Publication: Micro-level Estimation of Child Malnutrition Indicators and Its Application in Cambodia
Loading...
Published
2005-07
ISSN
Date
2012-06-15
Author(s)
Editor(s)
Abstract
One of the major limitations in addressing child malnutrition is lack of information that could be used to target resources. By combining demographic and health survey (DHS) and population census data, the author disaggregates the estimates of the prevalence of child malnutrition in Cambodia from currently available 17 DHS strata into 1,594 communes. The methodology is built on the small-area estimation technique developed by Elbers, Lanjouw, and Lanjouw. The author extends it to jointly estimate multiple indicators and to allow for a richer structure of error terms. Average standard errors for the commune-level estimates in this study were about 4 percent, a magnitude comparable to those for stratum-level estimates derived from DHS only. The author demonstrates three applications of these estimates. First, he explores the relationship between malnutrition, consumption poverty, and inequality. The nonlinear effects of consumption on nutritional status of children are a key component of the relationship. Second, he conducts a decomposition analysis of health inequality and finds that the between-location share of health inequality is lower than with consumption inequality. Finally, he evaluates the potential gains from geographic targeting. The author finds that the savings in the cost of a nutrition program from commune-level targeting is on average at least two to three times higher than that from stratum-level targeting when the per capita cost of the program is fixed.
Link to Data Set
Citation
“Fujii, Tomoki. 2005. Micro-level Estimation of Child Malnutrition Indicators and Its Application in Cambodia. Policy Research Working Paper; No. 3662. © World Bank. http://hdl.handle.net/10986/8206 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Publication The Macroeconomic Implications of Climate Change Impacts and Adaptation Options(Washington, DC: World Bank, 2025-05-29)Estimating the macroeconomic implications of climate change impacts and adaptation options is a topic of intense research. This paper presents a framework in the World Bank's macrostructural model to assess climate-related damages. This approach has been used in many Country Climate and Development Reports, a World Bank diagnostic that identifies priorities to ensure continued development in spite of climate change and climate policy objectives. The methodology captures a set of impact channels through which climate change affects the economy by (1) connecting a set of biophysical models to the macroeconomic model and (2) exploring a set of development and climate scenarios. The paper summarizes the results for five countries, highlighting the sources and magnitudes of their vulnerability --- with estimated gross domestic product losses in 2050 exceeding 10 percent of gross domestic product in some countries and scenarios, although only a small set of impact channels is included. The paper also presents estimates of the macroeconomic gains from sector-level adaptation interventions, considering their upfront costs and avoided climate impacts and finding significant net gross domestic product gains from adaptation opportunities identified in the Country Climate and Development Reports. Finally, the paper discusses the limits of current modeling approaches, and their complementarity with empirical approaches based on historical data series. The integrated modeling approach proposed in this paper can inform policymakers as they make proactive decisions on climate change adaptation and resilience.Publication South Africa’s Fragmented Cities: The Unequal Burden of Labor Market Frictions(Washington, DC: World Bank, 2026-01-08)Using high-resolution administrative, census, and satellite data, this paper shows that South African cities are characterized by spatial mismatches between where people live and where jobs are located, relative to 20 global peers. Areas within 5 kilometers of commercial centers have 9,300 fewer residents per square kilometer than expected, which is 60 percent below the global median. Poor, dense neighborhoods are most affected. In Johannesburg, a 10-percentile increase in distance from the nearest business hub corresponds to a 3.7-percentile drop in asset wealth (a proxy of household wellbeing) and 4.9-percentile drop in employment. In Cape Town, the declines are 4.0 and 3.7 percentiles, respectively. Employment is 87 percent lower in the poorest decile than the richest in Johannesburg and 61 percent lower in Cape Town. These findings suggest that South Africa’s spatial organization of people and economic activity constrains agglomeration and reinforces inequality. This methodology provides a scalable and standardized data-driven framework to analyze spatial accessibility and agglomeration frictions in complex, data-constrained urban systems.Publication The Evolution of Local Participatory Democracy in Nepal(Washington, DC: World Bank, 2025-11-05)Nepal is, according to its constitution, among the world’s most decentralized countries, with a long and complex tradition of local-level public participation. This paper traces the evolution of Nepal’s modern participatory institutions, examining the extent to which they are “induced” by external interventions versus being “organically” rooted in indigenous practices. The paper identifies three broad phases: an initial focus on participation in project implementation; a subsequent phase that expanded citizen engagement; and a third phase of citizen empowerment, culminating in the 2015 federal constitution, which granted unprecedented local autonomy. The analysis yields five key findings. First, over the past 50 years, successive reforms have progressively expanded opportunities for citizens to influence local decision-making. Second, these reforms have integrated traditional participatory mechanisms into formal institutions of local government. Third, although central-level initiatives exist, most participatory platforms continue to operate at the local level. Fourth, the federal constitution has created a new landscape of local democracy, embedding autonomy and accountability. Fifth, although they are still valued in many ethnic and territorial communities, traditional participatory practices are gradually disappearing. The paper concludes by offering policy recommendations to help donor agencies and governments strengthen Nepal’s democratic trajectory. It argues that effective interventions should build on Nepal’s deep participatory traditions while recognizing the constitutional reality of far-reaching local autonomy.Publication Institutional Capacity for Policy Implementation: An Analytical Framework(Washington, DC: World Bank, 2026-01-07)State capacity is an important prerequisite for policy implementation, yet at the country level it is difficult to measure, assess, and reform. This paper proposes a focus on institutional capacity: the ability of public institutions to implement the specific policy mandates for which they are responsible. Based on a review of existing literature, the paper defines the different dimensions that compose institutional capacity and groups them into two cross-cutting categories: organizational dimensions (personnel, financial resources, information systems, and management practices) and governance dimensions (transparency, independence, and accountability). The paper proposes measures for organizational and governance dimensions using existing data, shows intra-institutional variation of these measures within countries, and discusses how new data could be collected for better measurement of these concepts. Finally, the paper illustrates how the framework can be used to diagnose the sources of common problems related to weak policy implementation.Publication Closing the Gender Gap in Entrepreneurship: Overcoming Challenges in Law and Practice for Female Entrepreneurs(Washington, DC: World Bank, 2026-01-07)Despite significant strides toward gender equality, women around the world continue to encounter systemic obstacles that hinder their entrepreneurial success. This paper systematically reviews the literature on the barriers female entrepreneurs face and the solutions proposed to overcome these challenges. It discusses institutional factors, financial factors, human capital factors, and social and cultural factors. The literature overview is complemented by a series of stylized facts that illustrate how overcoming some of these existing barriers is correlated with improved women’s entrepreneurship and female labor force participation, drawing on the World Bank’s Women, Business and the Law database as well as the World Bank’s Enterprise Surveys. The findings underscore the need for creating an enabling environment where women can thrive as entrepreneurs.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Micro-Level Estimation of Child Undernutrition Indicators in Cambodia(World Bank, 2011-03-30)One major limitation to addressing child undernutrition is a lack of the information required to target resources. This article extends the small-area estimation technique of Elbers, Lanjouw, and Lanjouw (2002, 2003) to jointly estimate multiple equations while allowing for individual-specific random errors across equations (in addition to cluster- and household-specific random errors). Estimates of the prevalence of stunting and underweight for children under age 5 in Cambodia from 17 Demographic and Health Survey strata are disaggregated into 1,594 communes by combining the Demographic and Health Survey data. The estimates are consistent with the survey-only estimates at the aggregate and primary sampling unit levels. The accuracy of the commune-level estimates is comparable to the survey-only estimates at the stratum level. The results are robust, and the estimates are useful for policy analysis and formulation. The small-area estimates can be presented in various ways. The strengths of each representation are also discussed.Publication Malnutrition in Afghanistan : Scale, Scope, Causes, and Potential Response(World Bank, 2011)This book has the potential to contribute to a reversing of this trend, whereby activities in not only the health sector but also in other sectors relevant to nutrition will gain increased support and prominence in national development planning. South Asia has by far the largest number of malnourished women and children, and no other region of the world has higher rates of malnutrition. Malnutrition in childhood is the biggest contributor to child mortality; a third of child deaths have malnutrition as an underlying cause. For the surviving children, malnutrition has lifelong implications because it severely reduces a child's ability to learn and to grow to his or her full potential. Malnutrition thus leads to less productive adults and weaker national economic performance. Therefore, the impact of malnutrition on a society's productivity and well being and a nation's long-term development is hard to underestimate. For the South Asia region of the World Bank, malnutrition is a key development priority, and in the coming years, the Bank intends to enhance dramatically its response to this challenge. As a first step, a series of country assessments such as this one are being carried out. These assessments will be used to reinforce the dialogue with governments and other development partners to scale up an evidence-based response against malnutrition. To succeed, we will need to address the problem comprehensively, which will require engaging several sectors. This assessment of malnutrition in Afghanistan lays out the scale, scope, and causes of the problem. The assessment also indicates key elements of a potential response.Publication Stagnant Stunting Rate Despite Rapid Economic Growth in Papua New Guinea(World Bank, Washington, DC, 2015-06)Maternal and child undernutrition is a pervasive and detrimental condition in Papua New Guinea. Despite rapid economic growth during the past decade, the stunting rate for children under 5, one of the primary indicators for child undernutrition, was estimated at 46 percent in Papua New Guinea in 2010, stagnant from 44 percent in 2005. This paper analyzes the association between the demographic, socioeconomic, environmental, and health-related factors on nutritional status for children under age 5 years, using the 2009–10 Papua New Guinea Household Income and Expenditure Survey. Stunting and underweight rates sharply rise in the first 24 months. Even in the better-off quintiles, children suffer from suboptimal breastfeeding and complementary food in the first 24 months. In general, the regression results showed that household wealth and geographic location are crucial factors that contribute to children’s malnutrition. More importantly, food quality, measured by protein intake, has significant predicting power on child malnutrition. Broadly increasing socioeconomic status and improving the quantity and quality of caloric intake are general steps to improving health outcomes in Papua New Guinea. In addition, three key areas were identified as critical to alleviating the persistent and detrimental stunting rate in the country: (1) exclusive breastfeeding and complementary food; (2) interventions by health workers; and (3) nutrition education.Publication The Impact of Early Childhood Nutritional Status on Cognitive Development : Does the Timing of Malnutrition Matter?(Washington, DC: World Bank, 2001-01)This article uses longitudinal data from the Philippines to examine whether the timing of malnutrition in early childhood is a critical factor in determining subsequent cognitive development. Although some observers have argued that the first six months of life are the most critical in the sense that malnutrition during that time period harms cognitive development more than malnutrition later in life, analysis of the Philippines data does not support this claim. To the contrary, the data suggest that malnutrition in the second year of life may have a larger negative impact than malnutrition in the first year of life.Publication United Republic of Tanzania : Advancing Nutrition for Long-Term Equitable Growth(Washington, DC, 2007-12)This report explores the importance of nutrition for Tanzania. It demonstrates that the prevalence of malnutrition is very high. In fact, Tanzania appears to be affected by a double burden of malnutrition, with a very high incidence of undernourished children, but with a high prevalence of overweight and obese adults as well, particularly in urban areas. The report highlights the high (economic and welfare) costs associated to such high rates of malnutrition by discussing the consequence of malnutrition for infant mortality, education outcomes, the health system and labor productivity. For nutrition to be successfully advanced high level support is needed. Efforts to advance nutrition in Tanzania have made before, with the earliest attempts dating back to the late 1970s. Most have not been very successful. To enhance the likelihood of success this time, commitment from all stakeholders is needed. A social contract that is announced at a public event by a high level policy maker may be one way to commit the actors to change. Such a social contract would have to set clear objectives and a timeline, it would have to define roles and responsibilities of the various stakeholders and provide an accountability framework. The high incidence of malnutrition thus presents an opportunity to enhance school performance, reduce maternal and infant and child mortality and to improve the ability of the labor force to be productive.
Users also downloaded
Showing related downloaded files
Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication Commodity Markets Outlook, October 2023(Washington, DC: World Bank, 2023-10-30)The conflict in the Middle East—the latest of an extraordinary series of shocks in recent years—has heightened geopolitical risks for commodity markets, in an already uncertain global environment. Before the conflict began, voluntary oil supply withdrawals by OPEC+ producers pushed energy prices up 9 percent in the third quarter. As a result, the World Bank’s commodity price index rose 5 percent over that period and is now 45 percent above its 2015-19 average. For now, the war’s impact on commodity prices have been muted. Prices of oil and gold have risen moderately, but most other commodity prices have remained relatively stable. Nevertheless, history suggests that an escalation of the conflict represents a major risk that could lead to surging prices of oil and other commodities. A Special Focus section provides a preliminary assessment of the potential impact of the conflict on commodity prices. It finds that the effects of the conflict are likely to be limited, assuming the conflict does not widen. Under that assumption, the baseline forecast calls for commodity prices to decline slightly over the next two years. If the conflict does escalate, the assessment also includes what might happen under three risk scenarios, relying upon historical precedents to estimate the effects of small, moderate, and large disruptions to the global oil supply. The magnitude of the effects will depend on the duration and scale of the supply disruptions.Publication Corporate Governance and Enterprise Reform in China : Building the Institutions of Modern Markets(Washington, DC: World Bank and the International Finance Corporation, 2002-03)This book explores the short- to medium-term corporate governance issues that China is encountering during the course of corporation and ownership transformation of its enterprise sector. The study looks at companies participating in the two main forms of ownership diversification: listed companies and small and medium enterprises whose ownership structure is dominated by insiders. The focus is on the new mechanisms and stakeholders emerging during the process of ownership diversification and their role in corporate governance. Recommended priorities for action are based on the following guiding principles: 1) Corporate governance scandals in emerging and developed markets indicate that there is no perfect corporate governance model. An effective corporate governance system should be capable of identifying weaknesses before they develop into systemic problems. 2) The institutional mechanisms of corporate governance comprise a system that can employ alternative yet complementary instruments of control to effectuate changes in companies' behavior. Based on these principles, the following areas emerge as recommended priorities for policy action: a) alleviate the negative impact of dominant state ownership on market discipline and on the regulatory capacity of the state; b) building an institutional investor base; and c) strengthening the role of banks in corporate governance.Publication Republic of Togo Basic Agricultural Public Expenditure Diagnostic Review(Washington, DC, 2012-01)After 15 years of political stagnation due to political troubles from 1990 to 2005, Togo is now enjoying political stability and economical revival. Agricultural sector is doing especially well and the government is reviewing the public expenditures in this domain. The goal is to learn lessons from the past in terms of budget and to increase the performances of the programs to come. The objectives of this document are: a) better understand how the country is performing in agriculture; b) learn lessons from the past in terms of budgetary execution in agriculture to make new programs more effective; c) increase the knowledge of the government and his partners on their resources so they can make knowledgeable decisions regarding the agriculture budget; and d) contribute to the internalization of the review of public expenditures.Publication Hunting for Leopards : Long Run Country Income Dynamics in Africa(World Bank, Washington, DC, 2008-09)This paper examines the country-level dynamics of long-run growth in Africa between 1975 and 2005. The authors examine how growth has affected mobility and the distribution of income among countries. They analyze changes in cross-country income structure and convergence, and look for evidence of the formation of country groups or "clubs." Using a novel method of breaking up the growth histories of African economies into medium-term spells of growth accelerations and declines, the authors investigate whether a group of African "leopards" - the regional equivalent of Asia's "tigers" - is beginning to emerge.