Decomposing Changes in Child Health Inequality in Sub-Saharan Africa

We analyse recent changes in child health inequality in 15 Sub-Saharan African countries, identifying both observed and unobserved factors that contribute to these changes within each country. We also explore the cross-country correlation between changes in child health inequality and changes in mean child health. We use a regression-based decomposition approach to estimate the contribution of a set of factors to changes in child health inequality, which is fully comparable to existing decomposition methods used for mean child health. Observed characteristics include between-regional features related to geographical aspects and within-regional factors such as family background, mother’s demography, family structure, and home infrastructure. While child health inequality declined in most countries, the proportion of inequality explained by observed factors increased. Unobserved and between-regional features contribute to reducing health inequality, whereas within-regional factors related to family background and mother’s demography have increased it. These two groups of factors are behind the positive cross-country correlation between changes in child health inequality and changes in mean child health: their contributions worsen health inequality even as they improve mean health.