DOI: 10.1097/pn9.0000000000000146 ISSN: 2563-9021

Disentangling wealth and stunting: structural and macroeconomic determinants of child nutrition across countries

Amr Abdelkader Saber

Background:

This study investigates whether the observed negative relationship between national income and child stunting prevalence reflects short-term causal effects or long-term structural differences between countries.

Methods:

A balanced panel of 104 countries from 2000 to 2020 was analyzed using pooled ordinary least squares and two-way fixed effects estimators. Robustness checks included lagged specifications, Hausman tests, and dynamic panel System Generalized Method of Moments models with clustered standard errors.

Results:

Approximately 95% to 96% of the observed income–stunting association was attributable to cross-sectional differences rather than short-run within-country dynamics. While pooled ordinary least squares suggested that a 1% increase in gross domestic product per capita was associated with a 0.84 percentage-point reduction in stunting prevalence, the within-country effect declined to 0.03 percentage points after controlling for country and year effects. No statistically robust short-run within-country association was detected between aggregate consumer price index inflation and stunting prevalence.

Conclusions:

The findings suggest that child stunting is shaped more by long-term structural determinants than by short-run macroeconomic fluctuations. Policies should prioritize sustained investments in institutional quality, health systems, sanitation, maternal education, human capital, and social protection.

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