Trends and differentials in the nutritional status of children are analyzed using data from DHS surveys conducted in French-speaking Sahelian countries (Senegal, Mali, Burkina-Faso, Niger, Chad and Mauritania). The study covers as much as possible the 1990-2015 period, with variations across countries depending on data availability. Data from Mauritania do not allow for trend analysis, but only for differential analysis. Trends are analyzed using linear regression models by cohort (year of birth), taking into account gender and age. Differential analysis focuses on place of residence, household wealth, and adult level of education.
In the five countries with available data, the height of children aged 12-59 months increased steadily over the period, indicating a marked improvement in nutritional status. This increase in height was particularly notable in Senegal and Burkina Faso. The change in weight was also positive, but more contrasted and particularly weak in Senegal and Chad. Thus, the weight / height ratio (Body-Mass-Index or BMI) evolved differently in the five countries: it decreased in Senegal and Chad, remained virtually constant in Burkina and Niger, and increased only significantly in Mali. Differences between countries were due in part to differences in baseline levels (in 1990), and in part to differences in economic development and in public health. The prevalence of malnutrition declined sharply in all five countries due to average improvements and to decreasing inequality as measured by the reduction in standard deviations.
The order of magnitude of the differentials was remarkably consistent between countries. The sex differences in weight, height and weight-for-height were almost identical, with boys being taller and heavier. The effect of urban residence on height was more marked in Mali; that on weight was more marked in Burkina and Niger; in contrast, that on BMI was negative in Mali and Chad. The effects of household wealth and level of education were always positive on weight and height, but not on BMI in Senegal. In Mauritania, differentials were broadly consistent with those of other countries, but more difficult to interpret because of small sample size. The highest socio-economic groups were close to international standards in weight and height for age.
Overall, progress in public health, and in particular the control of infectious diseases, appears to have had a significant effect on children’s height, but economic growth has been insufficient to allow for an improvement in BMI.