Parental investment can moderate the negative effects of low socioeconomic status on children’s health: an analysis of Kenyan national data

Abstract

# Background Stunting is an indicator for cumulative growth deficits and long-term undernutrition. Determinants of stunting include poverty, food insecurity, poor sanitation, and low maternal education. Stunting has both short and long-term detrimental health and developmental effects on children. In 2020, around 149 million children under five were stunted worldwide. This study examines whether parental investment moderates the association between maternal education and childhood stunting in Kenya. # Methods The 2014 Kenya Demographic and Health Survey was used to examine the variation in childhood stunting, analysed using binary logistic regression. Subgroup effect modification models were utilized to incorporate the interactions between maternal education and parental investments: marital status, household size, number of antenatal visits and breastfeeding duration on childhood stunting. # Results This analysis included 17247 children under 5 years. The results indicated that 26% of Kenyan children under five were stunted in 2014. The prevalence of stunting was greater among males (30%) than females (22%). There was an increasing adverse effect of decreasing maternal education levels on stunting as secondary education (odd ratios (OR)=1.63; 95% confidence interval (CI)=1.40-1.98), primary education (OR=2.95; 95% CI=2.51-3.46) and no education (OR=3.07; 95% CI=2.56-3.68) relative to higher education. Breastfeeding for ≥12 months was associated with a lower risk of adverse effects of primary education (OR=3.03; 95% CI=1.82-3.36), compared to breastfeeding for <6 months (OR=4.01; 95% CI=1.11-15.50), relative to higher education. Smaller households (2-4 members) (OR=2.96; 95% CI=1.81-5.12) and 5-7 ANC visits (OR=2.22; 95% CI=1.50-3.43) diminished the adverse effects of no maternal education relative to higher education on stunting. # Conclusions In Kenya, childhood stunting still is a critical public health challenge. Parents can invest more in their offspring through planning for fewer children, attending sufficient antenatal clinics, and providing adequate breastfeeding to moderate the negative effects of low socio-economics status on their children's health.