaneous Access to One or More of the Drivers of Nutrition in Different Groups of Countries -- Table 5.5 Marginal Effects on the Probability of Stunting of Simultaneous Access to One or More of the Drivers of Nutrition for Different Areas and Socioeconomic Groups within Countries. |
Table 5.6 The Marginal Effect on the Probability of Stunting of Access |
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to Adequate Levels in Combinations of the Underlying Drivers of Nutrition. |
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Sommario/riassunto |
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In Sub-Saharan Africa, the scale of undernutrition is staggering; 58 million children under the age of five are too short for their age (stunted), and 14 million weigh too little for their height (wasted). Poor diets in terms of diversity, quality, and quantity, combined with illness and poor water and sanitation facilities, are linked with deficiencies of micronutrients - such as iodine, vitamin A, and iron - associated with growth, development, and immune function. In the short term, inequities in access to the determinants of nutrition increase the incidence of undernutrition and diarrheal disease. In the long term, the chronic undernutrition of children has important consequences for individuals and societies: a high risk of stunting, impaired cognitive development, lower school attendance rates, reduced human capital attainment, and a higher risk of chronic disease and health problems in adulthood. Inequities in access to services early in life contribute to the intergenerational transmission of poverty. Recent World Bank estimates suggest that the income penalty a country incurs for not having eliminated stunting when today's workers were children is about 9-10 percent of gross domestic product per capita in Sub-Saharan Africa. Much of the effort to date has focused on the costing, financing, and impact of nutrition-specific interventions delivered mainly through the health sector to reach the global nutrition targets for stunting, anemia, and breastfeeding, and interventions for treating wasting. However, the determinants of undernutrition are multisectoral, and the solution to undernutrition requires multisectoral approaches. An acceleration of the progress to reduce stunting in Sub-Saharan Africa requires engaging additional sectors - such as agriculture; education; social protection; and water, sanitation, and hygiene (WASH) - to improve nutrition. This book lays the ground work for more effective multisectoral action by analyzing and generating empirical evidence to inform the joint targeting of nutrition-sensitive interventions. Using information from 33 recent Demographic and Health Surveys (DHS), measures are constructed to capture a child's access to food security, care practices, health care, and WASH, to identify gaps in access among different socioeconomic groups; and to relate access to the senutrition drivers to nutrition outcomes. All Hands on Deck: Reducing Stunting through Multisectoral Efforts in Sub-Saharan Africa addresses three main questions: - Do children have inadequate access to the underlying determinants of nutrition? - What is the association between stunting and inadequate food, care practices, health, and WASH access? - Can the sectors that have the greatest impact on stunting be identified? This book provides country authorities with a holistic picture of the gaps in access to the drivers of nutrition within countries to assist them in the formulation of a more informed, evidence-based, and balanced multisectoral strategy against undernutrition. |
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