Ajieroh (2009) promotes the use of the conceptual framework when assessing the analysis of NDHS as having a better fit at the underlying causal level (food, health and care) of the framework. The results indicated that generally, across rural and urban areas, household economic status has statistically significant and positive effects on child nutrition. Household economic status had statistically significant and positive effects in rural North East and in urban areas of the North East and North West. Similarly for the mother generally in rural and urban areas, household economic status had positive and significant but weak effect on maternal nutrition and in all urban areas except the North East.
Ajieroh has directly related his analysis to the conceptual framework using the nutritional status indicators as the dependent variable and various independent variables to represent factors at the underlying level. The objectives of this analysis were to:
- Identify household and community characteristics and regional-specific risks that affect malnutrition in children 0-3 years and adult women of gestational age;
- Develop a set of typologies of vulnerability to malnutrition based on this assessment;
- Assess how current nutritional strategies and interventions do or do not address these determinants, and
- Recommend improvements in policies and programmes.
These regressions teased out independent correlates which showed that, nationally: (a) household economic status have statistically significant and widespread but limited overall effects, (b) households involved in agriculture have lower child nutrition status scores, even controlling for economic status, (c) when mothers work, this has a positive association with child nutrition status in rural areas, independent of household economic status, (d) maternal education has a strong association with child and maternal nutrition and (e) access to health care (e.g. antenatal visits) has less association with nutrition outcomes, perhaps signalling quality issues. Therefore household economic status, maternal education and women’s empowerment are important predictors of maternal and child malnutrition in Northern Nigeria.
The socioeconomic status of a household is vital as it often determines the family’s ability to procure nutritious foods for children and to care for their health. Household economic status correlates with the family’s ability to seek and finance health care for their children since Nigeria lacks a publicly funded health care system that would provide access to good and basic health care services to the poor households.
Some determinants cut across many of the rural and urban regions and zones, the effects of other determinants are more localized in rural or urban settings of particular regions and zones. While maternal education and knowledge are critical for improved maternal and child nutrition, efforts to improve household economic status, increase the rural farmers’ benefits from agriculture, and empower mothers to earn income and take decisions, complemented with nutritional and public health services, are more likely to improve child and maternal nutrition in the rural areas where it is most needed.
Agriculture and Food Production
Ajieroh finds that at the national level, households involved in agriculture have lower child nutrition status scores, even controlling for economic status. He suggests that any prediction of nutritional outcomes across a country as diverse as Nigeria should take into account the links between nutritional status and types of farming systems, and crops grown and consumed. Thus he finds that the agro-ecological approach is a strong predictor that can capture the range of contexts that together affect the well being of mothers and their children. Ajieroh finds that agriculture, when a primary source of income for households, was found to have a significant negative effect in child nutritional status, and was found to be significant in North Central but not in North West or North East.