Child malnutrition continues to be an issue of growing interest for the international
development community in general and African governments and policy makers in particular.
Over 6.5 million children in developing countries under the age of five die every year because of
malnutrition and hunger-related diseases (UNICEF, 2006). For many countries, implementation
of effective malnutrition prevention initiatives is becoming a priority. These initiatives typically
focus on promoting proper feeding practices, improving maternal health, and providing access to
adequate sanitary conditions. Among specific examples of such initiatives are three of the eight
Millennium Development Goals focused on reducing hunger and child mortality and improving
maternal health, and the World Health Organization and United Nations Children’s Fund’s
(UNICEF) Global Strategy on Infant and Young Child Feeding, a program focused on improving
the health, growth and development of infants and young children. These initiatives along with
many others are aimed at reducing the prevalence rates of child malnutrition, which will not only
impact children’s well-being in a short-run, but also will promote human development needed
for long-run economic growth.
Ghana is one of the countries where child malnutrition continues to be an important issue.
Although Ghana has evolved into a middle income country with a stable and mature democracy,
there are still areas in Ghana experiencing extreme poverty and food insecurity. These
impoverished and food insecure areas are predominately found in rural parts of northern Ghana.
There is a large disparity in the health and well-being of people living in rural areas in northern
Ghana compared to those living in the Greater Accra Region. Thus, many of intervention
programs have shifted their focus and are targeting areas in northern Ghana. The main goal of
Ghana’s national health programs is improving the health and nutrition status of children (ICF
Macro, 2010). The majority of child malnutrition programs have been initiated by development
partners such as United States Agency of International Development (USAID), UNICEF, and
World Food Programme.
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Child malnutrition is a result of inadequate food intake and improper treatment of illness.
It is commonly measured by using three anthropometric indicators of stunting, wasting, and
underweight.  A child is considered stunted if their height-for-age is more than two standard
deviations below the median of an international reference population. Stunting is an indicator of
chronic deficiency, and this malnutrition affects cognitive and physical development and its
effects are usually permanent. A child is considered to be wasted if their weight-for-height is
more than two standard deviations below the median of the international reference population.
Wasting is an indicator of acute undernutrition, and its affect can be fatal. Underweight is a
composite measure of both chronic and acute undernutrition (Gillespie and McNeill, 1994;
Arnold et al., 2003). Malnourished children face a higher risk of mortality than well-nourished
children (ICF Macro, 2010).
The purpose of this paper is to improve the understanding of the complexity and the
magnitude of the issue of child malnutrition in northern Ghana by examining the changes in
prevalence of child malnutrition over time. Assessing trends in child malnutrition levels will
provide insights into the effectiveness of the implemented programs and will assist policy
makers and program managers in the design and implementation of new programs that target
most vulnerable groups. Even though most individual programs have impact evaluation
component as part of their respective projects, these evaluations can only provide a snapshot
over the duration of their project or focus area and do not provide a complete view of the
changes in child malnutrition over a longer period of time. Thus, the objective of this paper is to
conduct a comprehensive longitudinal analysis of child malnutrition trends in Ghana using
nationally representative data from Ghana Demographic and Health Surveys (DHS) 1988-2008.
More specifically, this study will investigate the factors that influence child malnutrition in
Ghana and how these determinants have changed over twenty year period.
The paper is divided into five sections. The second section provides a description of the
econometric method and the DHS 1988-2008 data. Following this, section three presents the
results from the analyses, and section four provides a discussion of the notable findings and their
implications for policy choices and assistance programs aimed to combat child malnutrition.
Final section presents conclusions and unresolved issues.