DHS ANALYTICAL

STUDIES 76

HOUSEHOLD WEALTH RELATIVE TO 

COMMUNITY WEALTH: ASSOCIATIONS 

WITH SPECIFIC ASSET OWNERSHIP AND 

MATERNAL AND CHILD HEALTH INDICATORS

September 2020

This publication was produced for review by the United States Agency for International Development. It was prepared by

William Winfrey and Sara Riese.

DHS Analytical Studies No. 76

Household Wealth Relative to Community Wealth: 

Associations with Specific Asset Ownership and Maternal 

and Child Health Indicators

William Winfrey1, 2

Sara Riese2

ICF

Rockville, Maryland, USA

September 2020

1 Avenir Health

2 The DHS Program, ICF

Corresponding author: Sara Riese, The DHS Program, 530 Gaither Road, Suite 500, Rockville, MD 

20850, USA; phone: +1 301-572-0546; fax: +1 301-407-6501; email: Sara.Riese@icf.com
Acknowledgments: The authors wish to thank Shea Rutstein for valuable comments on this report. We 

also gratefully acknowledge Diane Stoy for editorial assistance and Natalie Shattuck for formatting support. 

Editor: Diane Stoy

Document Production: Natalie Shattuck

This study was carried out with support provided by the United States Agency for International 

Development (USAID) through The DHS Program (#720-0AA-18C00083). The views expressed are those 

of the authors and do not necessarily reflect the views of USAID or the United States Government.

The DHS Program assists countries worldwide in the collection and use of data to monitor and evaluate 

population, health, and nutrition programs. Additional information about The DHS Program can be obtained 

from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850 USA; telephone: +1 301-407-6500, fax: 

+1 301-407-6501, email: info@DHSprogram.com, Internet: www.DHSprogram.com.

Recommended citation:

Winfrey, William and Sara Riese. 2020. Household Wealth Relative to Community Wealth: Associations 

with Specific Asset Ownership and Maternal and Child Health Indicators. DHS Analytical Studies No. 76. 

Rockville, Maryland, USA: ICF.
iii

CONTENTS

TABLES...................................................................................................................................................... vii

FIGURES ..................................................................................................................................................... ix

PREFACE................................................................................................................................................... xv

ACRONYMS ............................................................................................................................................. xvii

ABSTRACT................................................................................................................................................ xix

1 INTRODUCTION.............................................................................................................................. 1

1.1 Background......................................................................................................................... 1

1.2 Rationale ............................................................................................................................. 1

1.2.1 Specific asset ownership ....................................................................................... 1

1.2.2 MCH coverage ....................................................................................................... 2

2 DATA AND METHODS ................................................................................................................... 3

2.1 Data..................................................................................................................................... 3

2.2 Measures ............................................................................................................................ 3

2.2.1 Wealth inequality measures................................................................................... 3

2.2.2 Specific asset ownership ....................................................................................... 4

2.2.3 MCH outcomes ...................................................................................................... 5

2.2.4 Covariates.............................................................................................................. 6

2.3 Analysis............................................................................................................................... 6

2.3.1 Identifying specific asset drivers of quintile membership....................................... 6

2.3.2 Assessing inequalities in MCH health indicators by household wealth relative 

to average community wealth ................................................................................ 9

3 OVERALL RESULTS .................................................................................................................... 11

3.1 Household wealth relative to average community wealth................................................. 11

3.2 Asset ownership and household wealth relative to average community wealth............... 12

3.3 Health indicators and household wealth relative to community average wealth .............. 17

4 DISCUSSION AND CONCLUSION............................................................................................... 21

5 COUNTRY-SPECIFIC RESULTS.................................................................................................. 25

5.1 DRC .................................................................................................................................. 25

5.1.1 Household wealth relative to average community wealth.................................... 25

5.1.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 25

5.1.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 27

5.2 Ghana ............................................................................................................................... 31

5.2.1 Household wealth relative to average community wealth.................................... 31

5.2.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 31

5.2.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 33
iv

5.3 Haiti ................................................................................................................................... 37

5.3.1 Household wealth relative to average community wealth.................................... 37

5.3.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 37

5.3.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 39

5.4 Indonesia........................................................................................................................... 43

5.4.1 Household wealth relative to average community wealth.................................... 43

5.4.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 44

5.4.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 45

5.5 Kenya ................................................................................................................................ 48

5.5.1 Household wealth relative to average community wealth.................................... 48

5.5.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 49

5.5.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 50

5.6 Liberia ............................................................................................................................... 54

5.6.1 Household wealth relative to average community wealth.................................... 54

5.6.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 55

5.6.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 56

5.7 Mali.................................................................................................................................... 61

5.7.1 Household wealth relative to average community wealth.................................... 61

5.7.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 61

5.7.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 63

5.8 Nigeria............................................................................................................................... 67

5.8.1 Household wealth relative to average community wealth.................................... 67

5.8.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 68

5.8.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 69

5.9 Pakistan ............................................................................................................................ 74

5.9.1 Household wealth relative to average community wealth.................................... 74

5.9.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 74

5.9.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 76

5.10 Senegal ............................................................................................................................. 80

5.10.1 Household wealth relative to average community wealth.................................... 80

5.10.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 81

5.10.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 82
v

5.11 Zambia .............................................................................................................................. 86

5.11.1 Household wealth relative to average community wealth.................................... 86

5.11.2 Asset ownership and household wealth relative to average community 

wealth................................................................................................................... 87

5.11.3 Health indicators and household wealth relative to average community 

wealth................................................................................................................... 88

REFERENCES............................................................................................................................................ 93

APPENDIX.................................................................................................................................................. 95

vii

TABLES

Table 1 DHS surveys included in the analysis........................................................................ 3

Table 2 Distribution of household wealth relative to community average wealth, 

by country ................................................................................................................ 12

Table 3 Summary results of effect of having electricity on relative community wealth 

category ................................................................................................................... 13

Table 4 Summary results of effect of owning a vehicle on relative community wealth 

category ................................................................................................................... 13

Table 5 Summary results of effect of owning a telephone on relative community wealth 

category ................................................................................................................... 14

Table 6 Summary results of effect of having a bank account on relative community 

wealth category........................................................................................................ 14

Table 7 Summary results of effect of having an improved water source on relative 

community wealth category ..................................................................................... 15

Table 8 Summary results of effect of having improved sanitation on relative community 

wealth category........................................................................................................ 15

Table 9 Summary results of effect of having improved flooring on relative community 

wealth category........................................................................................................ 16

Table 10 Summary results of effect of having improved walls on relative community 

wealth category........................................................................................................ 16

Table 11 Average marginal effect of being a poor household relative to community 

compared to being a rich household relative to community .................................... 19

Table 12 Summary table of programmatically important differences in asset ownership ...... 22

Appendix Table A1 Regressions of assets on household wealth quintiles and household relative 

to community............................................................................................................ 96

Appendix Table A2 Marginal effect of a household being wealthy relative to community 

versus a household being poor relative to community .......................................... 107

Appendix Table A3 Unadjusted and adjusted odds ratios for maternal and reproductive health 

indicators................................................................................................................ 113

Appendix Table A4 Unadjusted and adjusted odds ratios for child health indicators ........................... 124

Appendix Table A5 Unadjusted and adjusted odds ratios for child nutrition indicators among 

children under age 5 .............................................................................................. 135

Appendix Table A6 Average marginal effects (AMEs) and 95% confidence intervals (CI) of being 

a poor household relative to community compared to being a rich household 

relative to community on each outcome by country .............................................. 140

ix

FIGURES

Figure 1 Predicted probability of vehicle ownership by household wealth quintile, 

Mali 2018 ................................................................................................................... 8

Figure 2 Predicted probability of vehicle ownership by household wealth quintile, 

Mali 2018 ................................................................................................................... 9

Figure 3 Bar graph of household wealth relative to community average wealth inequality 

score, overall and by indicator category .................................................................. 17

Figure 4 Distribution of household wealth relative to community average, 

DRC 2013-14 ........................................................................................................... 25

Figure 5 Predicted probabilities of asset ownership (vehicle, telephone, and bank 

account) by household wealth quintile, DRC 2013-14............................................. 26

Figure 6 Predicted probabilities of asset ownership (improved water source, improved 

sanitation, and improved wall) by household wealth quintile, DRC 2013-14........... 27

Figure 7 Levels of MRH indicators, by household wealth quintile, DRC 2013-14 ................. 27

Figure 8 Predicted probabilities of MRH indicators by household wealth quintile, 

DRC 2013-14 ........................................................................................................... 28

Figure 9 Levels of child health indicators, by household wealth quintile, DRC 2013-14 ....... 29

Figure 10 Predicted probabilities of child health indicators by household wealth quintile, 

DRC 2013-14 ........................................................................................................... 29

Figure 11 Levels of child nutrition indicators, by household wealth quintile, 

DRC 2013-14 ........................................................................................................... 30

Figure 12 Predicted probabilities of child nutrition indicators by household wealth quintile, 

DRC 2013-14 ........................................................................................................... 30

Figure 13 Distribution of household wealth relative to community average, Ghana 2014....... 31

Figure 14 Predicted probabilities of asset ownership (electricity, vehicle, telephone, 

and bank account) by household wealth quintile, Ghana 2014............................... 32

Figure 15 Predicted probabilities of asset ownership (Improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Ghana 2014 ..... 33

Figure 16 Levels of MRH indicators, by household wealth quintile, Ghana 2014 ................... 33

Figure 17 Predicted probabilities of MRH indicators by household wealth quintile, 

Ghana 2014 ............................................................................................................. 34

Figure 18 Levels of child health indicators, by household wealth quintile, Ghana 2014 ......... 35

Figure 19 Predicted probabilities of child health indicators by household wealth quintile, 

Ghana 2014 ............................................................................................................. 35

Figure 20 Levels of child nutrition indicators, by household wealth quintile, Ghana 2014 ...... 36

Figure 21 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Ghana 2014 ............................................................................................................. 36

Figure 22 Distribution of household wealth relative to community average, 

Haiti 2016-17............................................................................................................ 37
x

Figure 23 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Haiti 2016-17 .................................... 38

Figure 24 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, 

Haiti 2016-17............................................................................................................ 39

Figure 25 Levels of MRH indicators, by household wealth quintile, Haiti 2016-17.................. 39

Figure 26 Predicted probabilities of MRH indicators by household wealth quintile, 

Haiti 2016-17............................................................................................................ 40

Figure 27 Levels of child health indicators, by household wealth quintile, Haiti 2016-17........ 41

Figure 28 Predicted probabilities of child health indicators by household wealth quintile, 

Haiti 2016-17............................................................................................................ 42

Figure 29 Levels of child nutrition indicators, by household wealth quintile, 

Haiti 2016-17............................................................................................................ 42

Figure 30 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Haiti 2016-17............................................................................................................ 43

Figure 31 Distribution of household wealth relative to community average, 

Indonesia 2017 ........................................................................................................ 44

Figure 32 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Indonesia 2017 ................................. 44

Figure 33 Predicted probabilities of asset ownership (improved water, improved 

sanitation, improved floor, and improved wall) by household wealth quintile, 

Indonesia 2017 ........................................................................................................ 45

Figure 34 Levels of MRH indicators, by household wealth quintile, Indonesia 2017............... 46

Figure 35 Predicted probabilities of MRH indicators by household wealth quintile, 

Indonesia 2017 ........................................................................................................ 47

Figure 36 Levels of child health indicators, by household wealth quintile, Indonesia 2017..... 47

Figure 37 Predicted probabilities of child health indicators by household wealth quintile, 

Haiti 2016-2017........................................................................................................ 48

Figure 38 Distribution of household wealth relative to community average, Kenya 2014 ....... 49

Figure 39 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Kenya 2014....................................... 49

Figure 40 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Kenya 2014...... 50

Figure 41 Levels of MRH indicators, by household wealth quintile, Kenya 2014 .................... 51

Figure 42 Predicted probabilities of MRH indicators by household wealth quintile, 

Kenya 2014.............................................................................................................. 51

Figure 43 Levels of child health indicators, by household wealth quintile, Kenya 2014.......... 52

Figure 44 Predicted probabilities of child health indicators by household wealth quintile, 

Kenya 2014.............................................................................................................. 53

Figure 45 Levels of child nutrition indicators, by household wealth quintile, Kenya 2014....... 53
xi

Figure 46 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Kenya 2014.............................................................................................................. 54

Figure 47 Distribution of household wealth relative to community average, Liberia 2013....... 55

Figure 48 Predicted probabilities of asset ownership (vehicle, telephone, and bank 

account) by household wealth quintile, Liberia 2013............................................... 55

Figure 49 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Liberia 2013 ..... 56

Figure 50 Levels of MRH indicators, by household wealth quintile, Liberia 2013 ................... 57

Figure 51 Predicted probabilities of MRH indicators by household wealth quintile, 

Liberia 2013 ............................................................................................................. 58

Figure 52 Levels of child health indicators, by household wealth quintile, Liberia 2013 ......... 58

Figure 53 Predicted probabilities of child health indicators by household wealth quintile, 

Liberia 2013 ............................................................................................................. 59

Figure 54 Levels of child nutrition indicators, by household wealth quintile, Liberia 2013 ...... 60

Figure 55 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Liberia 2013 ............................................................................................................. 60

Figure 56 Distribution of household wealth relative to community average, Mali 2018........... 61

Figure 57 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Mali 2018 ......................................... 62

Figure 58 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Mali 2018.......... 63

Figure 59 Levels of MRH indicators, by household wealth quintile, Mali 2018........................ 64

Figure 60 Predicted probabilities of MRH indicators by household wealth quintile, 

Mali 2018 ................................................................................................................. 65

Figure 61 Levels of child health indicators, by household wealth quintile, Mali 2018.............. 65

Figure 62 Predicted probabilities of child health indicators by household wealth quintile, 

Mali 2018 ................................................................................................................. 66

Figure 63 Levels of child nutrition indicators, by household wealth quintile, Mali 2018........... 66

Figure 64 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Mali 2018 ................................................................................................................. 67

Figure 65 Distribution of household wealth relative to community average, Nigeria 2018...... 68

Figure 66 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Nigeria 2018 .................................... 68

Figure 67 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Nigeria 2018..... 69

Figure 68 Levels of MRH indicators, by household wealth quintile, Nigeria 2018................... 70

Figure 69 Predicted probabilities of MRH indicators by household wealth quintile, 

Nigeria 2018............................................................................................................. 71

Figure 70 Levels of child health indicators, by household wealth quintile, Nigeria 2018......... 71
xii

Figure 71 Predicted probabilities of child health indicators by household wealth quintile, 

Nigeria 2018............................................................................................................. 72

Figure 72 Levels of child nutrition indicators, by household wealth quintile, Nigeria 2018...... 73

Figure 73 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Nigeria 2018............................................................................................................. 73

Figure 74 Distribution of household wealth relative to community average, Pakistan 

2017-18.................................................................................................................... 74

Figure 75 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Pakistan 2017-18.............................. 75

Figure 76 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Pakistan 

2017-18.................................................................................................................... 76

Figure 77 Levels of MRH indicators, by household wealth quintile, Pakistan 2017-18 ........... 77

Figure 78 Predicted probabilities of MRH indicators by household wealth quintile, 

Pakistan 2017-18..................................................................................................... 77

Figure 79 Levels of child health indicators, by household wealth quintile, Pakistan 

2017-18.................................................................................................................... 78

Figure 80 Predicted probabilities of child health indicators by household wealth quintile, 

Pakistan 2017- 18.................................................................................................... 79

Figure 81 Levels of child nutrition indicators, by household wealth quintile, 

Pakistan 2017-18..................................................................................................... 79

Figure 82 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Pakistan 2017-18..................................................................................................... 80

Figure 83 Distribution of household wealth relative to community average, Senegal 2018 .... 81

Figure 84 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Senegal 2018.................................... 81

Figure 85 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Senegal 2018... 82

Figure 86 Levels of MRH indicators, by household wealth quintile, Senegal 2018................. 83

Figure 87 Predicted probabilities of MRH indicators by household wealth quintile, 

Senegal 2018........................................................................................................... 83

Figure 88 Levels of child health indicators, by household wealth quintile, Senegal 2018....... 84

Figure 89 Predicted probabilities of child health indicators by household wealth quintile, 

Senegal 2018........................................................................................................... 85

Figure 90 Levels of child nutrition indicators, by household wealth quintile, Senegal 2018.... 85

Figure 91 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Senegal 2018........................................................................................................... 86

Figure 92 Distribution of household wealth relative to community average, Zambia 2018 ..... 87

Figure 93 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and

bank account) by household wealth quintile, Zambia 2018..................................... 87
xiii

Figure 94 Predicted probabilities of asset ownership (improved water, improved sanitation, 

improved floor, and improved wall) by household wealth quintile, Zambia 2018 .... 88

Figure 95 Levels of MRH indicators, by household wealth quintile, Zambia 2018 .................. 89

Figure 96 Predicted probabilities of MRH indicators by household wealth quintile, 

Zambia 2018 ............................................................................................................ 89

Figure 97 Levels of child health indicators, by household wealth quintile, Zambia 2018 ........ 90

Figure 98 Predicted probabilities of child health indicators by household wealth quintile, 

Zambia 2018 ............................................................................................................ 91

Figure 99 Levels of child nutrition indicators, by household wealth quintile, Zambia 2018 ..... 91

Figure 100 Predicted probabilities of child nutrition indicators by household wealth quintile, 

Zambia 2018 ............................................................................................................ 92

xv

PREFACE

The Demographic and Health Surveys (DHS) Program is one of the principal sources of international data 

on fertility, family planning, maternal and child health, nutrition, mortality, environmental health, 

HIV/AIDS, malaria, and provision of health services. 

One of the objectives of The DHS Program is to analyze DHS data and provide findings that will be useful 

to policymakers and program managers in low- and middle-income countries. DHS Analytical Studies serve 

this objective by providing in-depth research on a wide range of topics, typically including several countries 

and applying multivariate statistical tools and models. These reports are also intended to illustrate research 

methods and applications of DHS data that may build the capacity of other researchers. 

The topics in this series are selected by The DHS Program in consultation with the U.S. Agency for 

International Development.

It is hoped that the DHS Analytical Studies will be useful to researchers, policymakers, and survey 

specialists, particularly those engaged in work in low- and middle-income countries.

Sunita Kishor

Director, The DHS Program

xvii

ACRONYMS

AME average marginal effects

ANC antenatal care

ARI acute respiratory infection

CI confidence interval

DHF delivery at a health facility

DHS Demographic and Health Survey 

DPT diphtheria-pertussis-tetanus

DRC Democratic Republic of the Congo

EBF exclusive breastfeeding 

IUD intrauterine device

MCH maternal and child health

mCPR modern contraceptive prevalence

MNCH maternal, newborn, and child health

MRH maternal and reproductive health

PCA principal components analysis

RMNCH reproductive, maternal, newborn, and child health

USAID United States Agency for International Development

WHO World Health Organization

xix

ABSTRACT

This report describes inequalities in asset ownership and maternal and child health indicator coverage in 11 

countries, using the most recent Demographic and Health surveys from each country. Inequalities are 

assessed by categorizing households according to their wealth relative to their community’s average wealth 

(poor compared to community, similar to community, rich compared to community). The overall 

distribution of household wealth relative to community average wealth is presented, along with associations 

with specific asset ownership and maternal and child health indicator coverage. Four countries (the 

Democratic Republic of Congo, Zambia, Indonesia, and Liberia) are heterogeneous when assessed by 

household wealth relative to average community wealth. This means that large proportions of households 

live in communities of differing average wealth. Kenya, Mali, Pakistan, Senegal, Ghana, and Nigeria are 

homogenous when assessed by household wealth relative to average community wealth. This means that 

most households live in communities of similar average wealth. Electricity and improved walls are assets 

associated with homogeneity and are more likely to be owned by households that are poor relative to their 

community. In contrast, ownership of vehicles is more common among households that are rich relative to 

the community. Pakistan and Indonesia have the highest proportion of health indicator inequalities of all 

countries, while the most common indicator with inequality by household wealth status relative to 

community was health facility delivery. Despite limitations, these findings may support programs that focus 

interventions on improving equity in maternal and child health.

Key words: maternal health, child health, measures of inequality, asset index

1

1 INTRODUCTION

1.1 Background

The objective of this analysis is to further explore two aspects of rural inequality in 11 United States Agency 

for International Development (USAID) maternal and child health (MCH) priority countries—the 

importance of specific assets to a household’s wealth and the role of relative wealth within the community 

on a household’s probability of achieving specific health indicators.

Inequality in MCH coverage has been a persistent challenge between and within countries, with lower

wealth associated with worse health outcomes (Barros et al. 2012; Boerma et al. 2008). Most research to 

date on inequality in MCH indicators focused on national and regional inequality. However, this research

frequently neglects inequalities that occur closer to home and at the community level.

The following section describes the rationale for assessing each topic in this analysis from a relative 

community inequality perspective.

1.2 Rationale

1.2.1 Specific asset ownership

The Demographic and Health Survey (DHS) Program uses an asset-based wealth index to estimate a 

household’s living standard. Households are asked about a large number of potential household assets, for 

which each has been assigned a weight generated through principal components analysis (PCA). 

Households are assigned a score based on whether or not they own the asset, and these scores are then 

summed. The final wealth index value places households on a continuum of wealth. Wealth quintiles are 

created by dividing this continuum into five equal groups, so that 20% of the population is in each group: 

the poorest, the poor, the middle, the rich, and the richest.

There is relatively little literature that explores the importance of specific assets in defining the wealth 

quintile of a household. Patterns in the distribution of specific types of assets, such as environmental health 

assets,

1

across wealth quintiles have been assessed (Graham, Kaur, and Jeuland 2018). Some have argued 

that certain assets included in the wealth index, such as electricity or source of drinking water, can be viewed 

as indicators of community-level infrastructure rather than household wealth (Houweling, Kunst, and 

Mackenbach 2003; Howe 2009). Despite this, attempts to improve identifying household wealth status by 

removing these indicators have been mixed. Houweling et al. (2003) found that inequalities in child 

mortality changed when these community assets were removed from the wealth index. However, the 

direction and magnitude of these changes were not consistent across countries, and removing these 

indicators had little effect on the wealth index characteristics (Howe 2009).

 

1 The authors cite “piped water and sanitation facilities, and other technologies such as clean cook stoves, bed nets, 

and point-of-use water treatment devices” as environmental assets.
2

1.2.2 MCH coverage

Persistent inequities in MCH outcomes have been documented over time. These inequities are persistent 

when using absolute or relative measures of inequality and when assessing inequalities at national or 

regional levels (Assaf 2016).

There is limited evidence on the association of inequality within a smaller geographic area, and specifically

community, with these same MCH outcomes. Much of the available research on this topic focuses on 

community inequality and contraceptive use. Community-level wealth has been associated with individual 

contraceptive uptake in Ethiopia (Abate and Tareke 2019), and both community-level wealth and the 

relative wealth status of women within their communities have been shown to be associated with modern 

contraceptive uptake in Mozambique (Dias and de Oliveira 2015). In the child nutrition arena, greater 

community wealth has shown to be associated with greater odds of child stunting in Bangladesh and Kenya 

(Reinbold 2011).

The concept that the relative wealth of a household, as compared to its community, can affect health is 

closely related to the concept of relative deprivation, which proposes that an individual’s health is 

determined by their own wealth or resources, and by their relative wealth or resources (Caner and Yiğit 

2019). Relative deprivation suggests that being deprived of something while others have it will affect health 

in one of two ways: either by limiting access to material goods, or by negative psychosocial effects

(Wilkinson 1997). Relative deprivation has been associated with mortality in South Africa (Salti 2010),

poor nutritional outcomes in adults in Zambia (Cole 2012), and depression in adults in Uganda (Smith et 

al. 2019). There is little evidence on relative deprivation, receipt of reproductive, maternal, newborn, and 

child health (RMNCH) interventions, and care-seeking in low- and middle-income countries.

Although relative deprivation focuses on the feeling of deprivation, our assessment of relative communitylevel wealth includes those who are wealthier than their community average. This analysis considers the 

following question: What does a household’s relative community wealth, that is, its wealth as compared 

with the average wealth of its community, mean for coverage of health interventions and health outcomes?

This report investigates two related issues. First, we investigate the relative contribution that particular 

assets make to a household’s wealth status, contingent upon whether a household is poor or rich relative to 

the average wealth of its community. For example, within a given wealth status, are households that are 

poor relative to their community more or less likely to own a vehicle than households that are wealthy 

relative to their community? Second, we examine the association between a household’s wealth status 

relative to its community versus use of various MCH services. For example, are women from households 

that are wealthy relative to their community more or less likely to receive adequate antenatal care (ANC)

than women who live in households that are rich relative to their community? For reasons that will be 

explained in the data and methods section, we restrict our analysis to rural areas.

In the data and methods section of this report, we describe the many results in tables and graphs. The results 

for each country are interesting. Taken as a whole, the sum of the results is overwhelming. To facilitate easy 

reading, we have organized the results into two sections. In the overall results section, we present summaries 

that compare results across countries. At the end of the report, we present the detailed analysis for each

country, after the discussion and conclusions and before the references and appendices.
3

2 DATA AND METHODS

2.1 Data 

This report uses data from 11 high-priority USAID MCH countries with recent DHS surveys. 

The community is a key element in our analysis. In general, the DHS program does not specifically collect 

information on communities. In our analysis, we use the sampling cluster as a proxy for communities. The 

sampling clusters are typically based on census enumeration areas or other partitions of the population 

where the population is geographically contiguous and more or less compact.

2

In rural areas, there is 

typically one health facility that serves a community or group of communities. In urban areas with denser 

populations, the catchment areas of health facilities are less clear. Health facilities may serve overlapping 

catchment areas. Households may also have access to more than one health facility. In this way, urban 

communities that are proxied by sampling clusters are analytically much less useful than rural communities 

proxied by sampling clusters. Therefore, we limited our analysis to rural areas. The study used the standard 

DHS urban-rural classifications, which rely on each country’s own census definitions. Table 1 shows the 

list of countries included in this analysis, the year the DHS data were collected, total sample size, and the 

rural sample size for the survey.

Table 1 DHS surveys included in the analysis

Year

Total household 

sample size

Rural household 

sample size

Democratic Republic of the Congo 2013-14 18,171 12,430

Ghana 2014 11,835 5,332

Haiti 2016-17 13,405 8,032

Indonesia 2017 47,963 24,505

Kenya 2014 36,430 22,516

Liberia 2013 9,333 4,044

Mali 2018 9,510 6,565

Nigeria 2018 40,427 21,487

Pakistan 2017-18 11,869 5,778

Senegal 2018 4,592 2,274

Zambia 2018 12,831 8,117

2.2 Measures

2.2.1 Wealth inequality measures

Using a standardized approach for measuring wealth across both urban and rural settings has been shown 

to be problematic (Chakraborty et al. 2016; Steinert et al. 2018). When using a standardized approach, urban 

households dominated the higher wealth quintiles, and rural households the bottom quintiles in most 

settings (Rutstein 2008). The DHS program responded to this by creating separate urban and rural wealth 

indices and then combining them into one national wealth index, based on the presence or absence of 

household items or characteristics thought to be common and having common weighting in both urban and 

 

2 There is variability in how the clusters are selected. Sometimes census tracts are combined if there are insufficient 

households in the tract for the second stage of sampling. Other times census tracts are subdivided if there are too many 

households in the tract.
4

rural areas. In more recent surveys, urban-specific and rural-specific wealth quintiles are by default 

calculated by the DHS program and included in the standardized datasets. When available, we used these 

wealth indices. In the older data sets,

3 we used the national level continuous wealth index with the quintiles 

recalculated to be equal across the rural areas. Further details on the calculation of the wealth index are 

available at the DHS program website.

To describe the relative socioeconomic position of a household to the average socioeconomic position in 

its community, we computed an additional measure of wealth inequality. The mean of the continuous wealth 

score for each cluster was calculated. These values were divided into quintiles to create community-level 

wealth quintiles. Each household was then categorized according to its socioeconomic position in the 

community relative to the community mean. Households in a lower wealth quintile compared to the average 

wealth quintile of its community were labeled as “poor relative to the community.” A household that was

in the same wealth quintile as the average wealth quintile of their community was labeled as “similar wealth 

relative to the community.” If the household was in a higher wealth quintile compared to the average wealth 

quintile of its community, it was labeled as “wealthy relative to the community.”

2.2.2 Specific asset ownership

In this report, we assessed ownership of eight specific assets:

Electricity in the household: Households were counted as having electricity if they responded yes to the 

question, “Does your household have electricity?”

Ownership of a phone: Households were counted as owning a phone if they responded yes to the question,

“Does any member of this household own a mobile phone?” or yes to the question, “Does your household 

have a non-mobile phone?”

Ownership of a vehicle: Households were counted as owning a vehicle if they responded yes to either of 

the questions, “Does any member of this household own a motorcycle or motor scooter?” or “Does any 

member of this household own a car or a truck?”

Ownership of a bank account: Households were counted as owning a bank account if they responded yes 

to the question, “Does any member of this household have a bank account?”

Improved water source: With some variation, we followed the World Health Organization (WHO)

definition for improved water sources,

4 which categorizes piped household water connection, public 

standpipe, borehole, protected dug well, protected spring, and rainwater collection as common improved 

drinking water sources. Unimproved drinking water sources include unprotected dug well, unprotected 

spring, surface water (river, dam, lake, pond, stream, canal, irrigation channel), vendor-provided water (cart 

with small tank/drum, tanker truck), bottled water (bottled water is considered improved only when the 

household uses an improved source of water for cooking and personal hygiene), and tanker truck water.

5

 

3 DRC, Ghana, Kenya, and Liberia.

4 https://www.who.int/water_sanitation_health/monitoring/jmp2012/key_terms/en/

5 For Ghana, Haiti, Indonesia, Nigeria, Pakistan and Senegal, we made exceptions to this definition where a special 

category of water queried in the survey was a clear case of improved water.
5

Improved sanitation: We used the WHO definition for improved sanitation, which includes households 

with sewer connections, septic system connections, pour-flush latrines, ventilated improved pit latrines, and 

pit latrines with a slab or covered pit. Unimproved sanitation facilities include pit latrines without slabs or 

platforms or open pit; hanging latrines; bucket latrines; open defecation in fields; forests, bushes, bodies of 

water, or other open spaces; or disposal of human feces with other forms of solid waste.

Improved flooring: We followed the standard recode in which flooring coded from 31 to 39 is typically 

considered improved flooring such as polished wood, vinyl, ceramic tiles, or cement.

Improved walls: We followed the standard recode where wall construction coded from 31 to 39 is typically 

improved walls such as cement, stones, bricks, or cement block.

2.2.3 MCH outcomes

This report focuses on 11 indicators related to MCH outcomes, as defined below.

Four or more visits for antenatal care (ANC): The proportion of women age 15-49 who have attended at 

least four ANC visits for their most recent pregnancy in the 5 years before the survey.

Contraceptive prevalence rate for modern methods (mCPR): The proportion of women age 15-49 who are 

currently in a union and are using a modern contraceptive method. Modern contraceptive methods include 

pills, IUD, injections, implants, diaphragm, female and male condoms, female and male sterilization, foam 

or jelly, standard days method, and the lactational amenorrhea method. The mCPR may also include other 

modern contraceptive methods that are country-specific or less common but were reported by the 

respondent and identified in the datasets as modern methods.

Delivery in a health facility (DHF): The proportion of women age 15-49 for whom the most recent birth 

in the 5 years before the survey was delivered in a health facility. Health facilities could be government, 

private, NGO, or another type such as a maternity clinic.

Completion of three doses of DPT vaccine (DPT3): The proportion of children age 12-23 months who 

have received the third dose of the DPT vaccine or third dose of the Pentavalent vaccine. The DPT3 

immunization is selected for the indicator because children who receive this vaccine generally have 

received all the other recommended immunizations.

Care-seeking for symptoms of acute respiratory infection (ARI): The proportion of children under age 5 

who had symptoms of ARI (or possibly pneumonia) in the 2 weeks before the survey and for whom advice 

or treatment was sought from a health facility or qualified provider. Symptoms of ARI are “short, rapid 

breaths” that are “due to a problem in the chest.” These symptoms are not equivalent to a medical diagnosis.

For all care-seeking indicators, the analysis excludes treatment sought from pharmacies, shops, or 

traditional healers.

Care-seeking for fever: The proportion of children under age 5 who had symptoms of fever in the 2 weeks 

before the survey and for whom advice or treatment was sought from a health facility or qualified provider.

Care-seeking for diarrhea: The proportion of children under age 5 who had diarrhea in the 2 weeks before 

the survey and for whom advice or treatment was sought from a health facility or qualified provider.
6

Exclusive breastfeeding: The proportion of children under age 6 months who are being breastfed and have 

not had any water, other liquids, or solids in the day or night before the survey. Limited to children who are 

living with the mother.

Stunting: Proportion of de facto6children under age 5 who have a height-for-age z-score less than two 

standard deviations below the median of the WHO 2007 reference population. Since the Indonesian DHS 

survey did not include height and weight measurements for children, stunting and wasting could not be 

computed for this survey.

Wasting: Proportion of de facto children under age 5 who have a weight-for-height z-score that is less than 

two standard deviations below the median of the WHO 2007 reference population.

2.2.4 Covariates

In the multivariate regression analysis (described below) of MCH indicators, additional sociodemographic 

covariates beyond wealth quintile and relative community wealth were included. 

For MRH indicators, the covariates were education (none, primary, secondary, or higher), number of living 

children (0, 1-2, 3-5, 6+), and health care decision-making (decides on own health care either alone or 

jointly with partner, or does not).

For the child health and child nutrition indicators, the covariates were maternal education (none, primary, 

secondary, or higher), sex of the child, and birth order (1, 2-4, 5+)

2.3 Analysis

We used Stata version 16.0 for the analysis. All statistical tests adjusted for the complex survey design and 

applied survey weights.

2.3.1 Identifying specific asset drivers of quintile membership

The construction of the DHS wealth asset index uses all possible responses to household assets and 

amenities as individual elements. It is therefore a tautology that the ownership of assets or access to 

amenities will be correlated to the asset index. However, the degree of correlation or the extent to which 

different assets or amenities are important at different levels of wealth is an empirical issue. 

To assess the independent influence of household wealth and household wealth relative to average 

community wealth, we ran logistic regressions of each asset group on the five rural household wealth 

quintiles and the household wealth relative to community average wealth. We emphasize that we are not 

attempting to demonstrate causality. The nature of the household wealth index almost guarantees that 

household wealth and any given asset or asset group will be correlated. We are most interested in whether 

or not a household’s wealth status relative to the community is correlated with ownership of the asset. This 

measure is not ex ante correlated with an asset. The results of these eight regressions (one for each asset) 

are presented as Appendix A1.

 

6 Slept in the household the previous night before the survey.
7

The regressions allowed us to calculate adjusted predictive margins for relative community wealth for each 

of the household wealth quintiles.

7 The adjusted predictive margin represents the predicted probability with 

95% CIs of asset ownership at each household wealth quintile depending on whether a household is poorer, 

similar, or wealthier than average community wealth. The predicted probabilities are presented graphically 

throughout this report with three lines – one for each of the relative household to community statuses across 

the wealth quintiles.

8 Using the predicted probabilities, we also calculated the average marginal effect 

(AME). The AMEs9are estimates of the difference in the predicted probability of an outcome between two 

groups. In this analysis, we compared predicted probabilities of asset ownership at each combination of 

wealth relative to community (poorer, similar, or wealthier) for each level of household wealth (quintile 

1/poorest through quintile 5/wealthiest), in order to capture inequalities. These results are presented in 

Appendix A2.

Figure 1 is the predicted probability graph for vehicle ownership for the Mali 2018 survey.

10 As noted above, 

there are three lines. The gray line shows the predicted probability for each level of household wealth for 

households that are wealthy relative its community. The red line is the same for households that are poor 

relative to average community wealth. The blue line illustrates the case of households that have a wealth 

status similar to the average community wealth. The red dot above wealth quintile 2 shows that the predicted 

probability of a household in quintile 2 that is poor relative to the community where it is located has a 

predicted probability of approximately 0.43 of owning a vehicle. Since the household is in quintile 2, it 

would be located in a community that is in the third, fourth, or fifth quintile of community wealth. The blue

dot above wealth quintile 2 in the vehicle graph represents the households in a community with similar 

wealth (community wealth quintile 2). The gray dot above wealth quintile 2 represents households that are 

wealthy relative to the average community wealth. In this case, the household would be in community 

quintile 1. This means that households in wealth quintile 2 that are wealthy relative to their community are 

20 percentage points more likely to own a vehicle than a similarly wealthy household that is poor relative 

to the community where it is located. 

 

7 The -margins- command in Stata converts logistic regression output into predicted probabilities by using the odds in 

the formula probability =

odds

(1+odds)

. The vce (unconditional) option was used with the -margins- command to account 

for complex survey design.

8 The regression results, average marginal effects and simulated probabilities are estimated or calculated with functions 

in the Stata statistical package.

9 Average marginal effects compare two hypothetical populations, one where all households are poor relative to their 

community average wealth, and another where all households are rich relative to their community average wealth and 

compute the probability of ownership of each asset for each population. The difference in the two probabilities is the 

marginal effect. This process is repeated and then averaged across every case in the sample, which provides the average 

marginal effect of the outcome.

10 The graphs presented below are similar to the graphs presented for the various MCH indicators. Their interpretation 

is roughly parallel.
8

Figure 1 Predicted probability of vehicle ownership by household wealth quintile, Mali 2018

A contrasting case is access to improved water in the Mali 2018 survey. The households that are poor 

relative to the communities where they are located (the red line) are more likely to have improved water 

than the households that are wealthy relative to their communities (the gray line). As expected, in both 

Figures 1 and 2, the slopes of all lines are positive, which indicates a positive correlation between ownership 

of the asset and household wealth status. We emphasize here that the relative position of the red line 

(households that are poor relative to their community) and the gray line (households that are wealthy relative 

to their community) is not a foregone conclusion.
9

Figure 2 Predicted probability of vehicle ownership by household wealth quintile, Mali 2018

2.3.2 Assessing inequalities in MCH health indicators by household wealth relative to 

community wealth 

For each of the 11 MCH indicators we performed the following analyses:

 To provide overall context, we used appropriate weights for the proportion of the population in 

need that satisfied the indicator definition. These are presented as graphs in the country results 

sections.

 We assessed bivariate and multivariate associations via logistic regressions for each MCH 

indicator. The covariates included household wealth quintile, household wealth relative to the 

community, and appropriate control variables as described in the data section of this report. The 

results of these regressions are shown in Appendix A3-A5.

 We calculated the predicted probability with 95% CIs of the outcome at each combination of 

relative community wealth and household wealth quintile, while holding the distribution of all other 

covariates the same in the population. (See section 2.3.1 for more description of predicted 

probability calculations.)

 We also calculated the AMEs.

11 The results of these calculations are presented in Appendix A6.

 

11 In this case, since there are covariates in our regression equation, the average marginal effects compare two 

hypothetical populations, one where all households are poor relative to their community average wealth, and another 

where all households are rich relative to their community average wealth and compute the probability of the outcome 
10

 We created graphs that show the predicted probabilities of achieving the various MCH indictors 

across household wealth quintiles for each of the household wealth statuses relative to the 

community. These are presented and interpreted in the country results sections.

In the discussion of AMEs, we use both statistical significance and programmatic importance to categorize 

findings. Although statistical significance is useful to identify differences that cannot be attributed to 

chance, there are cases where a statistically significant difference may not be programmatically important 

or actionable. In this analysis, we have set a 10% cutoff for programmatic importance. Differences above 

this value are discussed, regardless of their statistical significance.

 

for each population, leaving all other covariates values as they are for each observation. The difference in the two 

probabilities is the marginal effect. This process is repeated and then averaged across every case in the sample, which 

provides the average marginal effect of the outcome.
11

3 OVERALL RESULTS

In Part 1 of the results, we present the summary findings for household wealth relative to community, the 

specific asset drivers of wealth quintile membership and household wealth relative to community, and 

selected MCH indicators and household wealth relative to community. For country-specific results, please 

refer to Part 2 of this paper. This analysis is limited to the rural population in each country.

3.1 Household wealth relative to average community wealth 

To summarize the information on household wealth relative to average community wealth, we analyzed the 

proportion of households that are located in a community of similar wealth, both overall, and then in the 

poorest and richest quintiles (see Table 2). 

Random placement of the households across the three statuses relative to community would lead to 33.3% 

in each of the first three columns. The degree to which these proportions diverge from 33.3% is an indication 

of the relative homogeneity of wealth statuses in the communities. 

Table 2 is sorted by column 2, the percent of households in communities that have similar wealth. In one 

group that includes the DRC, Zambia, Indonesia, and Liberia, the overall level of households living in 

communities of similar wealth was low, between 30 and 40%.12 These countries are categorized as 

heterogeneous since they have relatively high proportions of households living in communities of different 

wealth. Households in these countries are nearly as likely to be poor or wealthy compared to their 

community as to be of similar wealth as their community. The other group of countries, which includes 

Kenya, Mali, Haiti, Pakistan, Senegal, Ghana, and Nigeria, are more homogeneous across quintiles. This 

resulted in higher proportions of households living in communities of similar wealth. All of these countries 

have over 40% of the overall population living in communities of similar wealth. In Nigeria, this proportion 

is 54%.

The fourth and fifth columns in Table 2 show where the degree of homogeneity is most pronounced among 

the poorest or wealthiest communities. In 8 of the 11 countries, the degree of homogeneity is greater among 

the wealthiest households than among the poorest communities. 

 

12 This categorization of countries is somewhat arbitrary. One of the deciding factors was the relatively large gap 

(43.6% versus 38.4%) between Kenya and Liberia, respectively.
12

Table 2 Distribution of household wealth relative to community average wealth, by country

Overall

Households in poorest and richest 

quintile having a wealth similar to its 

community

Household is poor 

relative to 

community (%)

Household has a 

wealth similar to

community (%)

Household is wealthy

relative to community 

(%)

Poorest 

quintile (%)

Richest 

quintile (%)

DRC 34.7 35.0 30.3 42.4 56.7

Zambia 33.7 36.3 30.0 48.0 54.9

Indonesia 34.4 37.0 28.7 53.4 45.9

Liberia 31.2 38.4 30.4 48.7 57.8

Kenya 31.3 43.6 25.2 67.4 57.6

Mali 25.8 44.7 29.5 54.4 70.1

Haiti 26.9 45.6 27.5 54.4 69.3

Pakistan 29.6 46.2 24.3 64.7 66.4

Senegal 28.9 49.0 22.1 60.7 76.3

Ghana 23.1 50.4 26.4 70.2 63.5

Nigeria 24.9 53.7 21.4 66.9 76.7

3.2 Asset ownership and household wealth relative to average 

community wealth 

In the country-specific results section, we present data that show the various marginal probabilities of 

owning various assets based on the household wealth quintile and whether a household was poor, wealthy,

or similar to its community. In the following section, we aggregate the results by asset, which allows us to 

quickly assess whether or not there are patterns across countries. In each of the following tables, there are 

five columns. The first column shows the relative position of the marginal curves. The categorizations are:

 Poor in wealthy – households in communities that are wealthy relative to their own household 

wealth status

 Wealthy in poor – households s in communities that are poor relative to their own household wealth 

status

 Similar – households in communities that have average wealth similar to their own household 

wealth status

The first column indicates that the three wealth categories relative to community wealth are most likely to 

own the particular asset. Since the curves never cross, we can make unambiguous statements. The second 

column specifies the average marginal effect (AME), which is the percentage point difference between the 

two curves where the household is either poor or wealthy relative to the community. The third column 

shows which quintiles have an AME of greater than 0.10.

13 The AME is the estimate of the difference in 

the predicted probability of the outcome between households that are poor relative to their community and 

those households that are rich relative to their community. We selected 0.10 because we believe that it is a 

programmatically significant difference.

14

 

13 The terms 0.10, 10 percentage points, and 10% (and similar statements) are used interchangeably in this section to 

ease the flow of interpretation. For example, the statement “a 12-percentage point difference” is the same as “a 

difference in proportions of 0.12”.

14 A difference of 0.10 or greater is statistically significant at p<.001 in all cases. See Appendix A2 for confidence 

intervals and p values.
13

Electricity

In 5 of the 11 countries, in at least one wealth quintile, households that are poor relative to their community 

are 10 percentage points more likely to have electricity. In Congo and Liberia, the situation in rural areas is 

so dire that almost no one has electricity, and this makes comparisons impossible. The countries were sorted 

by their degree of homogeneity (see Table 2). In Table 3, as the degree of homogeneity increases, the 

number of household wealth quintiles where there is a difference of greater than point 0.1 increases.

Table 3 Summary results of effect of having electricity on relative community wealth category

A relatively poor household in 

wealthier community; or a relatively 

wealthy household in poorer 

community is more likely to 

own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Neither

Zambia Poor in wealthy 0.01

Indonesia Poor in wealthy 0.01

Liberia Neither 0.01

Kenya Poor in wealthy 0.11 5

Mali Wealthy in poor 0.03

Haiti Poor in wealthy 0.15 4 5

Pakistan Poor in wealthy 0.14 1 2

Senegal Wealthy in poor 0.03

Ghana Poor in wealthy 0.15 1 2 3 4

Nigeria Poor in wealthy 0.2 2 3 4 5

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to 

the community’s average wealth.

Vehicle

In 9 of the 11 countries, vehicle ownership is higher among households that are wealthy relative to their 

communities. In Haiti and Liberia where this relationship is not found, vehicle ownership in the rural areas 

is negligible. In Ghana, Mali, Nigeria, Pakistan, and Senegal, all five quintiles show this relationship. In 

the other four countries, only one quintile shows the relationship. In Congo, Kenya, and Zambia, vehicle 

ownership is negligible until the fifth quintile. Similar to what we saw with electricity, the strength of the 

relationship appears to increase as the degree of homogeneity increases.

Table 4 Summary results of effect of owning a vehicle on relative community wealth category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community, is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Wealthy in poor 0.05 5

Zambia Wealthy in poor 0.04 5

Indonesia Wealthy in poor 0.05 1

Liberia Wealthy in poor 0.03

Kenya Wealthy in poor 0.07 5

Mali Wealthy in poor 0.14 1 2 3 4 5

Haiti Wealthy in poor 0.01

Pakistan Wealthy in poor 0.20 1 2 3 4 5

Senegal Wealthy in poor 0.19 1 2 3 4 5

Ghana Wealthy in poor 0.17 1 2 3 4 5

Nigeria Wealthy in poor 0.25 1 2 3 4 5

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.
14

Telephone

In contrast to the results with electricity and ownership of a vehicle, there is not a preponderant relationship

between telephone ownership and household wealth relative to community wealth across countries. The 

AME is less than 0.10 and the relationship is not the same across countries, although it seems to be 

advantageous to be poor in a wealthy community, and sometimes wealthy in a relatively poor community. 

Interestingly, Nigeria, the most homogeneous country, has the largest AME.

Table 5 Summary results of effect of owning a telephone on relative community wealth category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community, is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Poor in wealthy 0.07 4 5

Zambia Poor in wealthy 0.04

Indonesia Wealthy in poor 0.07 1

Liberia Wealthy in poor 0.05

Kenya Wealthy in poor 0.07 1 2

Mali Poor in wealthy 0.03

Haiti Wealthy in poor 0.04

Pakistan Wealthy in poor 0.03

Senegal Wealthy in poor 0.01

Ghana Wealthy in poor 0.02

Nigeria Wealthy in poor 0.11 1 2 3

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.

Bank account

For ownership of a bank account where there is a relatively large effect, households that are wealthy relative 

to their community are more likely to have bank accounts than households that are poor relative to their 

communities. Relative homogeneity does not appear to play a role in which countries have the strongest 

average marginal effect.

Table 6 Summary results of effect of having a bank account on relative community wealth category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community, is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Neither

Zambia Poor in wealthy 0.15 1 2 3 4

Indonesia Poor in wealthy 0.15 4 5

Liberia Poor in wealthy 0.01

Kenya Poor in wealthy 0.11 5

Mali Neither 0.01

Haiti Wealthy in poor 0.03

Pakistan Poor in wealthy 0.20 2 3 4 5

Senegal Poor in wealthy 0.14 1 2

Ghana Wealthy in poor 0.03

Nigeria Poor in wealthy 0.01

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.
15

Improved water

Having improved water is a clear marker of a poor household in a relatively wealthy community. In all 

countries, at least two of the quintiles have a gap between the two lines of greater than 0.10. In 7 of the 11 

countries, this observation holds for all household wealth quintiles. In the four countries where the 

relationship does not hold across all household wealth quintiles, access to improved water is nearly 

universal in the wealthier rural counties. The relationship appears to be stronger in countries with a higher 

degree of heterogeneity.

Table 7 Summary results of effect of having an improved water source on relative community wealth 

category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community. is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Poor in wealthy 0.34 1 2 3 4 5

Zambia Poor in wealthy 0.19 1 2 3 4 5

Indonesia Poor in wealthy 0.14 1 2 3 4

Liberia Poor in wealthy 0.34 1 2 3 4 5

Kenya Poor in wealthy 0.15 1 2 3 4 5

Mali Poor in wealthy 0.24 1 2 3 4 5

Haiti Poor in wealthy 0.29 1 2 3 4 5

Pakistan Poor in wealthy 0.09 1 2

Senegal Poor in wealthy 0.08 1

Ghana Poor in wealthy 0.11 1 2 3

Nigeria Poor in wealthy 0.13 1 2 3 4 5

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.

Improved sanitation

The evidence about improved sanitation is not as clear as the case for improved water. In 4 of the 11

countries, for at least one quintile there is a 10-percentage point advantage for poor households living in a 

relatively wealthy community. In Congo, the reverse is true for every household wealth quintile. In Congo, 

households that are wealthy relative to their communities are more likely to have improved sanitation.

Table 8 Summary results of effect of having improved sanitation on relative community wealth category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community, is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Wealthy in poor 0.13 1 2 3 4 5

Zambia Poor in wealthy 0.07

Indonesia Poor in wealthy 0.03

Liberia Poor in wealthy 0.06 5

Kenya Wealthy in poor 0.03

Mali Poor in wealthy 0.04

Haiti Wealthy in poor 0.02

Pakistan Poor in wealthy 0.18 1 2

Senegal Poor in wealthy 0.06

Ghana Poor in wealthy 0.18 1 2 3 4

Nigeria Poor in wealthy 0.07 4

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.
16

Improved flooring

Improved flooring does not show strong results across countries. In Indonesia and Pakistan, households 

that are poor relative to the average community wealth have a greater probability having improved flooring. 

In Mali, the reverse is true for the fourth quintile of household wealth. In no country is the relationship 

strong. Only in Pakistan does the average marginal effect exceed 0.10. There does not appear to be any 

pattern relative to the degree of homogeneity.

Table 9 Summary results of effect of having improved flooring on relative community wealth category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community, is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Neither

Zambia Poor in wealthy 0.01

Indonesia Poor in wealthy 0.08 1 2

Liberia Wealthy in poor 0.02

Kenya Poor in wealthy 0

Mali Wealthy in poor 0.06 4

Haiti Wealthy in poor 0.04

Pakistan Poor in wealthy 0.12 2 3 4

Senegal Wealthy in poor 0.04

Ghana Poor in wealthy 0.02

Nigeria Poor in wealthy 0.04

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.

Improved walls

In 5 of the 11 countries, a household is more likely to have improved walls if it is a poor household relative 

to the average wealth of its community. In the relatively homogeneous countries, if a differential effect 

exists, the effect is relatively large.

Table 10 Summary results of effect of having improved walls on relative community wealth category

A relatively poor household in 

wealthier community, or a relatively 

wealthy household in poorer 

community, is more likely to own asset

Average marginal 

effect (AME) +

Wealth quintiles 

where the AME is 

greater than 0.1

Congo Poor in wealthy 0.08 4 5

Zambia Poor in wealthy 0.02

Indonesia Wealthy in poor 0.02

Liberia Poor in wealthy 0

Kenya Poor in wealthy 0.12 2 3 4 5

Mali Poor in wealthy 0.05

Haiti Poor in wealthy 0.02

Pakistan Poor in wealthy 0.14 2 3 4

Senegal Poor in wealthy 0.03

Ghana Poor in wealthy 0.14 1 2 3 4

Nigeria Poor in wealthy 0.18 2 3 4

Note: +Average marginal effect of being a poor household relative to community’s average wealth compared to a rich household relative to the 

community’s average wealth.
17

3.3 Health indicators and household wealth relative to community 

average wealth

Figure 3 provides an overview of each country and each indicator category. Although there were a larger 

number of indicators with statistically significant AMEs, we focus on those differences large enough in 

magnitude to be programmatically important. The household wealth relative to wealth inequality score 

reflects the number of indicators with an AME we categorized as programmatically important, that is, of 

0.1 (10 percentage points) or greater, and divides the sum by the total number of indicators in that category. 

In the overall category, the total was divided by 10 for all countries except Indonesia, which did not have 

child nutrition data. In Indonesia, the total was divided by eight. For maternal health indicators, the total 

was divided by three; for child health, the total was divided by five; and for child nutrition, the total was 

divided by two. This value was then multiplied by 100 to represent the percentage of the maximum possible 

value. Using the DRC as an example, three of ten indicators (facility delivery, vaccination, and exclusive 

breastfeeding) met or exceeded the 0.10 threshold. Therefore, the overall bar for DRC is 30% (3 of 10); the 

maternal health bar is 33.3% (1 of 3); and the child health bar is 40% (2 of 5). The nutrition bar is 0% 

because neither stunting nor wasting exceeded the 0.10 threshold.

Each of the 11 countries had programmatically important differences between categories of household 

wealth relative to average community wealth inequalities on at least one MCH indicator included in this 

analysis. Pakistan and Indonesia have the highest overall community wealth inequality scores, with 40% 

and 38% respectively. The DRC, Haiti, Kenya, and Liberia all have the second highest, with 30%. Pakistan, 

DRC, Haiti, and Indonesia have a higher community wealth inequality score for child health indicators 

compared to the MRH indicators, while in Kenya and Liberia, the highest community wealth inequality 

score was the MRH indicators.

Kenya, Liberia, and Mali have the highest community wealth inequality scores for MRH, while Pakistan 

has the highest community wealth inequality score for child health. Nigeria was the only country with any 

programmatically important community wealth inequalities in the child nutrition indicators.

Figure 3 Bar graph of household wealth relative to community average wealth inequality score, overall 

and by indicator category

0%

10%

20%

30%

40%

50%

60%

70%

Pakistan Indonesia DRC Haiti Kenya Liberia Ghana Mali Senegal Nigeria Zambia

Overall Maternal health Child health Child nutrition
18

Table 11 shows the AME of a household being poor relative to the community compared to being wealthy 

relative to the community. The data indicate both statistical significance and programmatic importance for 

each AME. The highlighted cells indicate a programmatically important finding. With the exception of 

treatment of childhood illnesses and breastfeeding, the highlighted cells coincide with statistical 

significance. The general lack of statistical significance is partially explained by the relatively small sample 

sizes for these indicators.

15 The sign on the AME’s indicates whether households that are poor relative the 

community are favored (positive sign) or households that are wealthy relative to the community are favored 

(negative sign).

 

15 For Indonesia and Nigeria, both surveys with large sample sizes, statistical significance is achieved for several 

indicators with modest AMEs. For example, see the AME for ANC for Indonesia.
19

Table 11 Average marginal effect of being a poor household relative to community compared to being a rich household relative t

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent 

vaccine

Treatment for ARI 

symptoms

Advice or 

treatment sought 

for fever 

symptoms

Advice or 

treatment sought 

for diarrhea

Exclusive 

breastfeeding

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI 

DRC 0.08* 0.02 - 0.15 0.19*** 0.13 - 0.26 0.00 -0.02 - 0.03 0.23*** 0.14 - 0.32 0.00 -0.15 - 0.15 0.00 -0.07 - 0.07 0.06 -0.02 - 0.15 0.11 -0.00 - 0.22 

Ghana 0.04 -0.04 - 0.12 0.07 -0.04 - 0.17 -0.02 -0.08 - 0.04 0.03 -0.07 - 0.12 0.00 -0.33 - 0.32 0.10 -0.06 - 0.26 0.09 -0.10 - 0.27 -0.14 -0.31 - 0.03 

Haiti 0.03 -0.05 - 0.12 0.11*** 0.06 - 0.16 -0.01 -0.06 - 0.03 0.17** 0.05 - 0.28 -0.06 -0.22 - 0.10 0.15** 0.06 - 0.24 0.06 -0.02 - 0.14 -0.09 -0.28 - 0.09 

Indonesia 0.05** 0.02 - 0.08 0.12*** 0.07 - 0.17 0.00 -0.02 - 0.03 0.10* 0.02 - 0.18 -0.07 -0.20 - 0.06 -0.01 -0.07 - 0.06 -0.05 -0.15 - 0.05 -0.11 -0.22 - 0.00 

Kenya 0.00 -0.04 - 0.05 0.12*** 0.07 - 0.16 0.16*** 0.13 - 0.19 0.02 -0.03 - 0.08 0.00 -0.10 - 0.10 -0.02 -0.09 - 0.04 -0.02 -0.10 - 0.07 -0.11 -0.28 - 0.06 

Liberia 0.12** 0.05 - 0.19 0.13** 0.05 - 0.21 0.06* 0.01 - 0.11 0.26*** 0.16 - 0.37 0.06 -0.15 - 0.27 0.05 -0.07 - 0.18 0.09 -0.05 - 0.22 0.09 -0.07 - 0.26 

Mali 0.15*** 0.10 - 0.20 0.22*** 0.14 - 0.29 0.06*** 0.03 - 0.10 -0.09 -0.18 - 0.00 -0.09 -0.48 - 0.31 -0.01 -0.11 - 0.10 0.00 -0.08 - 0.08 -0.01 -0.13 - 0.10 

Nigeria 0.09*** 0.05 - 0.13 0.09*** 0.06 - 0.13 0.02* 0.00 - 0.03 0.09** 0.03 - 0.15 0.00 -0.17 - 0.18 0.04 -0.02 - 0.10 0.03 -0.05 - 0.11 0.01 -0.06 - 0.07 

Pakistan 0.14*** 0.08 - 0.20 0.04 -0.03 - 0.12 0.04 -0.00 - 0.08 0.23*** 0.15 - 0.32 0.12 -0.03 - 0.27 0.08 -0.02 - 0.19 0.03 -0.10 - 0.17 -0.20* -0.37 - -0.04 

Senegal 0.01 -0.04 - 0.06 0.13*** 0.07 - 0.20 0.00 -0.04 - 0.04 0.06* 0.00 - 0.13 -0.06 -0.26 - 0.15 0.04 -0.05 - 0.12 0.01 -0.08 - 0.09 0.11* 0.00 - 0.22 

Zambia 0.00 -0.05 - 0.05 0.06* 0.01 - 0.12 0.06* 0.01 - 0.11 0.06 -0.01 - 0.12 -0.14 -0.40 - 0.12 -0.05 -0.14 - 0.03 -0.02 -0.12 - 0.08 -0.04 -0.16 - 0.07 

Note: *p<0.05; **p<0.01; ***p<0.001

+ Other covariates included: level of education, number of living children, household health care decision-making (maternal health regressions only), and sex of child (child health regressions only).

Very programmatically important (>0.2)

Programmatically important (>0.1)
20

Maternal and reproductive health

For MRH, in all cases where there was a programmatically significant result, being in a household that is 

poor relative to the community was advantageous relative to being in a household that is wealthy relative 

to the community. Of the three MRH indicators, health facility delivery had the most frequent number of 

programmatically important AMEs, in 7 of 11 countries. In Mali, the AME was greater than 0.20 and was 

very programmatically important. Receiving 4+ ANC visits had the next most frequent number of 

programmatically important AMEs in 3 of the 11 countries. Modern contraceptive use among married 

women had only one programmatically important AME in Kenya. Kenya, Liberia, and Mali all had 

programmatically important AMEs for two of the three MRH indicators. In all cases of programmatically 

important AMEs, households that were poor relative to the community had greater predicted probability of 

the outcome compared to households that were wealthy relative to the community.

Child health

Of the five child health indicators, exclusive breastfeeding had the most frequent number of 

programmatically important AMEs, in 6 of 11 countries. In two countries (DRC and Senegal), households 

that were poor relative to the community had greater predicted probability of exclusively breastfeeding their 

infant at 6 months compared to households that were wealthy relative to the community. In the remaining 

four countries (Ghana, Indonesia, Kenya, and Pakistan), it was the reverse in that households that were 

wealthy relative to the community had greater predicted probability of exclusively breastfeeding (EBF)

their infant at 6 months compared to households that were poor relative to the community. In Pakistan, the 

predicted probability of EBF among households that were wealthy relative to the community was 0.2

greater than among households that were poor relative to the community. Of the six programmatically 

important differences, only two are statistically significant. This is likely due to the small sample sizes and 

large confidence intervals.

Receipt of three doses of Pentavalent vaccine had the next most frequent number of programmatically 

important AMEs, in 5 of 11 countries. Three of these were AMEs greater than 0.2. Care-seeking for ARI 

and fever had two programmatically important AMEs. In all cases for vaccination and fever care-seeking 

indicators, households that were poor relative to the community had greater predicted probability of the 

outcome compared to the households that were wealthy relative to the community. With ARI care-seeking, 

Pakistan households that were poor relative to the community had the greater predicted probability of the 

outcome, while in Zambia, households that were wealthy relative to the community had greater predicted 

probability of the outcome. Many countries had small sample sizes of children with ARI symptoms.

Confidence intervals for the AME estimates are wide, and the two programmatically important AMEs for 

ARI care-seeking were not statistically significant. There were no programmatically important AMEs in 

any country for diarrhea care-seeking.

Child nutrition

The only programmatically important AME for either child nutrition indicator was for stunting in Nigeria, 

where households that were wealthy relative to the community had greater predicted probability of having 

a stunted child compared to households that were poor relative to the community.
21

4 DISCUSSION AND CONCLUSION

This report provides an overview of relative community wealth inequality in 11 countries, and describes 

the specific assets responsible for these community inequalities, and their association with 10 MCH 

indicators. The concept of an association between a household’s wealth relative to their community’s wealth 

and health behaviors or outcomes has only been applied in a limited number of studies. This analysis 

examined not only which specific assets contribute to a household’s relative community wealth category, 

but also how relative community wealth may play a role in MCH. This analysis was limited to rural 

populations, given the differences in the definition of urban wealth and different levels of access to health 

services in urban and rural populations.

This analysis provided a description of two clear patterns of distributions of relative community wealth

within countries, which are either more heterogeneous countries (DRC, Indonesia, Liberia, and Zambia) or 

more homogenous countries (Ghana, Haiti, Mali, Nigeria, Pakistan, and Senegal). In homogenous 

countries, large proportions of households lived in communities of similar wealth, with smaller proportions 

living in communities with differing average wealth. In heterogeneous countries, there were larger 

proportions of households living in communities of differing average wealth. In both distributions, 

households in the middle quintiles were more likely to live in a community of differing average wealth, and 

households in the poorest and richest quintiles were more likely to live in similar communities. In 10 of the 

11 countries, over 50% of the wealthiest households lived in communities of similar average wealth. This

trend of clustering by socioeconomic status may be due to households in the poorest quintiles having fewer 

resources to live in richer communities, and the tendency of households in the richest quintiles to live among

other very wealthy households. This pattern can result in inequalities in access to health care services across 

the rural population.

Table 12 provides a summary across countries and asset groups in the overall results section. The final 

column in the table shows if the asset ownership is most affected by the heterogeneity of the wealth statuses 

within a community.

16

The two most striking assets in this table are the contrasting cases of ownership of vehicles and access to 

improved water. In all countries except Liberia and Haiti, where ownership of vehicles is negligible among 

rural households, for at least one household wealth quintile, households that are wealthy relative to their 

community are more likely to own a vehicle. The strength of this observation is strongest for the most 

homogeneous countries. In contrast, in all countries, households that are poor relative to their community 

are more likely to have access to an improved water source. In contrast to the result for ownership of 

vehicles, the strength of the relationship is strongest in relatively heterogeneous countries.

Access to improved water can be a shared community resource. In our collection of 11 countries, water 

piped into households or courtyards in rural areas is rare. Among the poorest households, improved water 

 

16 The impressionistic view was based on the correlation between our homogeneity measure (percent of households 

that are in a community with a similar wealth) and the average marginal effect for the asset. If the correlation is above 

0.25 we called it homogenous. If less than -0.25, we called it heterogeneous. If the correlation is between -0.25 and 

0.25, we called it neither. We call these assessments “impressionistic” because correlations we used are based on a 

very small set of countries. On the other hand, for the four cases where we assessed the asset as homogeneous or 

heterogeneous, the correlation had an absolute value of greater than 0.50.
22

most frequently means a protected well that can plausibly be a community or neighborhood resource.

Potentially, a greater degree of mixing relatively poor and relatively wealthy households (heterogeneity) in 

a community where there are shared water resources would lead to relatively poor households having 

greater access to improved water.

Among the collection of assets we examined, a vehicle is a good example of a private asset that does not 

require community infrastructure that might be necessary for electricity (a power grid), mobile phone

(cell tower), a bank account (bank), or depend upon community standards or shared resources such as water

and sanitation, or construction for floors and walls. Thus, a vehicle can be a way for a household to be 

wealthy relative to the average community wealth. With less certainty, in communities that are more similar 

(homogeneous), access to the infrastructure or adherence to standards of construction might be stronger.

This could explain why more homogeneous countries have relatively stronger vehicle ownership among 

wealthy households relative to the average wealth of their communities.

Our hypotheses for both access to improved water and ownership of vehicles are far from being proven 

here. Further investigation across more countries and/or more detailed investigation of the nature of rural 

communities in a given country is needed.

Table 12 Summary table of programmatically important differences in asset ownership

Number of countries where for at 

least one quintile a relatively rich 

household in a relatively poor 

community has a probability 10 

percentage points higher

Number of countries where for at 

least one quintile a poor 

household in a relatively rich 

community has a probability 10 

percentage points higher

Homogeneous or heterogeneous 

has strongest effect

Electricity 0 5 Homogeneous

Vehicle 9 0 Homogeneous

Telephone 3 1 Neither

Bank account 4 0 Neither

Water 0 11 Heterogeneous

Sanitation 1 3 Neither

Floor 1 2 Neither

Wall 0 5 Homogeneous

Research on wealth inequality and health outcomes has suggested that the geographic level of a community 

may affect the results, with smaller community units resulting in fewer associations (Wilkinson and Pickett 

2006). In our analysis with survey enumeration areas as the definition of community, we found numerous 

statistically significant and programmatically important associations. Although there were no clear 

consistent patterns to the inequities by household wealth relative to community average wealth, the results 

of this study suggest that there are places and indicators where they make a difference.

The approach in this analysis highlights inequalities in the levels of an indicator, but does not provide 

insights into the overall levels of an indicator. For example, modern contraceptive use in the DRC is 

incredibly low at 3% for the poorest quintile and 8% for the richest quintile. However, our analysis only 

highlights that there are no differences in modern contraceptive use across household wealth relative to the 

community wealth categories.

No country had household wealth relative to community wealth inequalities in every category and every 

country had household wealth relative to community wealth inequities in fewer than 50% of the total 

number of indicators. Pakistan had the highest overall household wealth relative to community inequality 
23

score (40%), followed closely by Indonesia (38%). Nigeria and Zambia had the lowest overallscores (10%).

These findings are inconsistent when compared with previous research that used DHS wealth quintiles to 

assess MCH inequalities (Assaf 2016). This suggests that the effect of household wealth relative to 

community wealth on MCH indicators differs by context and has a different effect compared to relative 

national wealth. In some cases, the same countries were identified with inequalities, such as with stunting, 

while Nigeria had consistent inequalities across multiple measures. In other cases, inequalities were 

identified in our study but not in the previous literature, such as Pakistan for EBF, which had the highest 

household wealth relative to community wealth inequality in this analysis, but was not among the top three 

countries for EBF inequality on any of the inequality measures in the 2016 analysis.

Of all the indicators, health facility delivery had the most frequent community health inequalities, in 7 of 

the 11 countries, while care-seeking for diarrhea and wasting among children under age 5 had no relative 

community health inequalities. This finding aligns with previous research that found community-based 

interventions to be more equally distributed than those delivered in health facilities (Barros et al. 2012).

Exclusive breastfeeding was the only indicator with a varying sign of the average marginal effect. This 

agrees with previous literature that found consistent associations of wealth on EBF, but with different 

directionality. In some countries, women from wealthier households are more likely to breastfeed (Ogbo, 

Agho, and Page 2015; Yalçin, Berde, and Yalçin 2016), while in others, women from poorer households are 

more likely to breastfeed (Bbaale 2014), which indicates that social pressure for or against EBF may interact 

with wealth and societal and family norms to explain the difference between country results. Our findings 

add to previous literature which indicated that an early start to breastfeeding was the most equitable MNCH 

intervention (Barros et al. 2012) and suggest that a household’s wealth relative to that of their community 

may play a role in EBF through age 6 months.

In 9 of 10 countries, households that are poor relative to their communities were more likely to use at least 

one maternal health care (ANC and facility delivery) or vaccination service. These services require qualified 

medical providers. With birth delivery, infrastructure is also required. We do not offer evidence, but it is 

likely that relatively wealthy communities are more likely to have adequate health services.

17 A household 

that is poor relative to the community is potentially better able to access the services of a relatively wealthy 

community. This reflects our findings for water in which households that are poor relative to the community 

were more likely in all 11 countries to have access to an improved water source. The prevalence of EBF 

could be related to being poor relative to community. It is possible that powdered formula is more available 

and less expensive in relatively wealthy communities.

The lack of consistent patterns in use of different services by relative wealth categories and household 

wealth quintile is noteworthy. As shown in Appendix A6, for some services, the use across the relative 

wealth categories converges as household wealth increase. For other services, the use diverges as household 

wealth increases, and for others there is neither convergence nor divergence. The lack of a pattern in any 

indicator or within any one country indicates that the relationship between these three variables is complex

and influenced by factors not included in this analysis. The case of Liberia is perhaps instructive. For 4+ 

ANC visits, the difference is largest for the poorest households and decreases with increasing household 

 

17 Rural health services are frequently supported financially and administratively by communities. Medical providers 

are frequently unwilling to serve in poor communities and poorer communities are frequently inaccessible or neglected 

by regional or central governments.
24

wealth; for health facility delivery, the difference remains consistent over household wealth quintiles; and 

for modern contraceptive use, the difference increases with increasing household wealth. This suggests that 

a household’s wealth relative to the community has an important but variable influence on access to specific 

health services and across different countries. 

Definitive conclusions are not possible with this report. Additional countries must be analyzed to assure 

that patterns across asset groups and MCH indicators are robust. It may also be enlightening to examine 

additional assets such as land and animal ownership. In addition, it is uncertain if the noted relationships 

would remain over time, across countries, or within countries. Other issues are methodological. Our 

assertions of relative homogeneity and heterogeneity assume that the differences in average wealth between 

communities are more or less the same for all countries. We did not offer evidence that these differences 

are the same across countries. There is a good possibility that the differences are not the same and would 

be related to the overall level of inequality in a country. Another issue is that the average number of 

households represented by a cluster can vary across countries. The greater the number of households 

represented in a cluster, the greater the possibility for heterogeneity.

18 Future analyses may also explore the 

associations of the assets investigated here, and their associations with the health indicators.

Our collection of MCH indicators is biased toward the use or provision of services rather than health 

outcomes. The exceptions to this are wasting and stunting. Given the apparent greater access to water (and 

maybe sanitation) for households that are poor relative to average wealth of their communities, future 

research could examine the incidence of ARI symptoms, fever, and diarrhea, as well as differences in 

neonatal, infant, and under-5 mortality.

There are multiple mechanisms through which a community’s socioeconomic status and a household’s 

relative socioeconomic status can influence health. Wealthier communities may have more access to health 

facilities and services, which can facilitate engagement with the health system. Beyond the family, a

household’s local community potentially plays the next most important role in forming norms around health

behaviors.

 

18 Please note that this issue is independent of the number of households used for interviews. An example is the most 

recent DHS in the DRC. The data collectors combined villages or divided villages in order to achieve a target sampling 

frame of 500 households from which to draw the cluster sample of 34 households. In Liberia, the targeted number of 

households for the sampling frame seems to have been 200 households.
25

5 COUNTRY-SPECIFIC RESULTS

Part two of the results section provides in-depth results for each of the 11 countries in this analysis. For 

each country, the first section presents the overall distribution of relative community wealth; the second 

section shows specific assets and their associations with relative community wealth; and the final section 

illustrates the associations between 10 MCH indicators and relative community wealth.

5.1 DRC

5.1.1 Household wealth relative to average community wealth 

In the 11 countries, the DRC has the most uniform division of the population across the three categories of 

household wealth relative to community wealth. The column at the far right in Figure 4 shows that 35% of 

households are poor compared to the average wealth of households in their community, while another 35% 

of households have similar wealth compared to the average wealth of households in their community.

19 The 

remaining 30% are rich compared to their community. This distribution suggests that rural communities in 

the DRC have a high level of wealth heterogeneity with a relatively equal proportion of households that are 

richer or poorer than the average of their community. Disaggregation by household wealth quintiles shows 

the heterogeneity to be most apparent in the four poorest quintiles. In the wealthiest quintiles, more than 

57% of the households are also in the wealthiest rural communities. This is the opposite for the poorest 

households, where 58% are located in communities that are on average wealthier. In the middle quintiles, 

no more than 27% of households are located in communities of average wealth similar to their own. 

Figure 4 Distribution of household wealth relative to community average, DRC 2013-14

5.1.2 Asset ownership and household wealth relative to average community wealth 

The DRC, along with Liberia and Haiti, has poverty that is greater than in the other eight countries. This 

limits the analysis across household quintiles and communities. Very few rural households in the DRC have 

 

19 Please refer to the Data and Methods section where we describe household wealth versus community wealth.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

HH wealth quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
26

access to electricity or improved floors. Thus, the asset regressions for electricity and improved flooring 

could not be analyzed and are not presented.

Poor rural households are also unlikely to have phones or own vehicles. At higher levels of wealth,

households that are poor relative to their community are more likely to own phones. For vehicles, this is 

reversed with households that are wealthy relative to their community being more likely to own a vehicle 

at the higher levels of household wealth.

Figure 5 Predicted probabilities of asset ownership (vehicle, telephone, and bank account) by 

household wealth quintile, DRC 2013-14

Households that are poor relative to the community are considerably more likely to have improved water 

than households that are wealthy relative to the community. This is reversed for sanitation, which is unusual 

because conditions do not seem to improve as wealth status improves (all three curves are relatively flat for 

the improved sanitation chart). This is one of the few cases in the asset regressions where wealth was not 

significantly correlated with one of the asset measures.

20 In a closer look at sanitation across wealth quintiles 

in rural households, we found that the proportion of households with a latrine without a slab increased 

across the wealth quintiles, although the proportion of households that had a latrine with a slab remained 

constant across the quintiles. By international standards, a latrine must have a slab to be defined as 

improved.

 

20 Our overwhelming expectation was that wealth would be significantly correlated with any asset because the wealth 

index is based on assets.
27

Figure 6 Predicted probabilities of asset ownership (improved water source, improved sanitation, and 

improved wall) by household wealth quintile, DRC 2013-14

5.1.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 7 shows the level of the three MRH indicators by wealth quintile. Across all five household wealth 

quintiles in the DRC, the proportion of women who attended at least four ANC visits for their most recent 

pregnancy remained relatively stable at approximately 40%. Facility delivery increased from approximately 

60% in the poorest quintile to 90% in the richest quintile. Modern contraceptive prevalence is very low, at 

less than 10% across all wealth quintiles.

Figure 7 Levels of MRH indicators, by household wealth quintile, DRC 2013-14

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household wealth quintile

4+ ANC visits Health facility delivery mCPR
28

Figure 8 answers the question “At any given level of household wealth, how does the household wealth 

status relative to average community affect use of maternal and reproductive health services?” The 

predicted probabilities of each MRH outcome in DRC by relative wealth category over each household 

wealth quintile are shown to visualize differences in the trends for each category of relative wealth. Across 

all household wealth quintiles, women living in households that are poor relative to the community are 

much more likely to deliver in a facility. There is little or no impact of this factor on ANC or modern 

contraceptive use.

Figure 8 Predicted probabilities of MRH indicators by household wealth quintile, DRC 2013-14

Child health 

With the exception of fever care-seeking, all child health indicators increase with increasing wealth in the 

DRC. The size of the increase differs, with DPT3 vaccination and ARI care-seeking increasing the greatest 

proportion from poorest quintile to richest, and diarrhea care-seeking and EBF increasing slightly (see

Figure 9).
29

Figure 9 Levels of child health indicators, by household wealth quintile, DRC 2013-14

Figure 10 presents the predicted probabilities for each child health outcome. The predicted probabilities are 

similar across all relative wealth categories for ARI and fever care-seeking. There is slightly more diarrhea 

care-seeking among poor households relative to the community. The probability of EBF is similar for poor 

households relative to the community and for households with wealth similar to the community, although 

households that are rich relative to the community had an 11% lower probability of EBF when compared 

to poor households relative to the community, over all household wealth quintiles. The largest differences 

are seen in DPT3 vaccination, in which there is an approximately 20% difference in the predicted 

probability between households that are rich relative to the community, compared to poor households that 

are poor relative to the community.

Figure 10 Predicted probabilities of child health indicators by household wealth quintile, DRC 2013-14

0%

20%

40%

60%

80%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
30

Child nutrition 

In rural areas of DRC, rates of stunting in children younger than age 5 are highest among the poorest 

households (50%) and decrease with increasing wealth. Rates of wasting in children younger than age 5 are 

stable at approximately 10% across all household wealth quintiles.

Figure 11 Levels of child nutrition indicators, by household wealth quintile, DRC 2013-14

Households that were poor relative to their community had a 4% higher probability of having a stunted 

child under age 5 when compared to rich households relative to their community. 

Figure 12 Predicted probabilities of child nutrition indicators by household wealth quintile, DRC 2013-14

0%

10%

20%

30%

40%

50%

60%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
31

5.2 Ghana

5.2.1 Household wealth relative to average community wealth 

As shown in Figure 13, half of Ghana’s rural households live in communities of similar wealth to their own.

By the definition, Ghana is second only to Nigeria in terms of homogeneity among the 11 countries. This 

homogeneity is most apparent in the fifth household wealth quintile, where over 60% of households live in 

communities of similar wealth. 

Figure 13 Distribution of household wealth relative to community average, Ghana 2014

5.2.2 Asset ownership and household wealth relative to average community wealth 

Figure 14 shows that households that are poor relative to the community are considerably more likely to 

have electricity than households of the same wealth status in a poorer community. The gap between the two 

groups diminishes at higher levels of household wealth as access to electricity approaches universality. This 

is reversed for vehicle ownership, where the households living in relatively poor communities are more 

likely to own a vehicle. In Ghana, motor scooters are less likely to be owned by wealthier rural households 

than poor rural households. In contrast, wealthy households are more likely to own cars. However, it is in 

the wealthiest of quintiles where the effect is large, and we see the moderate U shape for all three community 

curves for vehicles.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household wealth quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
32

Figure 14 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Ghana 2014

Figure 15 shows that for any given level of household wealth, improved water, sanitation, and walls are 

more likely to be owned by households that are poor relative to the community. In all three cases, the gaps 

between the two groups diminish as household wealth increases and ownership of the asset approaches 

100%.

For most assets, the probability of ownership does not vary greatly across the first two or three quintiles.

The only clear exception is improved sanitation where the upward slope is clear.
33

Figure 15 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Ghana 2014

5.2.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Ghana has high rates of 4+ ANC visits, at over 70% for all wealth quintiles. Rates of facility delivery vary 

by household wealth quintile, with just over 40% of women in the poorest quintile and over 80% of women 

in the richest quintile delivering at a health facility. While women in the poorest quintile have lower modern 

contraceptive use (19%), the other four quintiles are all similar at approximately 25%.

Figure 16 Levels of MRH indicators, by household wealth quintile, Ghana 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
34

Figure 17 presents the predicted probabilities of each of these outcomes, with different lines for each of the 

relative community wealth categories, by household wealth quintile. In the lower three household wealth 

quintiles, there is a slightly (5%) higher probability that women living in poor household relative to the 

community received 4+ ANC visits compared to women living in a rich household relative to the 

community. This difference narrows for the upper two quintiles. A similar pattern can be seen in the 

probability of women delivering at a health facility. These differences are programmatically important or 

statistically significant (see Appendix A6).

Figure 17 Predicted probabilities of MRH indicators by household wealth quintile, Ghana 2014

Child health

The results presented in Figure 18 show that DPT3 vaccination rates are high in rural Ghana, with all 

quintiles over 80%. Care-seeking for ARI, fever, and diarrhea vary, with different patterns of care-seeking 

by wealth quintile. Rates of both diarrhea care-seeking and EBF decrease with increasing wealth, until the 

richest quintile where there is a small increase.
35

Figure 18 Levels of child health indicators, by household wealth quintile, Ghana 2014

Figure 19 presents the child health outcomes for each relative community wealth category by household 

wealth quintile. For all child health outcomes except for EBF, there are small, non-programmatically 

important and nonstatistically significant differences between the relative community wealth categories. 

For EBF, however, there is a greater than 10% difference in the probability that women who live in rich 

households relative to the community exclusively breastfed their infant at age 6 months when compared to 

women who live in poor households relative to the community.

Figure 19 Predicted probabilities of child health indicators by household wealth quintile, Ghana 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5

*Quintiles 1 and 5 had fewer than 25 unweighted cases

* *
36

Child nutrition

Rates of stunting in children under age 5 are consistently approximately 25% for the poorest quintiles and 

then decrease to under 15% in the richest quintile. Wasting in children under age 5 is under 10% for all 

quintiles, with an increase in the richest quintile.

Figure 20 Levels of child nutrition indicators, by household wealth quintile, Ghana 2014

Figure 21 shows that there are no programmatically important or statistically significant differences 

between the relative community wealth categories in stunting or wasting among children under age 5 in 

Ghana.

Figure 21 Predicted probabilities of child nutrition indicators by household wealth quintile, Ghana 2014

0%

5%

10%

15%

20%

25%

30%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
37

5.3 Haiti

5.3.1 Household wealth relative to average community wealth 

The far-right columns in Figure 22 shows that nearly half of Haiti’s rural households live in communities 

of similar average wealth to their own. The wealthiest quintile is the starkest example where 69% of 

households in the first quintile of household wealth live in the communities that are the wealthiest on 

average. In the poorer quintiles, there is less homogeneity.

Figure 22 Distribution of household wealth relative to community average, Haiti 2016-17

5.3.2 Asset ownership and household wealth relative to average community wealth 

Among the poorest rural households, there is virtually no access to electricity. As household wealth 

increases, access to electricity increases, although access remains low even at the wealthiest quintiles. 

Households that are poor relative to the community are much more likely to have electricity. The gap 

between the households that are poor relative to the community and the households that are wealthy relative 

to their communities grows as household wealth status increases. Ownership of vehicles, telephones, and 

bank accounts are not strongly related to a household’s wealth relative to the community.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
38

Figure 23 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Haiti 2016-17

A household that is poor relative to the community is more likely to have an improved water source. The 

gap between the curves is persistent. Even as the wealthiest rural household in relatively wealth 

communities approaches 100% access to improved water, the gap persists. Ownership or access to 

improved sanitation, flooring, and walls is not strongly related to a whether a household is wealthy or poor 

relative to its community.
39

Figure 24 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Haiti 2016-17

5.3.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health

In Haiti, there are high rates of 4+ ANC visits compared to health facility delivery, with steady increases in 

both 4+ ANC visits and health facility delivery over the household wealth quintiles. This is in contrast to 

modern contraceptive use, which fluctuates around 30% at each wealth quintile (see Figure 25).

Figure 25 Levels of MRH indicators, by household wealth quintile, Haiti 2016-17

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
40

Similar patterns are shown in Figure 26, with health facility delivery showing large differences in the 

predicted probability of facility delivery by relative community wealth, and specifically between the 

households that are poor relative to their community and those that are rich relative to their community (6% 

at quintile 1, 10% at quintile 2, 12% at quintile 3, 15% at quintile 4, and 13% at quintile 5).

Figure 26 Predicted probabilities of MRH indicators by household wealth quintile, Haiti 2016-17

Child health

Figure 27 presents the child health indicators by wealth quintile for rural Haiti. Both DPT3 vaccination and 

ARI care-seeking show a sharp increase for households in the richest wealth quintile. Fever care- seeking 

has a more consistently positive change as wealth quintile increases. Diarrhea care-seeking and EBF show 

fluctuations as wealth quintiles increase.
41

Figure 27 Levels of child health indicators, by household wealth quintile, Haiti 2016-17

Figure 28 shows the predicted probabilities of each child health outcome for each category of relative 

community wealth, by household wealth quintile. The DPT3 vaccination, fever care-seeking, and EBF 

values have large differences in predicted probability by relative wealth category. Differences in DPT3 

range from 18% in quintiles 2-4 and 13% in quintile 5 and are statistically significant. Differences in fever 

care-seeking range from 13% in quintiles 1 and 2 to 17% in quintiles 4 and 5 and are statistically significant. 

In both cases, households that are poor relative to the community have a higher probability of the outcome. 

With EBF, there is an approximately 10% difference across the quintiles, although households that are rich 

relative to the community have the higher probability of the outcome. This difference is not statistically 

significant.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care seeking Fever care seeking Diarrhea care seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
42

Figure 28 Predicted probabilities of child health indicators by household wealth quintile, Haiti 2016-17

Child nutrition

Figure 29 presents child nutrition indicators by household wealth quintile. Rates of stunting in children 

under age 5 decrease consistently with increasing wealth, while rates of wasting remain consistently low 

(3-4%) over the wealth quintiles.

Figure 29 Levels of child nutrition indicators, by household wealth quintile, Haiti 2016-17

There are no notable differences in predicted probabilities of stunting or wasting between the categories of 

relative community wealth.

0%

5%

10%

15%

20%

25%

30%

35%

40%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
43

Figure 30 Predicted probabilities of child nutrition indicators by household wealth quintile, Haiti 2016-17

5.4 Indonesia

5.4.1 Household wealth relative to average community wealth 

Figure 31 presents the distribution of wealth quintiles based on the wealth of the household relative to 

community in rural Indonesia. There is an even distribution of households that have higher, equal, and lower 

wealth than their community’s average wealth. Nearly 50% of households in quintiles 1 and 2 are poor 

compared to the average wealth of the community in which they live. In the fifth quintile, more than 50% 

of the households are wealthy relative to the average wealth of their community.

Along with Liberia, DRC, and Zambia, Indonesia is classified as relatively heterogeneous in the results 

section of this report. Indonesia and the DRC offer a contrast among the homogeneous countries. In the 

DRC, only the four poorest quintiles were heterogeneous (see Section 5.1.1). In Indonesia, the heterogeneity 

exists across all five household quintiles, including the poorest.
44

Figure 31 Distribution of household wealth relative to community average, Indonesia 2017

5.4.2 Asset ownership and household wealth relative to average community wealth 

Indonesia is the wealthiest in our sample of 11 countries. Among the wealthiest rural households, ownership 

of electricity, telephones, and vehicles is nearly universal. Among the households classified as poor, those 

that are wealthy relative to their community are more likely to own a car or a telephone. The relationship 

holds true for having a bank account for the second, third, and fourth quintiles.

Figure 32 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Indonesia 2017

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
45

In contrast to the assets examined in Figure 33, households that are poor relative to the community are more 

likely to have improved water and improved flooring at low levels of household wealth. At higher levels of 

household wealth status, the gaps disappear as the assets are almost universally owned or accessed even in 

rural areas. 

Figure 33 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Indonesia 2017

5.4.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 34 shows MRH indicators by household wealth quintile for rural Indonesia. For 4+ ANC visits, there 

is a large increase from the poorest quintile to the next, with smaller increases seen in the other quintiles.

Health facility delivery increases consistently from 45% in quintile 1 to 86% in quintile 5. Modern 

contraceptive use fluctuates between 52% and 62% across the five quintiles.
46

Figure 34 Levels of MRH indicators, by household wealth quintile, Indonesia 2017

Figure 35 shows the predicted probability of the three MRH outcomes for each of the relative community 

wealth categories, by household wealth quintile. There is a significant difference in the predicted probability 

between poor and rich households compared to their community for both 4+ ANC visits and health facility 

delivery. In both cases, relatively poor households have a higher probability of the outcome than relatively 

rich households compared to their community. 

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
47

Figure 35 Predicted probabilities of MRH indicators by household wealth quintile, Indonesia 2017

Child health

Figure 36 shows the levels of each child health indicator in rural Indonesia by household wealth quintile.

There are general increases in DPT3 vaccination and fever care-seeking with increasing wealth. For ARI 

and diarrhea care-seeking, the poorest quintile has the lowest level, although the levels of each variable 

fluctuate across the remaining four quintiles. Rates of EBF decrease with increasing wealth.

Figure 36 Levels of child health indicators, by household wealth quintile, Indonesia 2017

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
48

Figure 37 shows the predicted probabilities of each child health outcome for each category of relative 

community wealth, by household wealth quintile. Statistically significant differences are seen in the 

predicted probability of DPT3 vaccination, across all household wealth quintiles, with ranges from 13% in 

quintile 1 to 9% in quintile 5. Households that are poor relative to the community have a higher probability 

of DPT3 vaccination compared to households that are rich relative to the community. 

There is also a programmatically important but not statistically significant difference in the predicted 

probability of EBF. However, households that are poor relative to the community have a lower probability 

of EBF when compared to households that are rich relative to the community.

Figure 37 Predicted probabilities of child health indicators by household wealth quintile, Indonesia 2017

5.5 Kenya

5.5.1 Household wealth relative to average community wealth 

Figure 38 presents the distribution of the relative community wealth variable by wealth quintile and overall 

for the rural population of Kenya. Overall, 44% of rural households in Kenya live in communities of average 

wealth similar to their own. In the overall results, we have categorized Kenya as being relatively 

homogeneous. However, among the homogeneous countries, Kenya is the least homogeneous by our chosen 

measure. The relative overall homogeneity is driven primarily by the poorest and richest quintiles. 

Counterbalancing the homogeneity of the first and second quintile, the second, third, and fourth quintiles 

are relatively heterogeneous, with 52% of the households in the second quintile poor relative to the 

community, and fewer than one-third of households in the third and fourth quintile in communities with 

average wealth similar to their own.
49

Figure 38 Distribution of household wealth relative to community average, Kenya 2014

5.5.2 Asset ownership and household wealth relative to average community wealth 

Access to electricity, ownership of a vehicle, and having a bank account are very low among the poorer 

households. At higher levels of household wealth, households that are poor relative to the community are 

more likely to have access to electricity than households that are wealthy relative to the community. This is 

reversed for vehicle ownership. Ownership of telephones is nearly universal for the wealthiest rural 

quintiles, but among the poorer quintiles, a household living in a community poor relative to its own wealth 

is more likely to own a telephone.

Figure 39 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Kenya 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
50

Across all household wealth quintiles, households that are poor relative to the community have a higher 

probability of having improved water. This pattern is repeated for improved walls, except in the poorest 

household wealth quintile where the ownership of improved walls is almost zero. 

Figure 40 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Kenya 2014

5.5.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 41 shows the levels of three MRH indicators, by household wealth quintile, for rural Kenya. Levels 

of 4+ ANC visits are low overall, although they increase from 43% in the poorest quintile to 64% in the 

richest quintile. Health facility delivery has a larger increase, starting at 28% for women in the poorest 

quintile and increasing to 82% in the richest quintile. Modern contraceptive prevalence is just 21% for 

married women in the poorest quintile, but this increases in the subsequent quintiles. 
51

Figure 41 Levels of MRH indicators, by household wealth quintile, Kenya 2014

Figure 42 provides the predicted probabilities of the maternal health outcomes. There are significant and 

programmatically important differences in the predicted probabilities of health facility delivery and modern 

contraceptive use. For health facility delivery, women in households that are poor relative to the community 

wealth are more likely to deliver in health facilities when compared to women in households that are rich 

relative to the community, over all household wealth quintiles. The same pattern holds for modern 

contraceptive use. In both cases the largest differences are seen in quintiles 2 and 3 (14% difference in 

health facility delivery and an 18% difference in modern contraceptive use).

Figure 42 Predicted probabilities of MRH indicators by household wealth quintile, Kenya 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
52

Child health

Figure 43 depicts the levels of five child health indicators by household wealth quintile for the rural 

population in Kenya. DPT3 vaccination has a clear increasing trend with increasing wealth. All three careseeking indicators were lowest for the poorest quintile and highest for the richest quintile, but fluctuated 

for the middle three quintiles. Exclusive breastfeeding remained around 55% for the poorest four quintiles 

but increased to nearly 70% for the richest quintile.

Figure 43 Levels of child health indicators, by household wealth quintile, Kenya 2014

There are no statistically significant differences in the predicted probability of any child health indicator 

presented in Figure 44. However, there is a programmatically important difference in EBF, where women 

in rich households relative to the community have an approximately 10% higher predicted probability of 

EBF when compared to women in poor households relative to the community.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
53

Figure 44 Predicted probabilities of child health indicators by household wealth quintile, Kenya 2014

Child nutrition

Figure 45 presents selected child nutrition indicators by household wealth quintile for rural Kenya. Both 

stunting and wasting decrease with increasing wealth, although stunting is much more common, found in 

27% compared with 9% wasting in children under age 5 in the poorest quintile, and 19% stunting compared 

with 2% wasting in children under age 5 in the richest quintile.

Figure 45 Levels of child nutrition indicators, by household wealth quintile, Kenya 2014

0%

5%

10%

15%

20%

25%

30%

35%

40%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
54

The predicted probabilities of both stunting and wasting differed significantly by relative community wealth 

status. Over all five wealth quintiles, stunting had a higher predicted probability in children from rich 

households compared to the community when compared to either of the other categories. This difference 

ranged from 6% in the poorest quintile when compared to households of similar wealth to the community, 

to 3% in the richest quintile when compared to poor households relative to the community. Children in the 

poorest wealth quintile from rich households relative to the community had a 3% higher probability of 

wasting compared to children in the poorest wealth quintile from poor households relative to the 

community. This difference decreased over the wealth quintiles but remained significant. It is important to 

note that these differences, while statistically significant, do not meet the 10% threshold for 

programmatically important differences. 

Figure 46 Predicted probabilities of child nutrition indicators by household wealth quintile, Kenya 2014

5.6 Liberia

5.6.1 Household wealth relative to average community wealth 

Figure 47 presents the distribution of relative community wealth overall and by household wealth quintile 

in rural Liberia. Less than 40% of households live in communities with an average wealth status similar to 

their own. We classify Liberia as being relatively heterogeneous. Half of households in the poorest quintile 

live in a community that is wealthy relative to its own wealth status. In the second, third, and fourth 

quintiles, fewer than one-third of the households live in a community of similar wealth status.
55

Figure 47 Distribution of household wealth relative to community average, Liberia 2013

5.6.2 Asset ownership and household wealth relative to average community wealth 

Access to electricity in rural Liberia was nearly zero in 2013, which made regression analysis impossible.

Ownership of vehicles and bank accounts was also low, but analysis was possible. None of the differences 

across the relative wealth statuses exceeds 0.10 in the graphs of Figure 48.

Figure 48 Predicted probabilities of asset ownership (vehicle, telephone, and bank account) by household 

wealth quintile, Liberia 2013

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
56

Across all household wealth statuses, being poor relative to community in all wealth quintiles boosts the 

probability of having an improved water source. Improved sanitation, improved flooring, and improved 

walls (except in quintile 5) are not strongly related to a household’s wealth relative to the community.

Figure 49 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Liberia 2013

5.6.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 50 shows that for all three maternal and reproductive health indicators, the indicator increases with 

increasing wealth. Most women across all five wealth quintiles attend 4+ ANC visits, while only 60% of 

women in the richest wealth quintile deliver at a health facility. Modern contraceptive use is low overall, 

with use by only 12% of married women in the poorest quintile and 22% of women in the richest quintile.
57

Figure 50 Levels of MRH indicators, by household wealth quintile, Liberia 2013

Figure 51 provides the predicted probabilities of the three MRH indicators for each category of relative 

community wealth by household wealth quintile. There are consistent statistically significant differences in 

all three indicators over all household wealth quintiles. In each case, women from poor households relative 

to the community have higher predicted probability of MRH when compared with women from rich 

households relative to the community. There are, however, slightly different patterns in these differences. 

The differences in the probability of 4+ ANC visits is largest for the poorest women (15%) and decreases 

with increasing wealth, where the difference is 7% for the richest women. Health facility delivery is 

consistently 12%-13% higher for women from poor households relative to the community compared with

women from rich households relative to the community. Finally, the difference in predicted probability of 

modern contraceptive use is smallest for the poorest women (4%) and largest for the richest women (8%).

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
58

Figure 51 Predicted probabilities of MRH indicators by household wealth quintile, Liberia 2013

Child health

Figure 52 shows the levels of the five child health indicators of interest. The DPT3 and diarrhea careseeking indicators increase consistently with increasing wealth. The ARI care-seeking is very low, at less 

than 40% for the poorest wealth quintile, and then varies between 50%-60% for the subsequent quintiles. 

Fever care-seeking and EBF increase, although not consistently, with increasing wealth.

Figure 52 Levels of child health indicators, by household wealth quintile, Liberia 2013

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
59

Figure 53 shows the predicted probabilities of the five child health indicators. Statistically significant and 

programmatically important differences are evident in DPT3 vaccination rates, where children from poor 

households relative to the community have higher predicted probability of DPT3 vaccination when 

compared with children from rich households relative to the community. While not statistically significant, 

differences in the probability of EBF are also programmatically important.

Figure 53 Predicted probabilities of child health indicators by household wealth quintile, Liberia 2013

Child nutrition

Figure 54 shows the levels of stunting and wasting in children under age 5 by wealth quintile. Levels of 

both indicators are consistent over the first four wealth quintiles, at around 35% for stunting and 6% for 

wasting, and decreasing in the richest quintile to 28% for stunting and 5% for wasting.
60

Figure 54 Levels of child nutrition indicators, by household wealth quintile, Liberia 2013

Figure 55 presents the predicted probabilities of stunting and wasting for each category of relative 

community wealth. None of the differences in the graphs are programmatically important or statistically 

significant.

Figure 55 Predicted probabilities of child nutrition indicators by household wealth quintile, Liberia 2013

0%

5%

10%

15%

20%

25%

30%

35%

40%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
61

5.7 Mali

5.7.1 Household wealth relative to average community wealth 

Figure 56 presents the relative community wealth of rural households in Mali by household wealth quintiles 

and overall. Nearly half (45%) of Mali’s rural households live in communities of similar average wealth to 

their own. We categorized Mali as being relatively homogeneous. This is driven to a large extent by the 

richest quintile, where 70% of the wealthiest households are also in the wealthiest of the rural communities. 

In contrast are households in the second and third wealth quintiles where fewer than one-third of the 

households are in communities of similar wealth status.

Figure 56 Distribution of household wealth relative to community average, Mali 2018

5.7.2 Asset ownership and household wealth relative to average community wealth 

Across all household wealth quintiles, households that are wealthy relative to their community are more 

likely to own a vehicle. Having a bank account is rare for rural Malians, although households in the 

wealthiest quintile that are wealthy relative to their community are more likely to have a bank account than 

households with similar wealth that are poor relative to their community.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
62

Figure 57 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Mali 2018

Across all household wealth quintiles, households that are poor relative to the community are more likely 

to have an improved water source than households that are wealthy relative to the community. Rural 

Malians in the wealthiest quintile who are wealthy relative to their communities are more likely to have 

improved flooring than those in households that are poor relative to their communities.
63

Figure 58 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Mali 2018

5.7.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 59 shows the levels of three MRH indicators by household wealth quintile in Mali. For each

indicator, the level increases with increasing household wealth. However, the size of the increase across the 

quintiles varies. The proportion of women attending 4+ ANC visits more than doubles from 25% in the 

poorest quintile to 56% in the richest quintile. Health facility delivery is more common across all wealth 

quintiles and increases from 47% in the poorest to 88% in the richest quintile. Modern contraceptive use is 

low overall, plateaus at 11-12% in the first three quintiles, and then increases to 21% in the richest quintile.
64

Figure 59 Levels of MRH indicators, by household wealth quintile, Mali 2018

Figure 60 presents the predicted probabilities of the MRH outcomes. For each indicator, there are 

statistically significant differences in predicted probability by relative community wealth. Poor households 

relative to the community have higher probability of 4+ ANC visits compared to households that are rich 

relative to the community, and this difference increases from 11% in the poorest quintile to 16% in the 

richest quintile. With health facility delivery, in the first four household wealth quintiles, households that 

are poor relative to the community have a 20% higher probability of health facility delivery compared to 

households that are rich relative to the community. For modern contraceptive use, the difference in 

probabilities is lower, between 5% in the lowest two quintiles and 9% in the highest quintile, but is 

statistically significant.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
65

Figure 60 Predicted probabilities of MRH indicators by household wealth quintile, Mali 2018

Child health

Figure 61 presents the levels of child health indicators by household wealth quintile in the rural population 

of Mali. The DPT3 vaccination rates increase consistently as household wealth increases. Fever and 

diarrhea care-seeking increase between the poorest and richest wealth quintiles, although the levels 

fluctuate in the middle three quintiles. Since there were fewer than 25 unweighted cases of ARI in four of 

the five household wealth quintiles, the proportions were not calculated.

Figure 61 Levels of child health indicators, by household wealth quintile, Mali 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5

*For ARI care-seeking, quintiles 1, and 3-5 had fewer than 25 unweighted cases.

* *
66

Figure 62 shows the predicted probabilities of child health indicators for different categories of relative 

community wealth. No statistically significant or programmatically important differences were identified 

for any of the child health indicators.

Figure 62 Predicted probabilities of child health indicators by household wealth quintile, Mali 2018

Child nutrition

Figure 63 shows the levels of child nutrition indicators by wealth quintile for children in rural households 

in Mali. Stunting remains at approximately 30% for the first four quintiles, dropping to 18% in the richest 

quintile, while wasting remains relatively consistent at approximately 10% for all quintiles.

Figure 63 Levels of child nutrition indicators, by household wealth quintile, Mali 2018

0%

5%

10%

15%

20%

25%

30%

35%

40%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
67

Figure 64 shows that there are statistically significant, while not programmatically important, differences 

in the predicted probability of stunting by relative community wealth. Over all household wealth quintiles, 

households that are poor relative to the community have 3%-4% lower probability of stunting than 

households that are rich relative to the community. There are no statistically significant or programmatically 

important differences in the predicted probability of wasting.

Figure 64 Predicted probabilities of child nutrition indicators by household wealth quintile, Mali 2018

5.8 Nigeria

5.8.1 Household wealth relative to average community wealth 

Figure 65 shows the relative community wealth of rural households in Nigeria by household wealth 

quintiles and overall. Over half (54%) of Nigeria’s rural households live in communities of similar average 

wealth to their own. Nigeria was rated the most homogeneous by this standard. This large proportion is 

most striking in the richest quintile where 77% of households are also in the wealth quintile of communities. 

The homogeneity holds across all of the quintiles. The proportion of households that live in communities 

of similar wealth is 38% or greater in all quintiles. 
68

Figure 65 Distribution of household wealth relative to community average, Nigeria 2018

5.8.2 Asset ownership and household wealth relative to average community wealth 

Households in household wealth quintiles 2, 3, 4 and 5 that are poor relative to their community are more 

likely to have electricity. Households across all quintiles that are wealthy relative to their community are 

more likely to own a vehicle. The same holds true for telephones among the poorer households. At higher 

levels of wealth, ownership of telephones is nearly universal. 

Figure 66 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Nigeria 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
69

Across all quintiles, households that are poor relative to their communities are more likely to have an 

improved water source. This same relationship holds for improved sanitation and improved walls, but only 

for quintile 4 and quintiles 2, 3, and 4, respectively. 

Figure 67 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Nigeria 2018

5.8.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

In Figure 68, all three MRH indicators increase with increasing household wealth. As shown, 4+ ANC visits 

increases from 26% in the poorest quintile to 74% in the richest quintile, while health facility delivery 

increases from 8% in the poorest quintile to 60% in the richest. Modern contraceptive use is low overall, 

but also increases from 3% in the poorest quintile to 16% in the richest.
70

Figure 68 Levels of MRH indicators, by household wealth quintile, Nigeria 2018

Figure 69 presents the predicted probabilities of the three MRH indicators by relative community wealth 

category. With 4+ ANC visits and health facility delivery, there are statistically significant differences in 

predicted probabilities across all five household wealth quintiles. The difference fluctuates between 8%-

10% across the five quintiles for 4+ ANC visits, with households that are poor relative to the community 

having a higher probability compared to households that are rich relative to their community. Poor 

households relative to the community have a higher probability of health facility delivery compared to 

households that are rich relative to the community. This difference increases from 4% in the poorest quintile 

to 13% in the richest quintile.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
71

Figure 69 Predicted probabilities of MRH indicators by household wealth quintile, Nigeria 2018

Child health

Figure 70 shows the levels of the five child health indictors of interest for children in rural households in 

Nigeria. The DPT3 vaccination and fever care-seeking indicators increase with increasing wealth. For ARI 

and diarrhea care-seeking, as well as EBF, the richest quintile consistently has higher levels than the poorest 

quintile, with fluctuations in the three middle three quintiles.

Figure 70 Levels of child health indicators, by household wealth quintile, Nigeria 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
72

Figure 71 shows the predicted probabilities of each child health indicator by relative community wealth 

category. Of the five indicators, there are statistically significant and programmatically important 

differences only in DPT3 vaccination. In this case, children from poor households relative to the community 

have higher predicted probability of DPT3 vaccination when compared with children from rich households 

relative to the community. This difference ranges from 7% in the poorest quintile to 10% in the richest 

quintile.

Figure 71 Predicted probabilities of child health indicators by household wealth quintile, Nigeria 2018

Child nutrition

Figure 72 shows the high rates of stunting in children under age 5 in rural Nigerian households. The rates 

of stunting decrease by over half from the poorest quintile (56%) to the richest quintile (25%). Rates of 

wasting are 11% in the poorest quintile and decrease to 6% in the richest quintile.
73

Figure 72 Levels of child nutrition indicators, by household wealth quintile, Nigeria 2018

Figure 73 indicates that for both stunting and wasting, there are statistically significant differences in the 

predicted probabilities according to relative community wealth. In both cases, households that are rich 

relative to the community have a higher probability of wasting and stunting, across household wealth 

quintiles. However, this difference decreases as household wealth increases – from 12% in quintile 1 to 9% 

in quintile 5 for stunting, and 4% in quintile 1 to 2% in quintile 5 for wasting.

Figure 73 Predicted probabilities of child nutrition indicators by household wealth quintile, Nigeria 2018

0%

10%

20%

30%

40%

50%

60%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
74

5.9 Pakistan

5.9.1 Household wealth relative to average community wealth 

Figure 74 presents the relative community wealth of rural households in Pakistan by household wealth 

quintiles and overall. A total of 46% of Pakistan’s rural households live in communities of average wealth 

similar to their own. We classified Pakistan as being relatively homogeneous. This homogeneity is driven 

equally by the poorest and richest quintiles, where high proportions of households (65% and 66%, 

respectively) live in communities of average wealth similar to their own. Quintile 2 is also relatively 

homogeneous. In contrast, quintiles 3 and 4 are relatively heterogeneous. Each has fewer than one-third of 

the households living in communities of similar wealth. 

Figure 74 Distribution of household wealth relative to community average, Pakistan 2017-18

5.9.2 Asset ownership and household wealth relative to average community wealth 

Across all quintiles, vehicle ownership is more likely in households that are wealthy relative to their 

communities. The same relationship holds for bank accounts, but only for quintiles 3, 4, and 5. Among the 

households in the poorest two quintiles, those that are poor relative to their communities are more likely to 

have electricity. In household wealth quintiles 3, 4, and 5, access to electricity is nearly universal.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
75

Figure 75 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Pakistan 2017-18

Households in the poorest quintiles (1 and 2) that are poor relative to their communities are more likely to 

have an improved water source than those that are relatively wealthy. At higher levels of household wealth, 

there is nearly universal access to water among all rural households. In the middle quintiles of household 

wealth (2, 3 and 4), those that are poor relative to their communities are more likely to have improved walls 

or floors. At low levels of household wealth, there is very little ownership of these assets. At high levels of 

wealth, there is near universal ownership in rural communities.
76

Figure 76 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Pakistan 2017-18

5.9.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 77 provides MRH indicators by household wealth quintile for rural Pakistan. The proportion of 

women receiving 4+ ANC visits increases with increasing household wealth from 23% in the poorest 

quintile to 73% in the richest quintile. Health facility delivery fluctuates around 50% in the first three 

household wealth quintiles, and then increases to 70% in the fourth and 86% in the fifth quintile. Modern 

contraceptive use remains low in the lower quintiles, at 17% in quintile 1 and 19% in quintile 2, and then 

increases in the higher quintiles, with 27% in quintile 5.
77

Figure 77 Levels of MRH indicators, by household wealth quintile, Pakistan 2017-18

Similar patterns are shown in Figure 78, with 4+ ANC visits showing large differences in the predicted 

probability of facility delivery by relative community wealth. More specifically, these differences were 

between the households that are poor relative to the community and those that are rich relative to the 

community (12% at quintile 1, 14% at quintile 2, 16% at quintile 3, 17% at quintile 4, and 12% at quintile 

5). Differences in the predicted probabilities of health facility delivery and modern contraceptive use by 

relative community wealth were not statistically significant or programmatically important.

Figure 78 Predicted probabilities of MRH indicators by household wealth quintile, Pakistan 2017-18

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
78

Child health

Figure 79 shows the levels of the five child health indicators in rural Pakistan. The DPT3 and ARI careseeking indicators increase consistently with increasing wealth. Both fever and diarrhea care-seeking 

decrease from the first to the second quintile and then increase in the last three quintiles. Exclusive 

breastfeeding fluctuates from quintile to quintile, with an overall decrease from the poorest to the richest 

quintiles.

Figure 79 Levels of child health indicators, by household wealth quintile, Pakistan 2017-18

Figure 80 presents the predicted probabilities for each child health outcome. The largest differences are 

seen in DPT3 vaccination. In the poorest quintile, households that are poor relative to the community have 

a 34% higher probability of DPT3 vaccination compared to rich households relative to their community. 

The size of this difference decreases with increasing wealth but remains statistically significant for all 

wealth quintiles. The probability of EBF is statistically significantly higher in households that are rich 

relative to the community when compared to poor households relative to their community, across all 

household wealth quintiles. This difference remains stable, at approximately 20% for all wealth quintiles. 

Although any differences seen in the probabilities of the three care-seeking indicators are not statistically 

significant, differences in the probability of ARI care-seeking are greater than 10% for four of the five 

household wealth quintiles.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
79

Figure 80 Predicted probabilities of child health indicators by household wealth quintile, Pakistan 

2017-18

Child nutrition

Figure 81 shows that in rural areas of Pakistan, the rates of stunting in children younger than age 5 are 

highest among the poorest households (60%) and then decrease with increasing wealth. Rates of wasting in 

children younger than age 5 fluctuate between 11% and 4% over all household wealth quintiles.

Figure 81 Levels of child nutrition indicators, by household wealth quintile, Pakistan 2017-18

0%

10%

20%

30%

40%

50%

60%

70%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
80

Figure 82 presents the predicted probabilities of stunting and wasting for each category of relative 

community wealth. The differences in probabilities by relative community wealth indicated in the graphs 

are not programmatically important or statistically significant.

Figure 82 Predicted probabilities of child nutrition indicators by household wealth quintile, Pakistan 

2017-18

5.10 Senegal

5.10.1 Household wealth relative to average community wealth 

Nearly half (49%) of Senegal’s rural households live in communities of average wealth similar to their own. 

We classified Senegal as homogeneous. This homogeneity is most striking in the wealthiest household 

wealth quintile where 76% of households live in communities of similar wealth. The homogeneity is less 

striking in the other wealth quintiles. In wealth quintiles 2 and 3, the percent of households in communities 

with similar wealth is about one-third.
81

Figure 83 Distribution of household wealth relative to community average, Senegal 2018

5.10.2 Asset ownership and household wealth relative to average community wealth 

Vehicles and bank accounts are more likely to be owned by households that are wealthy relative to their 

communities. This is true for all household quintiles, except for the poorest, for the ownership of a bank 

account. Ownership of a phone is nearly universal across all wealth categories.

Figure 84 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Senegal 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
82

Among the poorest three quintiles of household wealth, access to improved water source is greater for 

households that are poor relative to their community. There are no other apparent strong relationships

among the other three assets.

Figure 85 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Senegal 2018

5.10.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Figure 86 presents the levels of three MRH indicators by household wealth quintile. For each indicator, 

there are increases with increasing wealth. Health facility delivery increases most drastically, from 50% in 

the poorest quintile to 91% in the richest quintile. Modern contraceptive use adds only 1 percentage point 

per quintile from the first to the fourth quintile, until it increases to 24% in the fifth quintile.
83

Figure 86 Levels of MRH indicators, by household wealth quintile, Senegal 2018

Figure 87 provides the predicted probabilities of the three MRH indicators by relative community wealth. 

There are statistically significant and programmatically important differences in health facility delivery, 

where women in households that are poor compared to the community have a higher probability of facility 

delivery than women in households that are rich compared to the community, across all household wealth 

quintiles. There are no statistically significant or programmatically important difference in the other two 

indicators.

Figure 87 Predicted probabilities of MRH indicators by household wealth quintile, Senegal 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
84

Child health

Figure 88 shows the levels of five child health indicators by household wealth quintile for rural households 

in Senegal. Only DPT3 vaccination and diarrhea care-seeking show consistent increases with increasing 

household wealth. For ARI care-seeking, fever care-seeking, and EBF, the richest quintiles have higher 

levels than the poorest, but the levels of the middle three quintiles fluctuate.

Figure 88 Levels of child health indicators, by household wealth quintile, Senegal 2018

As shown in Figure 89, there are statistically significant and programmatically important differences in the 

predicted probability of EBF. Households that are poor relative to the community have a higher probability 

of EBF compared to households that are rich relative to the community. There were no statistically 

significant or programmatically important differences in predicted probabilities in the other four indicators.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
85

Figure 89 Predicted probabilities of child health indicators by household wealth quintile, Senegal 2018

Child nutrition

Figure 90 shows steep decreases in stunting over the five household wealth quintiles, from 31% in quintile 

1 to 11% in quintile 5. Wasting remains relatively flat, at 11% in quintile 1 and 8% in quintile 5.

Figure 90 Levels of child nutrition indicators, by household wealth quintile, Senegal 2018

0%

5%

10%

15%

20%

25%

30%

35%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
86

As shown in Figure 91, there are statistically significant but not programmatically important differences in 

the predicted probability of stunting by relative community wealth. Households that are rich relative to the 

community have a higher probability of stunting compared to households that are poor relative to the 

community over all five household wealth quintiles. There are no differences in the predicted probabilities 

for wasting.

Figure 91 Predicted probabilities of child nutrition indicators by household wealth quintile, Senegal 2018

5.11 Zambia

5.11.1 Household wealth relative to average community wealth 

Figure 92 presents the distribution of relative community wealth over the five household wealth quintiles 

and overall for rural households in Zambia. The distribution across the three relative wealth statuses is 

nearly even. A household is almost as likely to be relatively poor, relative rich, or similar in wealth status

to its community. Zambia was the second most heterogeneous country in our study. For quintiles 2, 3 and 

4, fewer than one-third of the households are in communities with similar average levels of wealth. The 

poorest households are more likely to be in a relatively wealthy community than in a community of similar 

average wealth.
87

Figure 92 Distribution of household wealth relative to community average, Zambia 2018

5.11.2 Asset ownership and household wealth relative to average community wealth 

With the exception of the wealthiest quintiles, electricity, vehicle ownership, and bank accounts are rare. 

Access to electricity is more likely among the wealthiest rural households in communities with average 

wealth similar to theirs. Vehicle ownership is more likely among the wealthiest rural households that are 

wealthy relative to their community.

Figure 93 Predicted probabilities of asset ownership (electricity, vehicle, telephone, and bank account) by 

household wealth quintile, Zambia 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5 Overall

Household Wealth Quintile

Rich HH relative to

community

HH wealth similar to

community

Poor HH relative to

community
88

Across all household wealth quintiles, households that are poor relative to the community are more likely 

to have access to an improved water source. Improved sanitation, improved flooring, and improved walls 

are not strongly associated with a household’s wealth relative to its community.

Figure 94 Predicted probabilities of asset ownership (improved water, improved sanitation, improved 

floor, and improved wall) by household wealth quintile, Zambia 2018

5.11.3 Health indicators and household wealth relative to average community wealth 

Maternal and reproductive health (MRH)

Levels of each of the three MRH indicators are shown in Figure 95. The number of 4+ ANC visits is the 

same (65%-66%) across all five wealth quintiles. Health facility delivery is high overall, and increases with 

increasing wealth, from 72% in the poorest quintile to 91% in the richest quintile. Modern contraceptive 

use is higher in the richest quintile (51%) compared to the poorest (34%), but fluctuates in the middle 

quintiles.
89

Figure 95 Levels of MRH indicators, by household wealth quintile, Zambia 2018

Figure 96 shows the predicted probabilities of the three MRH indicators for each category of relative 

community wealth. With both health facility delivery and modern contraceptive use, women in households 

that are poor compared to the community have higher probabilities than women in households that are rich 

compared to the community. The differences do not approach the 10% cutoff for programmatic importance. 

There are no differences in predicted probabilities for 4+ ANC visits.

Figure 96 Predicted probabilities of MRH indicators by household wealth quintile, Zambia 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

Household Wealth Quintile

4+ ANC visits Health facility delivery mCPR
90

Child health

Figure 97 depicts the levels of five child health indicators by household wealth quintile for the rural 

population in Zambia. DPT3 vaccination was lowest for the poorest quintile (87%) and highest for the 

richest quintile (98%) but plateaued at 90-91% in the middle three quintiles. There were too few ARI cases 

in the third to fifth quintiles to have reliable estimates. The remaining three indicators – fever care-seeking, 

diarrhea care-seeking, and EBF – had no clear pattern over household wealth.

Figure 97 Levels of child health indicators, by household wealth quintile, Zambia 2018

Figure 98 shows the predicted probabilities of the five child health indicators. There are no consistent 

statistically significant differences in the predicted probabilities by relative community wealth category in 

any indicator. The programmatically important differences in the probabilities of ARI care-seeking in 

certain household wealth quintiles are based on fewer than 25 unweighted cases, have wide confidence 

intervals, and should be interpreted with caution.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Received DPT3 ARI care-seeking Fever care-seeking Diarrhea care-seeking Exclusively breastfed

Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5

*For ARI care-seeking, quintiles 3-5 had fewer than 25 unweighted cases.

*
91

Figure 98 Predicted probabilities of child health indicators by household wealth quintile, Zambia 2018

Child nutrition

Figure 99 shows the levels of child nutrition indicators by household wealth quintile. Both stunting and 

wasting in children under age 5 are lower in the richest quintile compared to the poorest (29% and 39% for 

stunting; 3% and 5% for wasting), although they fluctuate in the middle three quintiles.

Figure 99 Levels of child nutrition indicators, by household wealth quintile, Zambia 2018

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

1 2 3 4 5

Household Wealth Quintile

Stunted Wasted
92

Figure 100 shows that there are no differences in the predicted probabilities of stunting or wasting by 

relative community wealth category in Zambia.

Figure 100 Predicted probabilities of child nutrition indicators by household wealth quintile, Zambia 2018
93

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95

APPENDIX
96

Appendix Table A1 Regressions of assets on household wealth quintiles and household relative to average community wealth

DRC

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

rat

Wealth 

quintile

Quintile 1 (Poorest) + 0.04*** 0.02 - 0.10 0.22 0.03 - 1.82 + 0.15*** 0.11 - 0.22 0.89 0.61 - 1.30 

Quintile 2 + 0.25*** 0.18 - 0.34 0.18*** 0.07 - 0.47 0.01*** 0.00 - 0.10 0.44*** 0.33 - 0.59 0.97 0.73 - 1.30 

Quintile 3 (Reference)

Quintile 4 0.11* 0.02 - 0.62 3.55*** 2.76 - 4.57 5.62*** 2.69 - 11.70 1.01 0.27 - 3.83 1.80*** 1.31 - 2.49 0.90 0.70 - 1.15 

Quintile 5 11.68*** 8.48 - 16.08 21.10*** 10.53 - 42.27 7.07*** 2.55 - 19.65 5.53*** 3.01 - 10.14 0.78 0.49 - 1.23 

Relative 

community 

wealth

Poor relative to 

community

+ 0.95 0.72 - 1.25 0.52 0.18 - 1.47 0.56 0.10 - 3.24 2.47*** 1.73 - 3.54 0.77 0.57 - 1.05 

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.67 0.17 - 2.73 0.55*** 0.41 - 0.74 2.45** 1.36 - 4.39 0.97 0.38 - 2.53 0.30*** 0.19 - 0.49 1.40* 1.01 - 1.96 0.6

Observations 3,622 12,729 12,729 9,346 12,729 12,729 1,86

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity
97

Appendix Table A1—Continued

Ghana

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adj

o

r

Wealth 

quintile

Quintile 1 (Poorest) 0.16*** 0.09 - 0.29 1.03 0.74 - 1.44 4.58*** 3.20 - 6.55 0.64** 0.48 - 0.85 1.09 0.61 - 1.94 0.11*** 0.07 - 0.16 0

Quintile 2 0.31*** 0.22 - 0.43 0.73* 0.57 - 0.93 1.53* 1.06 - 2.21 0.77 0.59 - 1.02 0.82 0.59 - 1.14 0.41*** 0.32 - 0.52 0

Quintile 3 (Reference)

Quintile 4 4.31*** 2.97 - 6.24 1.87*** 1.39 - 2.49 0.92 0.67 - 1.27 1.54*** 1.21 - 1.97 3.70*** 2.57 - 5.33 1.80*** 1.34 - 2.41 3

Quintile 5 24.34*** 14.65 - 40.44 10.42*** 6.82 - 15.92 2.40*** 1.68 - 3.43 6.78*** 5.21 - 8.82 12.28*** 6.24 - 24.17 7.79*** 5.24 - 11.56 12

Relative 

community 

wealth

Poor relative to 

community

1.46* 1.02 - 2.10 1.08 0.86 - 1.35 0.63* 0.45 - 0.90 0.87 0.67 - 1.13 1.58* 1.11 - 2.25 1.51** 1.15 - 1.99 1

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.53** 0.35 - 0.81 1.21 0.96 - 1.54 2.01*** 1.54 - 2.63 1.16 0.95 - 1.41 0.73 0.52 - 1.01 0.54*** 0.41 - 0.72 0

Observations 5,896 5,896 5,896 5,896 5,896 5,896 5,8

Note: *p<0.05; **p<0.01; ***p<0.001
98

Appendix Table A1—Continued

Haiti

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adj

o

r

Wealth 

quintile

Quintile 1 (Poorest) + 0.16*** 0.12 - 0.20 0.03*** 0.01 - 0.08 0.00*** 0.00 - 0.01 0.14*** 0.10 - 0.20 0.10*** 0.06 - 0.18 

Quintile 2 0.31** 0.15 - 0.64 0.71** 0.57 - 0.87 0.44** 0.26 - 0.73 0.31*** 0.17 - 0.55 0.62*** 0.49 - 0.79 0.53*** 0.43 - 0.66 

Quintile 3 (Reference)

Quintile 4 5.68*** 3.51 - 9.17 2.07*** 1.56 - 2.73 2.85*** 2.00 - 4.06 3.01*** 2.19 - 4.13 2.16*** 1.70 - 2.74 2.34*** 1.90 - 2.87 

Quintile 5 58.96*** 30.90 - 112.50 10.10*** 7.09 - 14.38 11.31*** 7.76 - 16.50 15.50*** 10.79 - 22.28 6.45*** 4.30 - 9.67 6.43*** 4.75 - 8.71 1

Relative 

community 

wealth

Poor relative to 

community

1.98* 1.18 - 3.31 0.84 0.69 - 1.03 1.03 0.71 - 1.48 1.01 0.70 - 1.46 2.19*** 1.70 - 2.83 0.73** 0.58 - 0.90 0

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.29*** 0.20 - 0.42 1.10 0.88 - 1.37 1.10 0.86 - 1.39 1.18 0.92 - 1.50 0.47*** 0.38 - 0.60 0.82* 0.68 - 1.00 0

Observations 6,763 8,888 8,888 8,888 8,888 8,888 6,7

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity
99

Appendix Table A1—Continued

Indonesia

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adj

o

r

Wealth 

quintile

Quintile 1 (Poorest) 0.06*** 0.04 - 0.11 0.11*** 0.09 - 0.14 0.10*** 0.08 - 0.12 0.30*** 0.25 - 0.35 0.26*** 0.21 - 0.32 0.17*** 0.13 - 0.22 

Quintile 2 0.56* 0.33 - 0.93 0.37*** 0.30 - 0.44 0.43*** 0.37 - 0.50 0.56*** 0.50 - 0.63 0.60*** 0.52 - 0.70 0.41*** 0.34 - 0.49 

Quintile 3 (Reference)

Quintile 4 3.18** 1.35 - 7.50 3.23*** 2.29 - 4.53 2.50*** 2.00 - 3.14 1.77*** 1.57 - 1.99 1.55*** 1.32 - 1.81 2.52*** 1.81 - 3.50 

Quintile 5 28.61*** 6.40 - 127.86 20.82*** 8.74 - 49.60 14.08*** 8.71 - 22.77 6.74*** 5.72 - 7.94 3.21*** 2.52 - 4.11 31.14*** 14.19 - 68.35 

Relative 

community 

wealth

Poor relative to 

community

2.20*** 1.64 - 2.93 0.77*** 0.66 - 0.89 0.90 0.79 - 1.03 0.65*** 0.58 - 0.73 1.65*** 1.42 - 1.92 1.26* 1.05 - 1.52 1

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

1.55 0.96 - 2.52 1.96*** 1.55 - 2.47 1.37*** 1.15 - 1.64 1.23*** 1.10 - 1.38 0.68*** 0.57 - 0.81 0.94 0.73 - 1.21 0

Observations 23,403 23,403 23,403 23,403 23,403 23,403 23,4

Note: *p<0.05; **p<0.01; ***p<0.001
100

Appendix Table A1—Continued

Kenya

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

ra

Wealth 

quintile

Quintile 1 (Poorest) 0.04*** 0.01 - 0.11 0.13*** 0.11 - 0.16 0.45*** 0.32 - 0.63 0.28*** 0.22 - 0.35 0.47*** 0.38 - 0.59 0.45*** 0.37 - 0.56 0.

Quintile 2 0.22* 0.06 - 0.80 0.33*** 0.28 - 0.38 0.65** 0.49 - 0.85 0.63*** 0.53 - 0.73 0.71*** 0.61 - 0.82 0.87* 0.76 - 0.99 0.

Quintile 3 (Reference)

Quintile 4 5.30*** 3.74 - 7.51 2.53*** 1.96 - 3.28 1.89*** 1.49 - 2.39 2.06*** 1.79 - 2.38 1.47*** 1.28 - 1.69 1.50*** 1.33 - 1.70 3.

Quintile 5 108.03*** 65.25 - 178.87 10.81*** 7.55 - 15.48 5.43*** 4.43 - 6.65 8.46*** 7.13 - 10.04 2.43*** 2.00 - 2.94 4.96*** 4.18 - 5.90 26.

Relative 

community 

wealth

Poor relative to 

community

1.71* 1.03 - 2.83 0.77*** 0.67 - 0.87 0.60*** 0.48 - 0.76 1.05 0.91 - 1.22 1.30*** 1.13 - 1.51 1.06 0.93 - 1.21 1.

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.23*** 0.18 - 0.31 1.50*** 1.22 - 1.85 1.40*** 1.18 - 1.67 0.88 0.76 - 1.01 0.66*** 0.57 - 0.78 1.27*** 1.11 - 1.44 0.

Observations 22,516 22,516 22,516 22,516 22,516 22,516 22,5

Note: *p<0.05; **p<0.01; ***p<0.001
101

Appendix Table A1—Continued

Liberia

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

rat

Wealth 

quintile

Quintile 1 (Poorest) + 0.18*** 0.13 - 0.24 0.12*** 0.05 - 0.28 0.11*** 0.04 - 0.28 0.09*** 0.06 - 0.14 0.07*** 0.04 - 0.13 

Quintile 2 + 0.53*** 0.42 - 0.66 0.57* 0.35 - 0.91 0.25*** 0.11 - 0.56 0.41*** 0.30 - 0.56 0.43*** 0.30 - 0.62 0.

Quintile 3 (Reference)

Quintile 4 3.19 0.40 - 25.13 1.84*** 1.44 - 2.35 1.72* 1.14 - 2.60 3.24*** 1.94 - 5.43 1.99*** 1.42 - 2.81 1.60** 1.14 - 2.23 9.

Quintile 5 52.32*** 10.88 - 251.70 4.65*** 3.55 - 6.10 4.37*** 2.97 - 6.42 7.58*** 4.19 - 13.72 6.75*** 4.01 - 11.37 4.09*** 2.71 - 6.18 143.

Relative 

community 

wealth

Poor relative to 

community

2.01 0.35 - 11.47 0.84 0.68 - 1.03 0.66 0.39 - 1.09 0.56* 0.36 - 0.88 2.90*** 2.11 - 3.97 1.02 0.69 - 1.49 0.8

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

1.04 0.47 - 2.30 1.06 0.86 - 1.30 1.13 0.81 - 1.56 0.65* 0.43 - 0.98 0.37*** 0.26 - 0.52 0.65** 0.49 - 0.88 1.0

Observations 3,104 5,883 5,883 5,883 5,883 5,883 4,38

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity
102

Appendix Table A1—Continued

Mali

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

ra

Wealth 

quintile

Quintile 1 (Poorest) 0.26*** 0.18 - 0.37 0.55*** 0.40 - 0.77 0.68** 0.53 - 0.89 0.04*** 0.01 - 0.16 0.14*** 0.10 - 0.19 0.22*** 0.14 - 0.34 0

Quintile 2 0.64*** 0.52 - 0.80 0.90 0.69 - 1.17 0.92 0.76 - 1.10 0.34** 0.15 - 0.77 0.41*** 0.33 - 0.51 0.50*** 0.37 - 0.66 0

Quintile 3 (Reference)

Quintile 4 2.18*** 1.70 - 2.80 1.85*** 1.29 - 2.66 1.43*** 1.17 - 1.74 2.24*** 1.41 - 3.58 1.98*** 1.57 - 2.50 2.20*** 1.75 - 2.78 4

Quintile 5 7.10*** 4.97 - 10.15 5.21*** 3.38 - 8.05 2.63*** 2.06 - 3.36 7.91*** 4.98 - 12.56 6.14*** 4.24 - 8.90 12.04*** 8.68 - 16.71 16

Relative 

community 

wealth

Poor relative to 

community

0.91 0.70 - 1.18 1.13 0.86 - 1.48 0.70*** 0.57 - 0.85 0.53* 0.31 - 0.91 1.72*** 1.33 - 2.24 1.08 0.84 - 1.39 0

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

1.05 0.85 - 1.29 0.85 0.64 - 1.12 1.26** 1.06 - 1.49 1.26 0.92 - 1.72 0.45*** 0.36 - 0.57 0.84 0.66 - 1.08 0.

Observations 6,565 6,565 6,565 6,565 6,565 6,565 6,5

Note: *p<0.05; **p<0.01; ***p<0.001
103

Appendix Table A1—Continued

Nigeria

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

ra

Wealth 

quintile

Quintile 1 (Poorest) 0.06*** 0.04 - 0.09 0.26*** 0.21 - 0.31 0.43*** 0.35 - 0.53 0.11*** 0.08 - 0.16 0.53*** 0.38 - 0.73 0.14*** 0.10 - 0.19 0

Quintile 2 0.30*** 0.24 - 0.38 0.60*** 0.51 - 0.70 0.78** 0.68 - 0.91 0.32*** 0.26 - 0.40 0.70*** 0.57 - 0.86 0.50*** 0.42 - 0.60 0

Quintile 3 (Reference)

Quintile 4 4.14*** 3.38 - 5.07 2.70*** 2.25 - 3.23 1.38*** 1.20 - 1.58 3.05*** 2.62 - 3.55 1.55*** 1.30 - 1.85 1.83*** 1.54 - 2.17 2

Quintile 5 19.82*** 14.68 - 26.75 13.68*** 9.37 - 19.97 1.82*** 1.54 - 2.15 16.98*** 14.05 - 20.51 3.38*** 2.65 - 4.30 7.02*** 5.53 - 8.91 12

Relative 

community 

wealth

Poor relative to 

community

1.97*** 1.63 - 2.38 0.62*** 0.54 - 0.70 0.60*** 0.53 - 0.68 0.97 0.83 - 1.13 1.36** 1.13 - 1.64 1.11 0.94 - 1.31 0

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.42*** 0.33 - 0.53 1.66*** 1.39 - 1.98 1.83*** 1.62 - 2.06 1.18* 1.03 - 1.34 0.74*** 0.63 - 0.89 0.73*** 0.61 - 0.86 0.

Observations 23,647 23,647 23,647 23,647 23,647 23,647 23,6

Note: *p<0.05; **p<0.01; ***p<0.001
104

Appendix Table A1—Continued

Pakistan

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

ra

Wealth 

quintile

Quintile 1 (Poorest) 0.01*** 0.01 - 0.04 0.16*** 0.10 - 0.26 0.46*** 0.34 - 0.64 0.21*** 0.14 - 0.32 0.19*** 0.08 - 0.48 0.04*** 0.03 - 0.07 0

Quintile 2 0.18*** 0.09 - 0.35 0.43*** 0.27 - 0.71 0.65*** 0.51 - 0.81 0.42*** 0.31 - 0.57 0.40*** 0.23 - 0.67 0.24*** 0.18 - 0.32 0

Quintile 3 (Reference)

Quintile 4 2.68 0.95 - 7.56 2.80** 1.31 - 6.00 1.48** 1.13 - 1.93 1.66*** 1.23 - 2.23 1.61 0.83 - 3.12 8.23*** 4.14 - 16.37 3

Quintile 5 7.47* 1.20 - 46.51 4.29*** 3.04 - 6.04 6.76*** 4.89 - 9.36 3.87*** 1.89 - 7.92 43

Relative 

community 

wealth

Poor relative to 

community

2.86*** 1.56 - 5.24 0.69* 0.51 - 0.95 0.56*** 0.44 - 0.72 0.58*** 0.43 - 0.78 2.25** 1.24 - 4.07 1.00 0.72 - 1.38 1

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.38** 0.21 - 0.70 1.09 0.66 - 1.82 1.45** 1.14 - 1.83 1.63*** 1.30 - 2.04 0.53* 0.29 - 0.97 0.77 0.54 - 1.09 0.

Observations 4,738 5,778 5,778 5,778 5,778 4,738 5,77

Note: *p<0.05; **p<0.01; ***p<0.001
105

Appendix Table A1—Continued

Senegal

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

ra

Wealth 

quintile

Quintile 1 (Poorest) 0.02*** 0.01 - 0.04 0.37 0.13 - 1.07 0.44** 0.27 - 0.72 0.23*** 0.13 - 0.40 0.39** 0.23 - 0.69 0.09*** 0.06 - 0.14 0

Quintile 2 0.16*** 0.10 - 0.26 1.03 0.37 - 2.88 0.61 0.36 - 1.05 0.67 0.41 - 1.10 0.59* 0.39 - 0.91 0.27*** 0.17 - 0.44 0

Quintile 3 (Reference)

Quintile 4 16.60*** 9.72 - 28.36 5.04 0.96 - 26.30 0.95 0.65 - 1.40 1.21 0.76 - 1.91 1.79* 1.11 - 2.87 2.79*** 1.83 - 4.27 

Quintile 5 137.72*** 43.55 - 435.53 1.49 0.48 - 4.70 1.80* 1.15 - 2.83 4.60*** 2.89 - 7.32 1.32 0.61 - 2.86 25.39*** 10.35 - 62.30 5

Relative 

community 

wealth

Poor relative to 

community

0.57 0.32 - 1.00 0.90 0.47 - 1.72 0.62* 0.39 - 0.97 0.34*** 0.23 - 0.51 1.39 0.93 - 2.09 1.10 0.75 - 1.60 1

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.79 0.48 - 1.30 1.44 0.58 - 3.59 2.03*** 1.48 - 2.78 1.31 0.89 - 1.93 0.91 0.56 - 1.49 0.74 0.48 - 1.15 1.

Observations 2,850 2,850 2,850 2,850 2,850 2,850 2,85

Note: *p<0.05; **p<0.01; ***p<0.001
106

Appendix Table A1—Continued

Zambia

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adjusted 

odds 

ratio 95% CI

Adju

od

rat

Wealth 

quintile

Quintile 1 (Poorest) + 0.11*** 0.09 - 0.14 0.06** 0.01 - 0.48 + 0.37*** 0.27 - 0.49 0.49*** 0.37 - 0.64 

Quintile 2 0.18*** 0.07 - 0.46 0.42*** 0.36 - 0.50 0.34* 0.12 - 0.93 0.22* 0.06 - 0.84 0.65*** 0.54 - 0.79 0.69*** 0.57 - 0.83 0.

Quintile 3 (Reference)

Quintile 4 2.50* 1.22 - 5.13 2.75*** 2.14 - 3.53 2.88*** 1.63 - 5.08 4.97*** 2.85 - 8.68 1.37** 1.09 - 1.72 1.03 0.86 - 1.23 13.

Quintile 5 29.67*** 11.17 - 78.78 18.43*** 12.70 - 26.74 17.21*** 10.83 - 27.34 57.01*** 32.56 - 99.85 2.77*** 2.07 - 3.71 2.96*** 2.27 - 3.86 161.

Relative 

community 

wealth

Poor relative to 

community

0.39* 0.17 - 0.90 1.35** 1.11 - 1.65 0.74 0.37 - 1.50 1.05 0.63 - 1.72 1.48** 1.16 - 1.90 1.09 0.86 - 1.38 0.8

Wealth similar to 

community 

(reference)

Wealthy relative to 

community

0.29*** 0.19 - 0.43 1.06 0.86 - 1.30 1.75** 1.25 - 2.44 0.70* 0.51 - 0.96 0.63*** 0.50 - 0.78 0.79* 0.65 - 0.97 0.7

Observations 6,263 8,117 8,117 6,263 8,117 8,117 6,26

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity
107

Appendix Table A2 Marginal effect of a household being wealthy relative to community versus a household being poor relative to 

DRC

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) + -0.00 -0.01 - 0.00 0.00 -0.00 - 0.01 + -0.13*** -0.16 - -0.10 0.13* 0.01 - 0.25 -0.

Quintile 2 + -0.02** -0.03 - -0.01 0.00 -0.00 - 0.00 + -0.28*** -0.35 - -0.22 0.14* 0.02 - 0.25 -0.

Quintile 3 (Reference) + -0.06** -0.10 - -0.02 0.01* 0.00 - 0.02 0.00 -0.00 - 0.01 -0.42*** -0.53 - -0.30 0.14* 0.02 - 0.25 -0.

Quintile 4 + -0.12** -0.20 - -0.04 0.06*** 0.02 - 0.09 0.00 -0.00 - 0.00 -0.47*** -0.62 - -0.33 0.13* 0.03 - 0.24 -0.

Quintile 5 + -0.13** -0.21 - -0.05 0.17*** 0.09 - 0.25 0.01 -0.01 - 0.03 -0.42*** -0.52 - -0.33 0.12** 0.03 - 0.22 -0.

Observations 3,622 12,729 12,729 9,346 12,729 12,729 12,7

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity

Ghana

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) -0.15*** -0.22 - -0.08 0.02 -0.03 - 0.07 0.26*** 0.18 - 0.35 0.05 -0.00 - 0.09 -0.15* -0.28 - -0.03 -0.12*** -0.16 - -0.07 -0.

Quintile 2 -0.21*** -0.32 - -0.10 0.03 -0.03 - 0.08 0.16*** 0.10 - 0.21 0.05 -0.00 - 0.10 -0.17** -0.29 - -0.05 -0.23*** -0.32 - -0.14 -0.

Quintile 3 (Reference) -0.24*** -0.38 - -0.10 0.02 -0.03 - 0.07 0.12*** 0.07 - 0.16 0.06* 0.00 - 0.12 -0.16** -0.26 - -0.05 -0.25*** -0.35 - -0.14 -0.

Quintile 4 -0.12** -0.20 - -0.05 0.02 -0.02 - 0.05 0.11*** 0.07 - 0.15 0.07* 0.00 - 0.14 -0.07** -0.11 - -0.02 -0.21*** -0.30 - -0.13 -0.

Quintile 5 -0.03** -0.05 - -0.01 0.00 -0.00 - 0.01 0.20*** 0.15 - 0.26 0.06 -0.00 - 0.12 -0.02** -0.04 - -0.01 -0.08*** -0.12 - -0.05 -0.

Observations 5,896 5,896 5,896 5,896 5,896 5,896 5,8

Note: *p<0.05; **p<0.01; ***p<0.001
108

Appendix Table A2—Continued

Haiti

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) + 0.06 -0.01 - 0.13 0.00 -0.00 - 0.00 0.00 -0.00 - 0.00 -0.24*** -0.28 - -0.19 0.01 -0.01 - 0.02 

Quintile 2 + 0.06 -0.01 - 0.12 0.00 -0.01 - 0.01 0.00 -0.00 - 0.01 -0.37*** -0.45 - -0.28 0.02 -0.03 - 0.07 

Quintile 3 (Reference) -0.07*** -0.11 - -0.03 0.05 -0.01 - 0.11 0.00 -0.02 - 0.02 0.01 -0.01 - 0.03 -0.35*** -0.42 - -0.27 0.03 -0.04 - 0.09 0.

Quintile 4 -0.27*** -0.40 - -0.14 0.03 -0.01 - 0.07 0.01 -0.04 - 0.05 0.02 -0.03 - 0.07 -0.26*** -0.32 - -0.21 0.03 -0.04 - 0.10 0.

Quintile 5 -0.41*** -0.53 - -0.29 0.01 -0.00 - 0.02 0.02 -0.08 - 0.11 0.04 -0.06 - 0.14 -0.13*** -0.17 - -0.09 0.02 -0.03 - 0.08 0.

Observations 6,763 8,888 8,888 8,888 8,888 8,888 6,7

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity

Indonesia

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) -0.04 -0.11 - 0.03 0.19*** 0.15 - 0.23 0.10*** 0.05 - 0.15 0.09*** 0.06 - 0.11 -0.19*** -0.26 - -0.13 -0.07 -0.14 - 0.01 -0.

Quintile 2 -0.01 -0.02 - 0.00 0.09*** 0.07 - 0.11 0.07*** 0.04 - 0.11 0.12*** 0.09 - 0.15 -0.15*** -0.20 - -0.10 -0.05 -0.10 - 0.01 -0.

Quintile 3 (Reference) -0.00 -0.01 - 0.00 0.04*** 0.03 - 0.05 0.04*** 0.02 - 0.06 0.15*** 0.11 - 0.19 -0.11*** -0.15 - -0.08 -0.02 -0.05 - 0.00 -0.

Quintile 4 -0.00 -0.00 - 0.00 0.01*** 0.01 - 0.02 0.02*** 0.01 - 0.03 0.16*** 0.12 - 0.19 -0.09*** -0.11 - -0.06 -0.01 -0.02 - 0.00 -0.

Quintile 5 -0.00 -0.00 - 0.00 0.00* 0.00 - 0.00 0.00** 0.00 - 0.01 0.10*** 0.07 - 0.13 -0.05*** -0.06 - -0.03 -0.00 -0.00 - 0.00 -0.

Observations 23,403 23,403 23,403 23,403 23,403 23,403 23,4

Note: *p<0.05; **p<0.01; ***p<0.001
109

Appendix Table A2—Continued

Kenya

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) + 0 0.16*** 0.11 - 0.21 0.02*** 0.01 - 0.03 -0.02* -0.03 -0.16*** -0.09 0.02 -0.05 

Quintile 2 0 -0.01 0.12*** 0.08 - 0.15 0.03*** 0.02 - 0.05 -0.03* -0.05 -0.17*** -0.11 0.03 -0.07 

Quintile 3 (Reference) -0.02*** -0.02 0.05*** 0.04 - 0.07 0.05*** 0.03 - 0.07 -0.04* -0.07 -0.17*** -0.11 0.04 -0.07 

Quintile 4 -0.09*** -0.08 0.02*** 0.02 - 0.03 0.08*** 0.06 - 0.11 -0.04* -0.08 -0.16*** -0.1 0.04 -0.08 -0.

Quintile 5 -0.46*** -0.26 0.01*** 0.00 - 0.01 0.16*** 0.12 - 0.20 -0.03* -0.06 -0.10*** -0.05 0.04 -0.08 -0.

Observations 22,516 22,516 22,516 22,516 22,516 22,516 22,5

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity.

Liberia

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) + 0.03 -0.01 - 0.06 0.00 -0.00 - 0.01 0.00 -0.00 - 0.00 -0.26*** -0.31 - -0.20 -0.01 -0.01 - 0.00 

Quintile 2 + 0.05 -0.01 - 0.11 0.01 -0.00 - 0.03 0.00 -0.00 - 0.00 -0.46*** -0.56 - -0.36 -0.04* -0.07 - -0.00 

Quintile 3 (Reference) + 0.06 -0.01 - 0.12 0.02* 0.00 - 0.04 0.00 -0.01 - 0.01 -0.45*** -0.55 - -0.34 -0.07 -0.13 - 0.00 0.

Quintile 4 -0.00 -0.01 - 0.01 0.06 -0.01 - 0.12 0.04* 0.00 - 0.07 0.01 -0.02 - 0.03 -0.36*** -0.44 - -0.27 -0.09 -0.17 - 0.00 0.

Quintile 5 -0.05 -0.23 - 0.12 0.04 -0.01 - 0.08 0.07* 0.01 - 0.14 0.01 -0.03 - 0.06 -0.17*** -0.22 - -0.12 -0.11* -0.22 - -0.00 0.

Observations 3,104 5,883 5,883 5,883 5,883 5,883 4,3

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity.
110

Appendix Table A2—Continued

Mali

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) 0.01 -0.02 - 0.05 -0.04 -0.10 - 0.02 0.14*** 0.08 - 0.20 0.00 -0.00 - 0.00 -0.23*** -0.28 - -0.17 -0.03 -0.07 - 0.01 0.

Quintile 2 0.03 -0.04 - 0.09 -0.03 -0.07 - 0.01 0.15*** 0.09 - 0.21 0.01** 0.00 - 0.02 -0.32*** -0.40 - -0.24 -0.05 -0.12 - 0.02 0.

Quintile 3 (Reference) 0.03 -0.04 - 0.11 -0.03 -0.07 - 0.01 0.15*** 0.09 - 0.21 0.03** 0.01 - 0.05 -0.29*** -0.37 - -0.22 -0.06 -0.15 - 0.03 0.

Quintile 4 0.04 -0.05 - 0.12 -0.02 -0.04 - 0.00 0.14*** 0.08 - 0.20 0.07*** 0.03 - 0.10 -0.22*** -0.27 - -0.17 -0.06 -0.14 - 0.03 0.

Quintile 5 0.02 -0.04 - 0.09 -0.01 -0.02 - 0.00 0.11*** 0.06 - 0.16 0.16*** 0.07 - 0.24 -0.10*** -0.13 - -0.07 -0.02 -0.05 - 0.01 0.

Observations 6,565 6,565 6,565 6,565 6,565 6,565 6,5

Note: *p<0.05; **p<0.01; ***p<0.001

Nigeria

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) -0.04*** -0.05 - -0.02 0.22*** 0.18 - 0.26 0.20*** 0.16 - 0.24 0.01 -0.00 - 0.01 -0.16*** -0.21 - -0.11 -0.03*** -0.04 - -0.01 -0.

Quintile 2 -0.14*** -0.17 - -0.11 0.15*** 0.13 - 0.18 0.25*** 0.21 - 0.29 0.01* 0.00 - 0.03 -0.17*** -0.23 - -0.11 -0.07*** -0.11 - -0.03 -0.

Quintile 3 (Reference) -0.29*** -0.35 - -0.24 0.11*** 0.09 - 0.13 0.26*** 0.23 - 0.30 0.03* 0.00 - 0.06 -0.17*** -0.24 - -0.11 -0.10*** -0.15 - -0.04 -0.

Quintile 4 -0.36*** -0.43 - -0.29 0.05*** 0.04 - 0.06 0.27*** 0.23 - 0.31 0.05* 0.00 - 0.09 -0.16*** -0.22 - -0.10 -0.11*** -0.16 - -0.05 -0.

Quintile 5 -0.18*** -0.21 - -0.14 0.01*** 0.01 - 0.01 0.27*** 0.23 - 0.31 0.03 -0.00 - 0.06 -0.11*** -0.14 - -0.07 -0.07*** -0.11 - -0.04 -0.

Observations 23,647 23,647 23,647 23,647 23,647 23,647 23,6

Note: *p<0.05; **p<0.01; ***p<0.001
111

Appendix Table A2—Continued

Pakistan

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) -0.46*** -0.65 - -0.28 0.07 -0.01 - 0.15 0.21*** 0.13 - 0.29 0.05*** 0.03 - 0.07 -0.22* -0.41 - -0.02 -0.05 -0.13 - 0.03 -0.

Quintile 2 -0.17** -0.29 - -0.05 0.04 -0.01 - 0.08 0.23*** 0.15 - 0.30 0.09*** 0.06 - 0.13 -0.13* -0.23 - -0.03 -0.06 -0.15 - 0.04 -0.

Quintile 3 (Reference) -0.04** -0.06 - -0.02 0.02 -0.00 - 0.04 0.23*** 0.15 - 0.31 0.16*** 0.11 - 0.22 -0.06*** -0.09 - -0.02 -0.03 -0.07 - 0.02 -0.

Quintile 4 -0.01* -0.03 - -0.00 0.01 -0.00 - 0.01 0.22*** 0.14 - 0.29 0.21*** 0.15 - 0.27 -0.04** -0.06 - -0.01 -0.00 -0.01 - 0.00 -0.2

Quintile 5 + 0.00 -0.00 - 0.01 0.13*** 0.07 - 0.19 0.24*** 0.16 - 0.32 -0.02** -0.03 - -0.00 + -0.

Observations 4,738 5,778 5,778 5,778 5,778 4,738 5,7

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity

Senegal

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) 0.00 -0.00 - 0.01 0.03 -0.03 - 0.08 0.12** 0.05 - 0.19 0.04** 0.01 - 0.07 -0.10 -0.27 - 0.06 -0.06 -0.13 - 0.01 0.

Quintile 2 0.02 -0.02 - 0.05 0.01 -0.01 - 0.03 0.15*** 0.08 - 0.23 0.11*** 0.05 - 0.16 -0.10 -0.25 - 0.06 -0.09 -0.21 - 0.02 0.

Quintile 3 (Reference) 0.07 -0.05 - 0.18 0.01 -0.02 - 0.04 0.20*** 0.12 - 0.29 0.14*** 0.08 - 0.20 -0.08 -0.20 - 0.05 -0.08 -0.17 - 0.02 0.

Quintile 4 0.04 -0.04 - 0.12 0.00 -0.00 - 0.01 0.20*** 0.12 - 0.28 0.16*** 0.10 - 0.23 -0.06 -0.14 - 0.02 -0.04 -0.09 - 0.01 0.

Quintile 5 0.01 -0.01 - 0.02 0.01 -0.01 - 0.03 0.26*** 0.16 - 0.37 0.31*** 0.22 - 0.40 -0.07 -0.16 - 0.02 -0.01 -0.01 - 0.00 0.

Observations 2,850 2,850 2,850 2,850 2,850 2,850 2,8

Note: *p<0.05; **p<0.01; ***p<0.001
112

Appendix Table A2—Continued

Zambia

Electricity Telephone Vehicle Bank

Improved 

water

Improved 

sanitation

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marginal 

effect 95% CI

Marg

effe

Wealth 

quintile

Quintile 1 (Poorest) + -0.04* -0.08 - -0.01 0.00 -0.00 - 0.00 + -0.19*** -0.25 - -0.13 -0.05* -0.10 - -0.00 

Quintile 2 + -0.06* -0.11 - -0.01 0.01 -0.00 - 0.01 + -0.21*** -0.29 - -0.13 -0.06* -0.13 - -0.00 

Quintile 3 (Reference) -0.00 -0.01 - 0.01 -0.05* -0.09 - -0.01 0.02** 0.00 - 0.03 -0.00 -0.01 - 0.00 -0.21*** -0.28 - -0.13 -0.07 -0.15 - 0.00 -0.

Quintile 4 -0.01 -0.03 - 0.02 -0.03* -0.05 - -0.00 0.04** 0.01 - 0.07 -0.02 -0.05 - 0.01 -0.19*** -0.26 - -0.12 -0.07 -0.15 - 0.00 -0.

Quintile 5 -0.05 -0.24 - 0.14 -0.00* -0.01 - -0.00 0.15** 0.06 - 0.25 -0.10 -0.23 - 0.04 -0.14*** -0.18 - -0.10 -0.07* -0.14 - -0.00 -0.

Observations 6,263 8,117 8,117 6,263 8,117 8,117 6,2

Note: *p<0.05; **p<0.01; ***p<0.001; + omitted due to collinearity
113

Appendix Table A3 Unadjusted and adjusted odds ratios for maternal and reproductive health indicators

DRC

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.15 0.96 - 1.38 1.18 0.94 - 1.47 1.14 0.90 - 1.46 1.36* 1.01 - 1.82 1.27 0.74 

Middle 1.26* 1.01 - 1.57 1.36* 1.02 - 1.83 1.70*** 1.31 - 2.20 2.48*** 1.74 - 3.52 1.49 0.93 

Rich 1.39** 1.11 - 1.75 1.58** 1.16 - 2.16 2.03*** 1.54 - 2.67 3.09*** 2.05 - 4.63 1.44 0.85 

Richest 1.31* 1.03 - 1.67 1.41 0.99 - 1.99 5.03*** 3.29 - 7.68 7.54*** 4.50 - 12.63 2.87*** 1.60 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 0.81* 0.69 - 0.96 0.77* 0.62 - 0.97 0.76 0.58 - 1.00 0.54*** 0.41 - 0.73 1.42 0.84 

Wealthy household relative 

to community

0.84 0.69 - 1.02 0.71* 0.54 - 0.94 0.64*** 0.50 - 0.82 0.32*** 0.22 - 0.48 1.36 0.90 

Education None (Ref)

Primary 1.57*** 1.33 - 1.85 1.52*** 1.26 - 1.83 2.20*** 1.85 - 2.61 1.98*** 1.65 - 2.38 1.72** 1.17 

Secondary or higher 1.77** 1.22 - 2.57 1.67* 1.06 - 2.63 3.14** 1.38 - 7.15 2.45* 1.07 - 5.58 5.49*** 3.26 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.01

+ 0.85 - 1.19 1.01 0.85 - 1.20 1.32* + 1.06 - 1.64 1.28* 1.04 - 1.58 1.15 0.86 

Number of 

living 

children

None (Ref)

1-2 1.01 0.61 - 1.65 1.13 0.57 - 2.21 0.76 0.43 - 1.34 0.95 0.52 - 1.73 3.73* 1.18 - 

3-5 0.89 0.55 - 1.44 1.06 0.55 - 2.04 0.58 0.33 - 1.03 0.74 0.41 - 1.32 3.14* 1.00 

6+ 0.74 0.44 - 1.25 0.89 0.45 - 1.75 0.61 0.34 - 1.08 0.77 0.42 - 1.42 3.41* 1.02 - 

Observations 7,861 6,757 7,861 6,757 8,668 

Note: *p<0.05; **p<0.01; ***p<0.001; +n=6,757
114

Appendix Table A3—Continued

Ghana

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.11 0.70 - 1.75 1.02 0.62 - 1.67 1.32 0.93 - 1.89 1.21 0.86 - 1.70 1.48* 1.06 

Middle 1.46 0.85 - 2.51 1.13 0.63 - 2.02 1.95** 1.31 - 2.91 1.54* 1.02 - 2.32 1.47* 1.02 

Rich 2.00* 1.06 - 3.76 1.58 0.76 - 3.29 2.51*** 1.59 - 3.94 1.98** 1.18 - 3.31 1.49* 1.06 

Richest 6.18*** 2.98 - 12.83 4.63** 1.76 - 12.19 6.36*** 4.02 - 10.06 4.03*** 2.20 - 7.36 1.42 0.97 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 0.95 0.63 - 1.43 0.79 0.50 - 1.24 0.97 0.64 - 1.48 0.81 0.55 - 1.19 0.87 0.68 

Wealthy household relative 

to community

1.03 0.67 - 1.60 0.73 0.39 - 1.39 1.16 0.79 - 1.69 0.73 0.43 - 1.22 1.02 0.77 

Education None (Ref)

Primary 2.18*** 1.51 - 3.15 1.45 0.99 - 2.13 2.58*** 1.99 - 3.35 1.51** 1.14 - 1.98 1.46*** 1.20 

Secondary or higher 3.63** 1.49 - 8.85 2.94 0.65 - 13.27 7.34*** 2.92 - 18.47 4.66** 1.57 - 13.81 2.25* 1.12 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

2.04**

+ 1.27 - 3.27 1.68* 1.12 - 2.51 2.23*** + 1.64 - 3.05 1.82*** 1.37 - 2.41 1.44* 1.09 

Number of 

living 

children

None (Ref)

1-2 1.53 0.51 - 4.63 3.25 0.71 - 14.90 0.42 0.12 - 1.48 0.31 0.05 - 1.79 3.67*** 1.84 

3-5 1.32 0.45 - 3.90 2.61 0.59 - 11.51 0.29 0.08 - 1.02 0.25 0.04 - 1.37 4.03*** 2.09 

6+ 0.82 0.27 - 2.47 2.18 0.47 - 10.07 0.20* 0.06 - 0.71 0.23 0.04 - 1.30 4.07*** 2.03 

Observations 2,516 2,145 2,516 2,145 2,997 

Note: *p<0.05; **p<0.01; ***p<0.001; +n=2,145
115

Appendix Table A3—Continued

Haiti

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.39* 1.07 - 1.80 1.37* 1.02 - 1.84 1.91*** 1.37 - 2.67 2.02*** 1.41 - 2.89 1.36* 1.05 

Middle 1.65*** 1.25 - 2.17 1.49* 1.06 - 2.09 2.80*** 2.00 - 3.93 2.61*** 1.75 - 3.91 1.27* 1.01 

Rich 2.85*** 1.96 - 4.15 2.32*** 1.44 - 3.74 4.78*** 3.46 - 6.61 4.04*** 2.68 - 6.09 1.55** 1.18 

Richest 5.47*** 3.71 - 8.06 3.81*** 2.41 - 6.03 13.25*** 9.57 - 18.33 11.74*** 7.79 - 17.68 1.15 0.88 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 1.33* 1.01 - 1.75 0.95 0.69 - 1.30 1.23 0.96 - 1.59 0.59*** 0.45 - 0.76 0.97 0.79 

Wealthy household relative 

to community

1.35* 1.01 - 1.78 0.86 0.58 - 1.28 1.18 0.89 - 1.58 0.51*** 0.38 - 0.70 1.14 0.94 

Education None (Ref)

Primary 2.41*** 1.95 - 2.98 1.65*** 1.34 - 2.04 3.63*** 3.00 - 4.40 1.75*** 1.37 - 2.25 1.18 0.99 

Secondary or higher 18.24*** 3.35 - 99.21 8.18* 1.20 - 55.74 17.24*** 8.87 - 33.50 4.07*** 1.96 - 8.46 0.52** 0.32 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.14

+ 0.92 - 1.41 1.15 0.90 - 1.48 1.11+ 0.90 - 1.36 1.16 0.92 - 1.46 1.18* 1.02 

Number of 

living 

children

None (Ref)

1-2 3.31** 1.46 - 7.53 2.67 0.98 - 7.25 1.45 0.68 - 3.08 1.45 0.40 - 5.31 5.52*** 3.03 - 

3-5 2.27* 1.04 - 4.96 2.22 0.83 - 5.96 0.68 0.31 - 1.48 0.91 0.25 - 3.39 6.97*** 3.74 - 

6+ 1.64 0.70 - 3.86 2.10 0.74 - 5.97 0.38* 0.16 - 0.89 0.71 0.17 - 2.92 4.13*** 2.17 

Observations 3,388 2,965 3,388 2,965 4,944 

Note: *p<0.05; **p<0.01; ***p<0.001; +n=2,965
116

Appendix Table A3—Continued

Indonesia

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 2.21*** 1.74 - 2.80 1.97*** 1.54 - 2.51 2.17*** 1.77 - 2.67 2.08*** 1.64 - 2.63 1.49*** 1.30 

Middle 2.81*** 2.13 - 3.70 2.52*** 1.87 - 3.40 3.54*** 2.81 - 4.45 3.55*** 2.71 - 4.66 1.44*** 1.25 

Rich 3.73*** 2.66 - 5.24 3.29*** 2.23 - 4.84 4.43*** 3.45 - 5.68 4.53*** 3.26 - 6.28 1.44*** 1.25 

Richest 7.31*** 5.07 - 10.53 6.66*** 4.21 - 10.54 7.66*** 5.84 - 10.05 8.64*** 5.94 - 12.54 1.26*** 1.10 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 0.80 0.63 - 1.02 0.83 0.66 - 1.05 0.78* 0.63 - 0.96 0.73** 0.59 - 0.90 0.85** 0.77 

Wealthy household relative 

to community

1.18 0.93 - 1.50 0.61** 0.45 - 0.82 1.07 0.86 - 1.33 0.50*** 0.37 - 0.68 0.97 0.88 

Education None (Ref)

Primary 2.88*** 2.20 - 3.77 1.86*** 1.40 - 2.48 2.31*** 1.85 - 2.87 1.42** 1.15 - 1.76 1.52*** 1.34 

Secondary or higher 5.22*** 3.81 - 7.17 2.39*** 1.70 - 3.37 4.03*** 3.16 - 5.16 1.76*** 1.37 - 2.25 0.93 0.82 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.54*** 

+ 1.24 - 1.91 1.41** 1.12 - 1.78 1.18+ 0.99 - 1.42 1.10 0.91 - 1.33 1.04 0.91 

Number of 

living 

children

None (Ref)

1-2 10.02*** 4.32 - 23.25 10.41*** 4.03 - 26.88 5.15*** 2.24 - 11.83 5.75*** 2.28 - 14.52 30.48*** 21.02 

3-5 5.21*** 2.21 - 12.29 6.32*** 2.41 - 16.58 2.83* 1.23 - 6.52 3.58** 1.40 - 9.12 30.56*** 20.92 

6+ 1.70 0.70 - 4.10 3.41* 1.27 - 9.14 0.97 0.39 - 2.38 1.99 0.73 - 5.41 13.30*** 8.54 - 

Observations 7,786 7,527 7,786 7,527 17,147 

Note: *p<0.05; **p<0.01; ***p<0.001; +n=7,527
117

Appendix Table A3—Continued

Kenya

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.18* 1.01 - 1.39 1.05 0.88 - 1.26 2.35*** 1.96 - 2.81 1.95*** 1.59 - 2.39 3.72*** 3.13 

Middle 1.38*** 1.17 - 1.63 1.20 0.98 - 1.47 3.23*** 2.65 - 3.95 2.44*** 1.97 - 3.04 4.85*** 4.09 

Rich 1.67*** 1.41 - 1.98 1.40** 1.14 - 1.71 5.62*** 4.59 - 6.88 4.35*** 3.39 - 5.57 5.90*** 5.01 

Richest 2.44*** 2.06 - 2.90 1.89*** 1.50 - 2.39 11.87*** 9.32 - 15.12 9.27*** 6.90 - 12.46 6.44*** 5.40 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 1.03 0.91 - 1.15 1.00 0.86 - 1.16 0.72*** 0.63 - 0.83 0.63*** 0.53 - 0.74 0.57*** 0.50 

Wealthy household relative 

to community

1.19* 1.03 - 1.37 0.98 0.83 - 1.17 1.15 0.97 - 1.37 0.55*** 0.44 - 0.69 0.80** 0.70 

Education None (Ref)

Primary 1.41*** 1.25 - 1.59 1.22* 1.05 - 1.41 2.98*** 2.62 - 3.39 1.57*** 1.35 - 1.83 2.18*** 1.96 

Secondary or higher 2.48*** 2.09 - 2.94 1.79*** 1.45 - 2.19 8.11*** 6.62 - 9.94 2.74*** 2.16 - 3.46 2.12*** 1.82 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.00

+ 0.89 - 1.11 0.97 0.87 - 1.09 1.18** + 1.06 - 1.31 1.15* 1.02 - 1.30 1.06 0.96 

Number of 

living 

children

None (Ref)

1-2 0.80 0.31 - 2.07 0.74 0.24 - 2.31 0.85 0.30 - 2.42 0.64 0.14 - 2.97 21.95*** 11.63 

3-5 0.69 0.27 - 1.77 0.63 0.20 - 1.95 0.38 0.14 - 1.08 0.34 0.07 - 1.57 27.31*** 14.82 

6+ 0.51 0.20 - 1.29 0.55 0.18 - 1.71 0.19** 0.07 - 0.54 0.24 0.05 - 1.10 14.06*** 7.67 - 

Observations 9,785 8,152 9,785 8,152 12,230 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=8,152
118

Appendix Table A3—Continued

Liberia

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.47* 1.07 - 2.02 1.73** 1.21 - 2.48 1.27 0.97 - 1.66 1.29 0.98 - 1.70 1.20 0.88 

Middle 1.66** 1.20 - 2.31 2.01*** 1.34 - 2.99 1.44* 1.08 - 1.93 1.65** 1.18 - 2.32 1.21 0.91 

Rich 1.98*** 1.41 - 2.78 2.66*** 1.73 - 4.08 2.04*** 1.49 - 2.79 1.96*** 1.34 - 2.87 1.74** 1.22 

Richest 3.41*** 2.42 - 4.81 4.45*** 2.91 - 6.80 2.44*** 1.67 - 3.56 2.53*** 1.57 - 4.08 2.08*** 1.54 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 0.93 0.72 - 1.21 0.79 0.58 - 1.08 0.90 0.69 - 1.18 0.70* 0.54 - 0.92 1.06 0.80 

Wealthy household relative 

to community

0.92 0.70 - 1.22 0.54** 0.37 - 0.79 0.91 0.69 - 1.22 0.59** 0.42 - 0.83 0.90 0.67 

Education None (Ref)

Primary 1.73*** 1.30 - 2.31 1.76** 1.21 - 2.57 2.04*** 1.57 - 2.66 1.61** 1.17 - 2.22 1.90*** 1.50 

Secondary or higher 3.16* 1.26 - 7.87 1.27 0.44 - 3.65 4.67*** 2.00 - 10.90 3.22* 1.17 - 8.87 2.79*** 1.53 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.08 

+ 0.82 - 1.42 1.13 0.85 - 1.51 1.02+ 0.80 - 1.30 1.09 0.84 - 1.41 1.26 0.97 

Number of 

living 

children

None (Ref)

1-2 1.22 0.57 - 2.61 1.78 0.51 - 6.21 1.40 0.66 - 2.95 1.12 0.28 - 4.47 3.58** 1.58 

3-5 1.13 0.53 - 2.42 1.77 0.50 - 6.22 0.87 0.42 - 1.82 0.83 0.21 - 3.26 5.34*** 2.37 - 

6+ 1.04 0.49 - 2.22 1.81 0.50 - 6.55 0.80 0.37 - 1.73 0.82 0.20 - 3.28 5.30*** 2.35 - 

Observations 3,493 2,761 3,493 2,761 3,863 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=2,761
119

Appendix Table A3—Continued

Mali

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.31* 1.02 - 1.69 1.48** 1.15 - 1.92 1.32 0.99 - 1.76 1.62** 1.18 - 2.22 0.98 0.69 

Middle 1.42** 1.10 - 1.85 1.84*** 1.38 - 2.45 1.61** 1.18 - 2.18 2.38*** 1.61 - 3.53 1.16 0.85 

Rich 1.86*** 1.42 - 2.43 2.44*** 1.81 - 3.29 2.47*** 1.73 - 3.54 3.90*** 2.39 - 6.36 1.87** 1.27 

Richest 3.84*** 2.89 - 5.11 4.60*** 3.33 - 6.36 7.88*** 5.08 - 12.21 11.21*** 6.44 - 19.51 2.24*** 1.57 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 1.29* 1.05 - 1.58 0.83 0.68 - 1.01 1.17 0.90 - 1.54 0.67* 0.50 - 0.91 1.02 0.81 

Wealthy household relative 

to community

0.87 0.72 - 1.06 0.50*** 0.39 - 0.65 0.78 0.60 - 1.00 0.34*** 0.22 - 0.52 0.88 0.69 

Education None (Ref)

Primary 2.18*** 1.76 - 2.70 1.57*** 1.27 - 1.95 3.53*** 2.63 - 4.74 2.05*** 1.52 - 2.78 2.43*** 1.96 

Secondary or higher 4.65*** 1.90 - 11.41 2.03 0.81 - 5.10 6.38* 1.28 - 31.81 1.56 0.38 - 6.35 2.54* 1.06 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

0.97 

+ 0.76 - 1.24 1.04 0.80 - 1.33 1.02 + 0.79 - 1.32 1.15 0.89 - 1.49 1.15 0.91 

Number of 

living 

children

None (Ref)

1-2 1.45 0.76 - 2.75 1.30 0.60 - 2.81 1.32 0.65 - 2.68 1.55 0.61 - 3.94 7.14*** 3.98 - 

3-5 1.30 0.68 - 2.46 1.27 0.59 - 2.75 1.00 0.49 - 2.02 1.34 0.53 - 3.40 8.46*** 4.78 - 

6+ 1.37 0.71 - 2.62 1.56 0.71 - 3.42 0.96 0.47 - 1.95 1.49 0.59 - 3.76 8.95*** 4.98 - 

Observations 4,642 4,495 4,642 4,495 5,963 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=4,495
120

Appendix Table A3—Continued

Nigeria

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.55*** 1.31 - 1.85 1.51*** 1.26 - 1.81 2.00*** 1.60 - 2.52 1.78*** 1.43 - 2.22 1.77** 1.23 

Middle 2.03*** 1.63 - 2.51 1.84*** 1.46 - 2.31 3.04*** 2.35 - 3.94 2.44*** 1.90 - 3.15 2.22*** 1.54 

Rich 3.78*** 3.07 - 4.65 2.82*** 2.21 - 3.59 6.67*** 5.06 - 8.80 4.16*** 3.10 - 5.59 4.02*** 2.87 

Richest 8.19*** 6.52 - 10.28 4.28*** 3.22 - 5.69 16.62*** 12.55 - 22.02 7.18*** 5.19 - 9.92 6.61*** 4.76 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 1.00 0.88 - 1.15 0.83** 0.73 - 0.96 1.00 0.86 - 1.16 0.66*** 0.56 - 0.78 0.99 0.82 

Wealthy household relative 

to community

0.89 0.75 - 1.05 0.64*** 0.52 - 0.78 0.88 0.72 - 1.08 0.54*** 0.42 - 0.68 0.86 0.69 

Education None (Ref)

Primary 3.00*** 2.60 - 3.46 1.93*** 1.66 - 2.24 4.88*** 4.17 - 5.71 2.66*** 2.24 - 3.16 3.88*** 3.22 

Secondary or higher 7.35*** 6.15 - 8.78 3.52*** 2.85 - 4.35 12.14*** 9.96 - 14.80 4.90*** 4.00 - 6.00 5.25*** 4.30 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

2.49*** 

+ 2.18 - 2.85 1.50*** 1.32 - 1.71 2.93***+ 2.52 - 3.40 1.48*** 1.27 - 1.73 2.91*** 2.43 

Number of 

living 

children

None (Ref)

1-2 1.33 0.93 - 1.91 0.91 0.61 - 1.37 1.50 0.95 - 2.37 0.87 0.49 - 1.55 12.19*** 6.43 - 

3-5 1.14 0.80 - 1.62 0.87 0.59 - 1.28 1.11 0.71 - 1.74 0.75 0.42 - 1.32 17.13*** 8.72 - 

6+ 0.96 0.66 - 1.39 0.93 0.62 - 1.40 0.74 0.47 - 1.16 0.69 0.39 - 1.23 13.99*** 6.93 - 

Observations 14,082 13,320 14,082 13,320 18,485 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=13,320
121

Appendix Table A3—Continued

Pakistan

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% C

Wealth quintile Poorest (Ref)

Poor 1.20 0.84 - 1.71 1.21 0.86 - 1.71 0.86 0.62 - 1.19 0.82 0.60 - 1.14 1.13 0.83 - 1

Middle 1.97*** 1.43 - 2.70 1.80*** 1.28 - 2.55 1.34 0.98 - 1.85 1.17 0.82 - 1.67 1.49* 1.08 - 2

Rich 3.11*** 2.16 - 4.49 2.82*** 1.91 - 4.16 2.40*** 1.71 - 3.37 2.02*** 1.36 - 3.00 1.70*** 1.25 - 2

Richest 8.99*** 6.13 - 13.17 6.88*** 4.37 - 10.84 6.07*** 3.94 - 9.35 4.07*** 2.37 - 6.99 1.82*** 1.32 - 2

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 0.94 0.70 - 1.26 0.61*** 0.47 - 0.79 1.16 0.87 - 1.55 0.83 0.64 - 1.09 0.82 0.66 - 1

Wealthy household relative 

to community

0.98 0.74 - 1.31 0.50*** 0.36 - 0.67 1.37* 1.00 - 1.88 0.81 0.56 - 1.18 0.80* 0.64 - 0

Education None (Ref)

Primary 2.84*** 2.17 - 3.72 1.58*** 1.22 - 2.06 2.23*** 1.71 - 2.90 1.40* 1.07 - 1.84 1.33** 1.10 - 1

Secondary or higher 6.49*** 4.70 - 8.97 2.27*** 1.61 - 3.19 5.56*** 3.75 - 8.24 2.11*** 1.40 - 3.20 1.40* 1.06 - 1

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.43*** 

+ 1.17 - 1.75 1.31* 1.06 - 1.61 1.29** + 1.07 - 1.57 1.24* 1.03 - 1.50 1.49*** 1.27 - 1

Number of 

living 

children

None (Ref)

1-2 1.35 0.66 - 2.75 1.02 0.45 - 2.30 0.63 0.27 - 1.49 0.47 0.19 - 1.18 64.88*** 13.97 - 30

3-5 0.95 0.46 - 1.94 0.77 0.34 - 1.75 0.35* 0.14 - 0.86 0.28** 0.11 - 0.73 198.19*** 40.95 - 95

6+ 0.51 0.25 - 1.04 0.60 0.26 - 1.39 0.25** 0.10 - 0.61 0.27** 0.10 - 0.69 223.91*** 46.00 - 1,0

Observations 3,645 3,595 3,645 3,595 6,036 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=3,595
122

Appendix Table A3—Continued

Senegal

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% C

Wealth quintile Poorest (Ref)

Poor 1.35** 1.11 - 1.65 1.31* 1.06 - 1.62 1.57*** 1.23 - 2.01 1.80*** 1.35 - 2.40 1.05 0.84 - 1

Middle 1.73*** 1.39 - 2.14 1.72*** 1.36 - 2.17 2.61*** 1.99 - 3.42 3.15*** 2.28 - 4.34 1.12 0.88 - 1

Rich 2.35*** 1.91 - 2.89 2.21*** 1.77 - 2.74 4.74*** 3.46 - 6.50 5.61*** 3.82 - 8.24 1.23 0.96 - 1

Richest 3.32*** 2.64 - 4.18 3.07*** 2.36 - 4.01 9.64*** 6.33 - 14.68 11.12*** 6.91 - 17.88 1.62** 1.15 - 2

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 1.21* 1.01 - 1.44 0.93 0.77 - 1.12 1.03 0.79 - 1.35 0.71** 0.54 - 0.91 1.24* 1.01 - 1

Wealthy household relative 

to community

1.35** 1.10 - 1.65 0.95 0.76 - 1.19 1.01 0.75 - 1.35 0.47*** 0.33 - 0.66 1.09 0.88 - 1

Education None (Ref)

Primary 1.53*** 1.20 - 1.94 1.30 0.96 - 1.75 3.35*** 2.43 - 4.62 1.84** 1.24 - 2.73 0.96 0.75 - 1

Secondary or higher 7.74*** 3.59 - 16.68 6.46*** 2.60 - 16.04 omitted because of collinearity 3.05*** 1.72 - 5

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

1.15 

+ 0.97 - 1.36 1.11 0.94 - 1.32 1.06 + 0.86 - 1.31 0.96 0.78 - 1.17 1.36*** 1.16 - 1

Number of 

living 

children

None (Ref)

1-2 1.26 0.63 - 2.53 1.13 0.49 - 2.62 1.05 0.50 - 2.21 0.62 0.27 - 1.41 13.72*** 7.13 - 26

3-5 1.13 0.55 - 2.29 1.06 0.45 - 2.48 0.55 0.27 - 1.11 0.36* 0.16 - 0.80 24.15*** 12.64 - 4

6+ 0.74 0.36 - 1.49 0.75 0.33 - 1.74 0.37** 0.18 - 0.77 0.28** 0.13 - 0.64 29.02*** 14.64 - 5

Observations 5,392 5,119 5,392 5,088 7,102 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=5,119
123

Appendix Table A3—Continued

Zambia

4+ ANC visits Delivered in health facility Mode

Covariates

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% CI

Adjusted 

odds ratio 95% CI

Unadjusted 

odds ratio 95% 

Wealth quintile Poorest (Ref)

Poor 1.06 0.86 - 1.31 1.08 0.84 - 1.38 1.51*** 1.19 - 1.91 1.53** 1.13 - 2.06 1.54*** 1.28 - 

Middle 1.03 0.82 - 1.28 1.12 0.86 - 1.47 1.77*** 1.38 - 2.26 1.98*** 1.42 - 2.78 1.44*** 1.19 - 

Rich 1.04 0.84 - 1.29 1.00 0.76 - 1.32 1.78*** 1.35 - 2.34 2.02*** 1.35 - 3.02 1.90*** 1.57 - 

Richest 1.05 0.83 - 1.32 1.04 0.74 - 1.46 3.80*** 2.57 - 5.61 3.62*** 2.20 - 5.97 2.03*** 1.63 - 

Relative 

community 

wealth

Poor household relative to 

community (Ref)

Wealth similar to community 0.99 0.82 - 1.18 0.98 0.79 - 1.23 1.04 0.82 - 1.33 0.87 0.65 - 1.16 0.95 0.80 - 

Wealthy household relative 

to community

0.98 0.83 - 1.16 1.00 0.80 - 1.25 1.08 0.85 - 1.37 0.66* 0.45 - 0.95 1.01 0.85 - 

Education None (Ref)

Primary 1.09 0.95 - 1.26 1.19 0.99 - 1.42 1.90*** 1.52 - 2.39 1.38* 1.07 - 1.77 1.28*** 1.11 - 

Secondary or higher 1.27 0.91 - 1.78 1.53 0.96 - 2.46 9.18*** 4.63 - 18.20 3.89** 1.52 - 9.97 1.12 0.82 - 

Health care 

decision 

making

Someone else makes health 

care decisions (Ref)

Decides on own health care 

either alone or jointly with 

partner

0.98 

+ 0.80 - 1.19 0.96 0.78 - 1.17 1.31* + 1.03 - 1.66 1.20 0.94 - 1.53 1.03 0.89 - 

Number of 

living 

children

None (Ref)

1-2 1.17 0.61 - 2.27 1.23 0.52 - 2.90 0.43 0.16 - 1.11 0.20* 0.05 - 0.89 33.51*** 13.18 - 

3-5 1.19 0.62 - 2.27 1.21 0.52 - 2.81 0.21** 0.08 - 0.54 0.10** 0.02 - 0.46 41.49*** 16.55 - 

6+ 1.20 0.63 - 2.29 1.29 0.56 - 2.95 0.16*** 0.06 - 0.41 0.08** 0.02 - 0.37 36.77*** 14.56 - 

Observations 4,961 3,790 4,961 3,790 5,002 

Note: *p<0.05; **p<0.01; ***p<0.001; + n=3,790
124

Appendix Table A4 Unadjusted and adjusted odds ratios for child health indicators

DRC

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.60** 1.13 - 2.28 1.95*** 1.32 - 2.88 1.11 0.51 - 2.39 0.94 0.48 - 1.85 1.26 0.96 - 1.65 1.27 0.93 - 1.73 1.12 0.74 - 1.70 1.16 0.76 - 1

Middle 1.20 0.83 - 1.74 1.74* 1.08 - 2.80 1.51 0.84 - 2.73 1.52 0.87 - 2.68 1.16 0.85 - 1.57 1.16 0.82 - 1.62 1.22 0.77 - 1.94 1.31 0.82 - 2

Rich 1.77*** 1.29 - 2.43 2.91*** 1.86 - 4.54 1.58 0.79 - 3.18 1.43 0.76 - 2.70 0.97 0.73 - 1.30 0.97 0.68 - 1.38 1.18 0.82 - 1.72 1.28 0.86 - 1

Richest 2.83*** 1.85 - 4.34 4.77*** 2.79 - 8.16 1.99* 1.11 - 3.57 2.10* 1.13 - 3.89 1.22 0.89 - 1.66 1.18 0.83 - 1.67 1.35 0.92 - 1.98 1.55* 1.00 - 2

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.91 0.67 - 1.23 0.68* 0.48 - 0.95 0.99 0.54 - 1.84 0.79 0.42 - 1.48 1.11 0.86 - 1.43 1.07 0.84 - 1.38 0.87 0.63 - 1.19 0.76 0.53 - 1

Wealthy 

relative to 

community

0.63** 0.46 - 0.88 0.37*** 0.24 - 0.58 1.28 0.72 - 2.29 0.99 0.51 - 1.90 1.03 0.78 - 1.35 0.99 0.74 - 1.34 0.91 0.64 - 1.28 0.77 0.54 - 1

Maternal 

education

None (Ref)

Primary 0.77 0.54 - 1.10 0.73 0.51 - 1.05 1.13 0.69 - 1.84 0.98 0.61 - 1.58 1.25 0.99 - 1.59 1.25 0.98 - 1.59 0.93 0.65 - 1.33 0.89 0.63 - 1

Secondary or 

higher

1.11 0.74 - 1.64 0.92 0.61 - 1.39 1.93 0.86 - 4.31 1.49 0.69 - 3.24 1.25 0.94 - 1.66 1.22 0.90 - 1.65 1.11 0.70 - 1.75 1.06 0.65 - 1

Birth order First (Ref)

Second thru 

fourth

0.93 0.67 - 1.30 0.95 0.68 - 1.32 0.61 0.36 - 1.03 0.56* 0.32 - 0.97 1.22 0.87 - 1.72 1.23 0.87 - 1.74 1.15 0.81 - 1.63 1.18 0.82 - 1

Fifth or 

higher

0.89 0.65 - 1.22 0.89 0.64 - 1.23 0.39** 0.22 - 0.71 0.38** 0.20 - 0.71 0.93 0.70 - 1.22 0.95 0.71 - 1.28 0.99 0.70 - 1.40 1.03 0.74 - 1

Sex of child Male child

(Ref)

Female child 1.05 0.82 - 1.34 1.04 0.80 - 1.35 0.71 0.49 - 1.02 0.75 0.52 - 1.08 1.06 0.90 - 1.25 1.05 0.89 - 1.25 1.04 0.80 - 1.34 1.05 0.80 - 1

Observations 2,393 2,393 778 778 3,648 3,648 1,907 1,907 

Note: *p<0.05; **p<0.01; ***p<0.001
125

Appendix Table A4—Continued

Ghana

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.89 0.92 - 3.90 1.73 0.78 - 3.84 0.61 0.14 - 2.70 0.44 0.07 - 2.66 1.18 0.64 - 2.17 1.27 0.62 - 2.58 0.67 0.34 - 1.31 0.73 0.36 - 1

Middle 1.42 0.59 - 3.46 1.16 0.45 - 2.98 0.47 0.11 - 1.97 0.32 0.06 - 1.67 0.88 0.49 - 1.60 0.86 0.42 - 1.77 0.60 0.27 - 1.31 0.56 0.24 - 1

Rich 1.38 0.54 - 3.54 1.35 0.52 - 3.53 1.80 0.41 - 7.90 1.61 0.32 - 8.22 1.97* 1.02 - 3.81 2.21* 1.04 - 4.68 0.46 0.17 - 1.25 0.47 0.18 - 1

Richest 5.41** 1.68 - 17.41 5.22* 1.48 - 18.48 0.99 0.23 - 4.23 0.51 0.07 - 3.56 2.27 0.88 - 5.86 2.59 0.78 - 8.61 0.55 0.22 - 1.34 0.55 0.21 - 1

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

1.11 0.45 - 2.74 0.95 0.44 - 2.05 1.05 0.32 - 3.47 1.13 0.26 - 4.84 0.95 0.50 - 1.80 0.76 0.40 - 1.44 0.73 0.36 - 1.47 0.79 0.38 - 1

Wealthy 

relative to 

community

1.04 0.43 - 2.51 0.75 0.29 - 1.95 0.79 0.19 - 3.29 1.01 0.22 - 4.54 0.96 0.49 - 1.88 0.63 0.30 - 1.34 0.57 0.28 - 1.17 0.69 0.31 - 1

Maternal 

education

None (Ref)

Primary 2.05 0.94 - 4.44 2.16* 1.05 - 4.43 3.07 0.94 - 10.07 4.88* 1.09 - 21.79 1.05 0.62 - 1.79 0.89 0.50 - 1.60 0.71 0.35 - 1.41 0.85 0.43 - 1

Secondary or 

higher

1.76 0.93 - 3.36 1.56 0.82 - 2.98 2.12 0.70 - 6.44 2.44 0.63 - 9.45 1.29 0.78 - 2.12 0.89 0.52 - 1.52 0.86 0.45 - 1.64 1.07 0.55 - 2

Birth order First (Ref)

Second thru 

fourth

1.41 0.71 - 2.82 1.93 0.97 - 3.85 0.88 0.23 - 3.38 1.32 0.34 - 5.15 1.22 0.65 - 2.31 1.42 0.78 - 2.59 1.74 0.84 - 3.62 1.93 0.96 - 3

Fifth or 

higher

1.40 0.68 - 2.85 2.29* 1.08 - 4.89 0.72 0.16 - 3.18 0.64 0.12 - 3.54 0.65 0.35 - 1.19 0.75 0.41 - 1.39 0.97 0.46 - 2.05 0.97 0.47 - 2

Sex of child Male child

(Ref)

Female child 1.46 0.78 - 2.71 1.48 0.74 - 2.93 0.72 0.34 - 1.55 0.62 0.28 - 1.38 1.60* 1.10 - 2.33 1.65** 1.13 - 2.42 1.57* 1.04 - 2.37 1.70* 1.12 - 2

Observations 676 676 130 130 522 522 410 410 

Note: *p<0.05; **p<0.01; ***p<0.001
126

Appendix Table A4—Continued

Haiti

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.26 0.81 - 1.97 1.32 0.84 - 2.08 1.20 0.45 - 3.21 1.01 0.40 - 2.55 0.94 0.58 - 1.53 1.03 0.64 - 1.63 0.62 0.37 - 1.06 0.72 0.44 - 1

Middle 1.43 0.88 - 2.34 1.44 0.82 - 2.53 0.91 0.42 - 1.99 0.80 0.34 - 1.91 1.59* 1.04 - 2.43 1.90** 1.23 - 2.93 1.16 0.64 - 2.07 1.23 0.66 - 2

Rich 1.23 0.76 - 2.01 1.15 0.61 - 2.16 1.09 0.46 - 2.61 1.06 0.35 - 3.19 1.93** 1.25 - 2.98 2.13** 1.33 - 3.41 1.48 0.91 - 2.43 1.28 0.75 - 2

Richest 3.79*** 2.34 - 6.14 3.31*** 1.80 - 6.07 3.47** 1.38 - 8.72 3.56* 1.30 - 9.79 2.46** 1.36 - 4.43 2.70** 1.41 - 5.17 1.13 0.64 - 2.02 0.88 0.45 - 1

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.89 0.59 - 1.34 0.65* 0.43 - 0.98 1.17 0.58 - 2.37 0.70 0.33 - 1.46 0.96 0.67 - 1.38 0.70 0.48 - 1.03 1.29 0.85 - 1.95 1.31 0.87 - 1

Wealthy 

relative to 

community

0.70 0.44 - 1.10 0.48** 0.28 - 0.82 1.52 0.75 - 3.10 1.36 0.60 - 3.07 0.81 0.55 - 1.19 0.50** 0.32 - 0.78 0.67 0.41 - 1.10 0.67 0.41 - 1

Maternal 

education

None (Ref)

Primary 1.20 0.79 - 1.84 1.08 0.70 - 1.66 0.49 0.24 - 1.00 0.37* 0.16 - 0.87 1.21 0.89 - 1.66 0.98 0.72 - 1.34 1.09 0.62 - 1.91 1.06 0.58 - 1

Secondary or 

higher

3.11*** 1.96 - 4.95 2.37** 1.32 - 4.26 1.25 0.63 - 2.49 0.70 0.25 - 1.97 2.09*** 1.50 - 2.90 1.33 0.89 - 1.98 2.11** 1.26 - 3.54 1.96* 1.01 - 3

Birth order First (Ref)

Second thru 

fourth

0.73 0.49 - 1.08 0.88 0.58 - 1.33 0.69 0.37 - 1.28 0.69 0.32 - 1.47 0.84 0.63 - 1.13 0.98 0.71 - 1.37 0.95 0.63 - 1.42 1.11 0.73 - 1

Fifth or 

higher

0.58* 0.38 - 0.89 0.90 0.54 - 1.52 0.65 0.30 - 1.39 0.67 0.26 - 1.71 0.61* 0.41 - 0.91 0.83 0.51 - 1.34 0.68 0.42 - 1.09 0.91 0.53 - 1

Sex of child Male child

(Ref)

Female child 1.27 0.87 - 1.83 1.28 0.88 - 1.86 1.40 0.91 - 2.17 1.39 0.88 - 2.18 1.09 0.81 - 1.48 1.15 0.83 - 1.60 0.97 0.67 - 1.40 0.94 0.65 - 1

Observations 844 844 419 419 1,296 1,296 845 845 

Note: *p<0.05; **p<0.01; ***p<0.001
127

Appendix Table A4—Continued

Indonesia

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% C

Wealth 

quintile

Poorest (Ref)

Poorest 1.17 0.81 - 1.70 1.11 0.74 - 1.66 1.36 0.65 - 2.84 1.18 0.50 - 2.76 1.51** 1.11 - 2.04 1.43* 1.05 - 1.96 1.98** 1.28 - 3.07 1.84* 1.15 - 2

Middle 1.67** 1.13 - 2.46 1.49 0.96 - 2.31 3.30* 1.13 - 9.58 2.91 0.91 - 9.37 1.74** 1.25 - 2.42 1.64** 1.15 - 2.34 1.72* 1.13 - 2.63 1.54 0.97 - 2

Rich 2.13** 1.32 - 3.44 1.78* 1.00 - 3.17 1.27 0.57 - 2.83 0.98 0.39 - 2.49 1.62** 1.18 - 2.22 1.52* 1.06 - 2.18 1.57 1.00 - 2.49 1.42 0.87 - 2

Richest 1.89** 1.21 - 2.96 1.68 0.95 - 3.00 2.81 0.89 - 8.88 2.89 0.86 - 9.68 2.00*** 1.42 - 2.82 1.87** 1.27 - 2.77 1.62* 1.02 - 2.56 1.46 0.86 - 2

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.71 0.51 - 1.01 0.71 0.49 - 1.03 0.89 0.42 - 1.87 0.89 0.38 - 2.05 0.93 0.71 - 1.22 0.95 0.71 - 1.25 0.93 0.65 - 1.33 1.00 0.70 - 1

Wealthy 

relative to 

community

0.74 0.51 - 1.09 0.56* 0.36 - 0.88 1.71 0.85 - 3.44 1.53 0.69 - 3.40 1.23 0.92 - 1.64 1.03 0.75 - 1.42 1.36 0.92 - 2.01 1.26 0.82 - 1

Maternal 

education

None (Ref)

Primary 2.24 0.79 - 6.36 1.74 0.63 - 4.80 2.45 0.52 - 11.62 2.19 0.38 - 12.67 1.77 0.88 - 3.59 1.52 0.79 - 2.90 3.02* 1.17 - 7.79 2.51 0.97 - 6

Secondary or 

higher

5.15** 1.84 - 14.42 3.64* 1.32 - 10.01 2.05 0.46 - 9.04 1.30 0.23 - 7.49 2.08* 1.05 - 4.13 1.61 0.85 - 3.03 2.87* 1.11 - 7.42 2.20 0.84 - 5

Birth order First (Ref)

Second thru 

fourth

0.85 0.61 - 1.18 1.01 0.72 - 1.42 0.80 0.39 - 1.61 0.69 0.35 - 1.38 1.07 0.87 - 1.31 1.09 0.87 - 1.35 0.88 0.66 - 1.18 0.89 0.66 - 1

Fifth or 

higher

0.41*** 0.24 - 0.69 0.64 0.36 - 1.13 0.71 0.28 - 1.76 0.66 0.26 - 1.66 0.89 0.60 - 1.31 1.07 0.72 - 1.60 1.32 0.71 - 2.45 1.46 0.78 - 2

Sex of child Male child

(Ref)

Female child 1.14 0.85 - 1.53 1.13 0.83 - 1.54 0.89 0.47 - 1.71 0.93 0.46 - 1.86 0.86 0.69 - 1.06 0.85 0.69 - 1.05 1.18 0.86 - 1.63 1.17 0.84 - 1

Observations 1,790 1,790 446 446 2,810 2,810 1,344 1,344 

Note: *p<0.05; **p<0.01; ***p<0.001
128

Appendix Table A4—Continued

Kenya

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 2.00** 1.30 - 3.09 1.53 0.90 - 2.60 1.64* 1.06 - 2.55 1.44 0.88 - 2.36 1.26 0.94 - 1.68 1.29 0.95 - 1.75 0.88 0.64 - 1.23 0.86 0.61 - 1

Middle 2.27** 1.39 - 3.71 1.61 0.88 - 2.96 1.21 0.81 - 1.82 1.00 0.62 - 1.62 1.12 0.83 - 1.50 1.09 0.79 - 1.51 0.71 0.50 - 1.00 0.66* 0.45 - 0

Rich 2.91** 1.51 - 5.59 2.05 0.86 - 4.86 1.31 0.82 - 2.10 1.00 0.57 - 1.78 1.19 0.86 - 1.64 1.08 0.74 - 1.58 0.85 0.58 - 1.25 0.74 0.46 - 1

Richest 5.62*** 2.69 - 11.73 3.89** 1.68 - 9.04 1.60 0.88 - 2.90 1.21 0.61 - 2.39 1.46 1.00 - 2.13 1.21 0.79 - 1.87 0.72 0.48 - 1.07 0.61* 0.38 - 0

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.64* 0.41 - 1.00 0.78 0.48 - 1.29 0.79 0.54 - 1.15 0.83 0.55 - 1.25 1.08 0.86 - 1.36 1.08 0.85 - 1.37 0.91 0.69 - 1.18 0.85 0.64 - 1

Wealthy 

relative to 

community

1.09 0.62 - 1.90 0.76 0.41 - 1.41 1.04 0.67 - 1.60 1.00 0.64 - 1.57 1.13 0.86 - 1.49 1.10 0.83 - 1.46 0.93 0.68 - 1.28 1.07 0.74 - 1

Maternal 

education

None (Ref)

Primary 2.59*** 1.78 - 3.76 1.55 0.97 - 2.47 1.45 0.97 - 2.15 1.20 0.72 - 2.01 0.97 0.74 - 1.26 0.86 0.64 - 1.17 0.73 0.52 - 1.03 0.76 0.53 - 1

Secondary or 

higher

4.46*** 2.66 - 7.47 1.52 0.75 - 3.09 2.16** 1.33 - 3.49 1.69 0.88 - 3.24 1.41* 1.01 - 1.96 1.15 0.77 - 1.72 0.91 0.63 - 1.31 1.00 0.63 - 1

Birth order First (Ref)

Second thru 

fourth

0.64 0.41 - 1.02 0.73 0.45 - 1.18 0.66* 0.45 - 0.97 0.69 0.47 - 1.03 0.80 0.63 - 1.02 0.83 0.65 - 1.05 1.04 0.79 - 1.36 1.05 0.79 - 1

Fifth or 

higher

0.28*** 0.17 - 0.45 0.37*** 0.22 - 0.64 0.54** 0.35 - 0.83 0.58* 0.37 - 0.92 0.64*** 0.49 - 0.82 0.68** 0.52 - 0.88 0.82 0.61 - 1.09 0.79 0.57 - 1

Sex of child Male child

(Ref)

Female child 0.95 0.70 - 1.31 1.00 0.73 - 1.36 0.99 0.75 - 1.31 1.03 0.77 - 1.36 0.99 0.83 - 1.17 0.99 0.83 - 1.17 0.95 0.77 - 1.18 0.93 0.75 - 1

Observations 2,791 2,791 1,195 1,195 3,274 3,274 2,012 2,012 

Note: *p<0.05; **p<0.01; ***p<0.001
129

Appendix Table A4—Continued

Liberia

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.06 0.61 - 1.82 1.37 0.76 - 2.46 2.30 0.98 - 5.44 2.67* 1.01 - 7.08 0.97 0.70 - 1.34 1.04 0.73 - 1.48 1.38 0.89 - 2.12 1.58 0.98 - 2

Middle 1.78* 1.12 - 2.84 2.86*** 1.68 - 4.86 2.00 0.94 - 4.25 2.28 0.94 - 5.54 1.22 0.80 - 1.85 1.33 0.83 - 2.12 1.34 0.92 - 1.96 1.53 0.94 - 2

Rich 2.43*** 1.45 - 4.07 4.07*** 2.29 - 7.22 1.64 0.69 - 3.90 1.66 0.61 - 4.53 1.67* 1.12 - 2.48 1.88** 1.18 - 3.01 1.70 0.97 - 2.97 2.09* 1.11 - 3

Richest 3.57*** 2.17 - 5.87 7.17*** 4.09 - 12.55 1.69 0.73 - 3.90 1.78 0.64 - 4.89 1.45 0.94 - 2.25 1.63 0.99 - 2.71 1.82** 1.21 - 2.74 1.98* 1.18 - 3

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.84 0.55 - 1.28 0.58* 0.37 - 0.92 1.19 0.58 - 2.47 1.22 0.58 - 2.57 1.22 0.86 - 1.73 1.13 0.80 - 1.61 1.23 0.82 - 1.85 1.19 0.77 - 1

Wealthy 

relative to 

community

0.61 0.37 - 1.01 0.27*** 0.15 - 0.48 0.93 0.43 - 2.05 0.78 0.31 - 1.93 1.00 0.65 - 1.54 0.80 0.48 - 1.34 0.89 0.55 - 1.44 0.70 0.40 - 1

Maternal 

education

None (Ref)

Primary 1.29 0.91 - 1.82 1.08 0.74 - 1.58 1.03 0.61 - 1.75 1.02 0.57 - 1.80 1.08 0.80 - 1.45 0.96 0.71 - 1.31 1.15 0.84 - 1.58 1.01 0.71 - 1

Secondary or 

higher

1.62 0.93 - 2.81 0.93 0.52 - 1.66 2.44* 1.13 - 5.28 2.70* 1.02 - 7.11 1.26 0.85 - 1.87 0.97 0.63 - 1.49 1.73* 1.08 - 2.77 1.27 0.75 - 2

Birth order First (Ref)

Second thru 

fourth

0.87 0.49 - 1.54 1.00 0.55 - 1.80 0.79 0.39 - 1.64 0.97 0.45 - 2.10 1.03 0.70 - 1.53 1.05 0.70 - 1.57 0.73 0.49 - 1.11 0.79 0.51 - 1

Fifth or 

higher

0.69 0.39 - 1.20 0.79 0.43 - 1.46 0.82 0.36 - 1.85 1.28 0.52 - 3.11 0.70 0.47 - 1.05 0.70 0.46 - 1.07 0.58** 0.38 - 0.87 0.64 0.40 - 1

Sex of child Male child

(Ref)

Female child 1.20 0.89 - 1.61 1.10 0.81 - 1.50 0.65* 0.43 - 0.99 0.65* 0.43 - 0.99 0.84 0.66 - 1.07 0.86 0.68 - 1.10 0.94 0.70 - 1.26 0.95 0.70 - 1

Observations 961 961 365 365 1,552 1,552 1,186 1,186 

Note: *p<0.05; **p<0.01; ***p<0.001
130

Appendix Table A4—Continued

Mali

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.30 0.82 - 2.05 1.24 0.79 - 1.93 0.35* 0.12 - 0.99 0.24 0.06 - 1.00 0.91 0.58 - 1.44 0.89 0.53 - 1.48 1.25 0.75 - 2.09 1.37 0.81 - 2

Middle 1.39 0.91 - 2.14 1.26 0.80 - 1.99 0.33 0.09 - 1.20 0.17 0.02 - 1.30 0.79 0.50 - 1.26 0.76 0.43 - 1.34 1.04 0.66 - 1.64 1.12 0.67 - 1

Rich 1.83** 1.17 - 2.86 1.53 0.92 - 2.55 0.12 0.01 - 1.10 0.08* 0.01 - 0.56 1.27 0.80 - 2.00 1.17 0.67 - 2.06 1.47 0.90 - 2.41 1.70 0.99 - 2

Richest 1.90* 1.07 - 3.38 1.50 0.78 - 2.90 0.48 0.12 - 1.95 0.42 0.08 - 2.27 1.58 0.91 - 2.75 1.38 0.70 - 2.72 1.68 0.99 - 2.86 1.71 0.92 - 3

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

1.36 0.95 - 1.94 1.23 0.85 - 1.78 0.84 0.16 - 4.33 0.68 0.13 - 3.53 1.20 0.80 - 1.79 1.10 0.72 - 1.70 1.48 1.00 - 2.18 1.40 0.93 - 2

Wealthy 

relative to 

community

1.74** 1.24 - 2.43 1.49 0.98 - 2.28 0.83 0.13 - 5.15 1.49 0.23 - 9.83 1.10 0.73 - 1.65 1.03 0.61 - 1.74 1.16 0.79 - 1.69 1.01 0.65 - 1

Maternal 

education

None (Ref)

Primary 1.18 0.83 - 1.69 1.16 0.81 - 1.65 0.50 0.07 - 3.38 0.64 0.08 - 5.03 1.47 0.95 - 2.30 1.51 0.96 - 2.37 1.09 0.73 - 1.63 1.11 0.73 - 1

Secondary or 

higher

1.67 0.99 - 2.81 1.55 0.88 - 2.74 1.22 0.18 - 8.06 1.23 0.09 - 16.51 1.77* 1.05 - 2.95 1.59 0.92 - 2.73 1.26 0.75 - 2.12 1.16 0.66 - 2

Birth order First (Ref)

Second thru 

fourth

0.88 0.62 - 1.25 0.97 0.69 - 1.37 0.46 0.08 - 2.54 0.51 0.08 - 3.07 1.37 0.87 - 2.17 1.49 0.94 - 2.39 1.34 0.83 - 2.15 1.46 0.90 - 2

Fifth or 

higher

0.97 0.67 - 1.41 1.22 0.84 - 1.77 0.37 0.07 - 1.95 0.36 0.06 - 2.10 1.23 0.74 - 2.04 1.55 0.92 - 2.64 1.47 0.92 - 2.36 1.74* 1.05 - 2

Sex of child Male child

(Ref)

Female child 1.01 0.79 - 1.29 1.03 0.80 - 1.32 1.26 0.49 - 3.21 1.29 0.46 - 3.60 0.94 0.70 - 1.24 0.97 0.73 - 1.28 0.73* 0.56 - 0.95 0.73* 0.56 - 0

Observations 1,438 1,438 86 86 1,174 1,174 1,228 1,228 

Note: *p<0.05; **p<0.01; ***p<0.001
131

Appendix Table A4—Continued

Nigeria

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.67** 1.23 - 2.28 1.68** 1.22 - 2.31 1.20 0.70 - 2.06 1.09 0.59 - 2.00 1.60*** 1.26 - 2.02 1.55*** 1.23 - 1.96 1.61*** 1.23 - 2.11 1.58** 1.20 - 2

Middle 2.22*** 1.60 - 3.08 1.93*** 1.36 - 2.73 1.08 0.57 - 2.05 0.93 0.43 - 2.01 1.66*** 1.26 - 2.17 1.61*** 1.23 - 2.11 1.41* 1.06 - 1.88 1.41* 1.04 - 1

Rich 3.20*** 2.29 - 4.49 2.10*** 1.46 - 3.02 1.43 0.76 - 2.70 1.12 0.52 - 2.40 1.71*** 1.33 - 2.20 1.57** 1.19 - 2.09 1.63** 1.19 - 2.23 1.62** 1.15 - 2

Richest 7.73*** 5.51 - 10.83 3.80*** 2.55 - 5.66 1.78 0.63 - 5.02 1.10 0.32 - 3.72 2.27*** 1.69 - 3.04 2.08*** 1.43 - 3.02 2.12*** 1.43 - 3.16 2.17*** 1.42 - 3

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.98 0.79 - 1.21 0.83 0.65 - 1.06 0.91 0.51 - 1.62 0.92 0.52 - 1.62 0.85 0.69 - 1.04 0.85 0.69 - 1.06 0.87 0.65 - 1.17 0.89 0.67 - 1

Wealthy 

relative to 

community

0.80 0.62 - 1.03 0.63** 0.47 - 0.85 0.94 0.46 - 1.95 0.98 0.44 - 2.22 1.00 0.78 - 1.29 0.84 0.63 - 1.11 1.08 0.79 - 1.49 0.89 0.64 - 1

Maternal 

education

None (Ref)

Primary 3.13*** 2.43 - 4.03 2.50*** 1.90 - 3.29 1.25 0.66 - 2.37 1.27 0.70 - 2.30 1.69*** 1.38 - 2.08 1.48*** 1.20 - 1.83 1.44** 1.13 - 1.84 1.27 0.99 - 1

Secondary or 

higher

6.32*** 5.03 - 7.95 4.24*** 3.30 - 5.44 2.66** 1.46 - 4.82 2.69* 1.19 - 6.09 1.48** 1.16 - 1.89 1.17 0.89 - 1.55 1.25 0.92 - 1.70 0.98 0.71 - 1

Birth order First (Ref)

Second thru 

fourth

0.92 0.75 - 1.13 1.02 0.81 - 1.29 0.92 0.48 - 1.78 1.03 0.54 - 1.96 0.94 0.78 - 1.14 0.94 0.78 - 1.14 1.13 0.88 - 1.46 1.15 0.89 - 1

Fifth or 

higher

0.73** 0.59 - 0.91 1.23 0.97 - 1.57 0.95 0.52 - 1.73 1.17 0.62 - 2.21 0.95 0.77 - 1.18 1.02 0.82 - 1.27 1.06 0.82 - 1.39 1.12 0.86 - 1

Sex of child Male child

(Ref)

Female child 1.10 0.95 - 1.27 1.09 0.93 - 1.26 0.95 0.65 - 1.38 0.95 0.65 - 1.39 0.90 0.79 - 1.03 0.91 0.79 - 1.04 0.98 0.84 - 1.15 1.00 0.85 - 1

Observations 3,959 3,959 565 565 5,390 5,390 2,858 2,858 

Note: *p<0.05; **p<0.01; ***p<0.001
132

Appendix Table A4—Continued

Pakistan

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.68 0.99 - 2.86 1.94* 1.15 - 3.27 1.11 0.63 - 1.95 1.42 0.79 - 2.54 0.93 0.64 - 1.37 1.06 0.71 - 1.56 0.66 0.37 - 1.16 0.69 0.39 - 

Middle 2.25** 1.31 - 3.89 2.34** 1.27 - 4.30 1.24 0.67 - 2.30 1.67 0.80 - 3.50 1.20 0.78 - 1.84 1.34 0.84 - 2.12 0.70 0.38 - 1.26 0.73 0.39 - 

Rich 4.17*** 2.28 - 7.65 4.44*** 2.28 - 8.65 1.37 0.79 - 2.38 1.79 0.88 - 3.64 1.41 0.96 - 2.08 1.57 0.97 - 2.54 1.06 0.59 - 1.91 1.11 0.59 - 

Richest 10.18*** 4.99 - 20.76 9.29*** 3.86 - 22.40 2.27* 1.00 - 5.14 2.59 0.97 - 6.92 1.80* 1.14 - 2.85 1.72 0.93 - 3.19 1.31 0.74 - 2.32 1.22 0.58 - 

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.58* 0.36 - 0.92 0.41*** 0.25 - 0.69 1.20 0.73 - 1.99 1.15 0.69 - 1.92 1.35 0.96 - 1.89 1.24 0.88 - 1.75 1.38 0.92 - 2.06 1.24 0.78 - 

Wealthy 

relative to 

community

0.47** 0.28 - 0.77 0.24*** 0.13 - 0.43 0.76 0.42 - 1.38 0.57 0.28 - 1.16 0.85 0.58 - 1.24 0.70 0.45 - 1.09 0.99 0.62 - 1.57 0.87 0.51 - 

Maternal 

education

None (Ref)

Primary 2.97*** 1.68 - 5.24 1.89* 1.07 - 3.36 0.87 0.48 - 1.56 0.76 0.41 - 1.42 1.25 0.87 - 1.79 1.14 0.79 - 1.63 1.32 0.84 - 2.07 1.32 0.81 - 

Secondary or 

higher

6.30*** 3.69 - 10.74 2.39** 1.28 - 4.44 2.21** 1.25 - 3.91 1.62 0.86 - 3.02 1.71** 1.16 - 2.53 1.22 0.74 - 2.00 1.53* 1.01 - 2.34 1.33 0.79 - 

Birth order First (Ref)

Second thru 

fourth

1.19 0.79 - 1.80 1.37 0.84 - 2.23 0.67 0.45 - 1.01 0.68 0.45 - 1.02 0.81 0.64 - 1.03 0.83 0.64 - 1.07 0.82 0.55 - 1.23 0.81 0.54 - 

Fifth or 

higher

0.73 0.45 - 1.19 1.25 0.72 - 2.16 0.70 0.42 - 1.17 0.81 0.48 - 1.37 0.67* 0.49 - 0.91 0.78 0.56 - 1.09 0.96 0.60 - 1.54 1.10 0.70 - 

Sex of child Male child

(Ref)

Female child 0.76* 0.58 - 0.99 0.72* 0.54 - 0.97 0.93 0.62 - 1.38 0.92 0.61 - 1.37 0.85 0.67 - 1.06 0.87 0.68 - 1.10 1.00 0.76 - 1.34 1.01 0.75 - 

Observations 1,012 1,012 720 720 1,915 1,915 993 993 

Note: *p<0.05; **p<0.01; ***p<0.001
133

Appendix Table A4—Continued

Senegal

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.56* 1.02 - 2.39 1.72* 1.12 - 2.66 2.64* 1.02 - 6.83 3.20* 1.11 - 9.21 0.97 0.68 - 1.37 1.06 0.77 - 1.48 1.06 0.76 - 1.46 1.11 0.80 - 

Middle 3.22*** 1.92 - 5.39 3.67*** 1.93 - 6.99 1.95 0.77 - 4.94 2.27 0.81 - 6.34 1.24 0.89 - 1.75 1.37 0.96 - 1.96 1.17 0.85 - 1.62 1.21 0.87 - 

Rich 3.47*** 1.93 - 6.23 4.12*** 2.08 - 8.14 1.71 0.67 - 4.36 1.78 0.74 - 4.27 1.21 0.84 - 1.74 1.33 0.88 - 2.00 1.42 0.99 - 2.02 1.46* 1.02 - 

Richest 4.54*** 2.12 - 9.71 4.94*** 2.08 - 11.72 11.15*** 2.74 - 45.34 8.49** 2.12 - 34.05 2.02*** 1.34 - 3.05 1.91** 1.19 - 3.07 1.48 0.97 - 2.26 1.43 0.88 - 

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.83 0.51 - 1.36 0.73 0.44 - 1.19 2.52* 1.04 - 6.15 2.11 0.84 - 5.29 1.46** 1.11 - 1.92 1.29 0.98 - 1.71 1.23 0.93 - 1.63 1.17 0.88 - 

Wealthy 

relative to 

community

0.90 0.52 - 1.54 0.50* 0.26 - 0.96 1.61 0.57 - 4.50 1.31 0.48 - 3.57 1.02 0.73 - 1.41 0.85 0.58 - 1.23 1.13 0.81 - 1.58 0.98 0.67 - 

Maternal 

education

None (Ref)

Primary 1.37 0.88 - 2.15 1.20 0.76 - 1.91 2.05* 1.08 - 3.89 1.85 0.81 - 4.24 1.22 0.87 - 1.70 1.19 0.87 - 1.63 1.10 0.76 - 1.60 1.10 0.74 - 

Secondary or 

higher

2.97** 1.34 - 6.59 2.34* 1.03 - 5.34 1.67 0.59 - 4.74 2.10 0.74 - 5.98 2.04*** 1.43 - 2.92 1.91** 1.27 - 2.86 1.39 0.89 - 2.16 1.32 0.84 - 

Birth order First (Ref)

Second thru 

fourth

1.07 0.69 - 1.68 1.26 0.80 - 1.97 1.32 0.53 - 3.27 1.30 0.54 - 3.14 1.04 0.78 - 1.39 1.17 0.88 - 1.57 1.03 0.75 - 1.42 1.07 0.78 - 

Fifth or 

higher

0.93 0.57 - 1.51 1.25 0.76 - 2.07 1.33 0.51 - 3.43 1.86 0.66 - 5.23 0.94 0.69 - 1.27 1.19 0.87 - 1.63 0.98 0.73 - 1.32 1.08 0.79 - 

Sex of child Male child

(Ref)

Female child 0.86 0.62 - 1.20 0.88 0.63 - 1.24 0.60 0.35 - 1.02 0.78 0.44 - 1.39 0.92 0.71 - 1.19 0.91 0.71 - 1.16 0.83 0.64 - 1.08 0.83 0.64 - 

Observations 1,593 1,593 248 248 1,523 1,523 1,489 1,489 

Note: *p<0.05; **p<0.01; ***p<0.001
134

Appendix Table A4—Continued

Zambia

3 doses of 

Pentavalent vaccine

Treatment for 

ARI symptoms

Advice or treatment sought 

for fever symptoms

Advice or treatment sought 

for diarrhea

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% CI

Unadjusted 

Odds 

Ratio 95% CI

Adjusted 

Odds 

Ratio 95% 

Wealth 

quintile

Poorest (Ref)

Poorest 1.31 0.74 - 2.32 1.30 0.69 - 2.46 4.49 0.99 - 20.42 3.84 0.80 - 18.43 1.59* 1.05 - 2.42 1.51 0.97 - 2.38 1.39 0.88 - 2.19 1.29 0.80 - 

Middle 1.35 0.69 - 2.65 1.38 0.62 - 3.09 1.91 0.48 - 7.64 0.86 0.18 - 4.01 1.70 0.99 - 2.90 1.48 0.84 - 2.59 1.15 0.68 - 1.94 1.02 0.58 - 

Rich 1.52 0.76 - 3.07 1.60 0.66 - 3.84 1.58 0.29 - 8.56 0.66 0.08 - 5.78 1.47 0.92 - 2.35 1.19 0.70 - 2.05 1.49 0.90 - 2.45 1.28 0.72 - 

Richest 5.99** 2.01 - 17.85 5.71** 1.65 - 19.78 2.34 0.41 - 13.38 0.82 0.06 - 10.77 1.35 0.77 - 2.38 0.86 0.44 - 1.66 0.86 0.47 - 1.57 0.70 0.34 - 

Relative 

community 

wealth

Poor relative 

to community

(Ref)

Wealth 

similar to 

community

0.62 0.33 - 1.17 0.54 0.29 - 1.00 1.93 0.50 - 7.47 3.47 0.82 - 14.73 1.18 0.78 - 1.80 1.19 0.78 - 1.82 0.85 0.58 - 1.26 0.95 0.64 - 

Wealthy 

relative to 

community

0.71 0.38 - 1.33 0.49 0.23 - 1.05 1.84 0.61 - 5.55 2.27 0.44 - 11.78 1.41 0.93 - 2.14 1.36 0.84 - 2.22 1.03 0.65 - 1.64 1.10 0.66 - 

Maternal 

education

None (Ref)

Primary 2.14* 1.16 - 3.93 1.99* 1.08 - 3.65 0.24 0.05 - 1.16 0.25 0.05 - 1.21 0.82 0.53 - 1.28 0.79 0.50 - 1.23 1.30 0.79 - 2.15 1.22 0.72 - 

Secondary or 

higher

4.83*** 2.05 - 11.34 3.38* 1.28 - 8.90 0.76 0.13 - 4.39 0.54 0.09 - 3.23 1.51 0.88 - 2.59 1.45 0.80 - 2.60 1.46 0.80 - 2.66 1.44 0.72 - 

Birth order First (Ref)

Second thru 

fourth

1.17 0.66 - 2.09 1.36 0.75 - 2.49 0.70 0.14 - 3.58 0.94 0.23 - 3.85 1.23 0.81 - 1.88 1.31 0.85 - 2.03 0.90 0.63 - 1.28 0.93 0.66 - 

Fifth or 

higher

0.86 0.47 - 1.58 1.22 0.64 - 2.33 0.65 0.13 - 3.12 0.57 0.14 - 2.42 0.86 0.58 - 1.28 0.98 0.63 - 1.51 0.72 0.50 - 1.05 0.76 0.52 - 

Sex of child Male child

(Ref)

Female child 1.26 0.82 - 1.94 1.28 0.81 - 2.01 0.27** 0.11 - 0.62 0.30** 0.13 - 0.73 0.75 0.53 - 1.07 0.77 0.54 - 1.10 1.03 0.76 - 1.39 1.03 0.76 - 

Observations 1,338 1,338 109 109 1,151 1,151 1,019 1,019 

Note: *p<0.05; **p<0.01; ***p<0.001
135

Appendix Table A5 Unadjusted and adjusted odds ratios for child nutrition indicators among children under 

age 5

DRC

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.99 0.80 - 1.21 0.98 0.79 - 1.21 0.95 0.66 - 1.37 0.94 0.62 - 1.41

Middle 0.92 0.72 - 1.17 0.95 0.73 - 1.23 1.05 0.73 - 1.52 1.09 0.67 - 1.76

Rich 0.85 0.69 - 1.06 0.94 0.73 - 1.21 1.12 0.73 - 1.70 1.16 0.71 - 1.89

Richest 0.75* 0.59 - 0.97 0.81 0.59 - 1.10 1.00 0.66 - 1.51 1.00 0.61 - 1.64

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.88 0.73 - 1.06 0.88 0.72 - 1.08 1.14 0.85 - 1.53 1.10 0.77 - 1.57

Wealthy relative to 

community

0.81* 0.68 - 0.97 0.85 0.70 - 1.04 1.12 0.81 - 1.55 1.06 0.70 - 1.59

Maternal 

education +

None (Ref)

Primary 0.93 0.81 - 1.07 0.92 0.80 - 1.06 1.37* 1.01 - 1.85 1.34 0.99 - 1.81

Secondary or higher 0.64*** 0.53 - 0.77 0.65*** 0.53 - 0.79 1.24 0.82 - 1.86 1.18 0.77 - 1.82

Birth order ++ First (Ref)

Second thru fourth 0.91 0.74 - 1.12 0.85 0.70 - 1.05 0.85 0.63 - 1.15 0.86 0.63 - 1.16

Fifth or higher 0.98 0.78 - 1.22 0.89 0.70 - 1.12 0.93 0.64 - 1.34 0.94 0.65 - 1.36

Sex of child Male child (Ref)

Female child 0.80** 0.69 - 0.93 0.80** 0.70 - 0.93 0.74* 0.55 - 0.99 0.69* 0.50 - 0.96

Observations 6,270 5,697 6,270 5,697

Note: *p<0.05; **p<0.01; ***p<0.001; + n= 5,795; ++ n= 5,697

Ghana

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.92 0.65 - 1.29 0.95 0.66 - 1.35 0.81 0.40 - 1.62 1.01 0.49 - 2.07

Middle 0.96 0.65 - 1.40 1.07 0.72 - 1.59 0.79 0.41 - 1.54 0.88 0.40 - 1.95

Rich 0.69 0.46 - 1.03 0.92 0.56 - 1.51 0.34* 0.14 - 0.83 0.39 0.15 - 1.03

Richest 0.45** 0.28 - 0.74 0.74 0.39 - 1.40 1.52 0.45 - 5.14 1.22 0.41 - 3.60

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.87 0.60 - 1.24 0.89 0.61 - 1.30 2.23 0.87 - 5.75 2.00 0.91 - 4.40

Wealthy relative to 

community

0.83 0.58 - 1.18 0.93 0.59 - 1.46 0.88 0.36 - 2.13 0.90 0.35 - 2.34

Maternal 

education +

None (Ref)

Primary 0.80 0.58 - 1.11 0.74 0.54 - 1.02 0.96 0.49 - 1.87 1.12 0.56 - 2.28

Secondary or higher 0.47*** 0.35 - 0.62 0.44*** 0.31 - 0.64 1.17 0.56 - 2.48 1.31 0.67 - 2.54

Birth order ++ First (Ref)

Second thru fourth 0.77 0.56 - 1.06 0.61** 0.43 - 0.86 1.20 0.60 - 2.39 1.43 0.83 - 2.44

Fifth or higher 1.02 0.72 - 1.44 0.68* 0.46 - 0.99 1.10 0.41 - 2.95 1.37 0.70 - 2.67

Sex of child Male child (Ref)

Female child 0.81 0.63 - 1.03 0.76* 0.59 - 0.98 1.02 0.63 - 1.65 1.00 0.65 - 1.54

Observations 1,804 1,625 1,804 1,625

Note: *p<0.05; **p<0.01; ***p<0.001; + n= 1,672; ++ n= 1,625

Continues...
136

Appendix Table A5—Continued

Haiti

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.83 0.66 - 1.04 0.81 0.62 - 1.05 1.00 0.64 - 1.56 1.01 0.59 - 1.71

Middle 0.62*** 0.51 - 0.76 0.62*** 0.48 - 0.80 1.00 0.57 - 1.75 1.26 0.65 - 2.43

Rich 0.33*** 0.25 - 0.42 0.32*** 0.24 - 0.44 0.77 0.42 - 1.42 0.76 0.39 - 1.46

Richest 0.19*** 0.13 - 0.28 0.20*** 0.13 - 0.31 0.74 0.40 - 1.36 0.88 0.42 - 1.84

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.84 0.66 - 1.07 1.07 0.83 - 1.39 1.20 0.75 - 1.94 1.17 0.70 - 1.94

Wealthy relative to 

community

0.80 0.62 - 1.04 1.18 0.88 - 1.58 1.15 0.64 - 2.04 1.21 0.63 - 2.33

Maternal 

education +

None (Ref)

Primary 0.67*** 0.56 - 0.82 0.84 0.68 - 1.04 1.10 0.65 - 1.88 0.89 0.51 - 1.55

Secondary or higher 0.31*** 0.24 - 0.41 0.59** 0.42 - 0.83 0.89 0.48 - 1.65 0.68 0.35 - 1.35

Birth order ++ First (Ref)

Second thru fourth 1.06 0.87 - 1.29 0.92 0.73 - 1.15 0.87 0.57 - 1.32 0.81 0.53 - 1.24

Fifth or higher 1.66*** 1.31 - 2.09 1.07 0.79 - 1.44 0.59 0.34 - 1.02 0.48* 0.27 - 0.89

Sex of child Male child (Ref)

Female child 0.79** 0.67 - 0.94 0.76** 0.62 - 0.93 0.82 0.58 - 1.16 0.84 0.58 - 1.22

Observations 4,883 4,018 4,862 4,000

Note: *p<0.05; **p<0.01; ***p<0.001; + Stunting n= 4,093; Wasting n=4,075; ++Stunting n= 4,018; Wasting n=4,000

Kenya

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.80*** 0.70 - 0.91 0.67*** 0.57 - 0.79 0.34*** 0.24 - 0.49 0.52** 0.34 - 0.79

Middle 0.73*** 0.63 - 0.84 0.64*** 0.54 - 0.75 0.27*** 0.19 - 0.39 0.39*** 0.25 - 0.61

Rich 0.52*** 0.45 - 0.61 0.45*** 0.37 - 0.54 0.40*** 0.28 - 0.57 0.43*** 0.27 - 0.69

Richest 0.39*** 0.33 - 0.46 0.35*** 0.28 - 0.44 0.19*** 0.13 - 0.30 0.18*** 0.10 - 0.34

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.96 0.84 - 1.09 0.97 0.84 - 1.13 2.37*** 1.71 - 3.29 1.65** 1.15 - 2.37

Wealthy relative to 

community

0.87* 0.75 - 1.00 1.25** 1.06 - 1.48 1.32 0.95 - 1.83 2.10*** 1.42 - 3.10

Maternal 

education +

None (Ref)

Primary 0.94 0.81 - 1.10 1.31** 1.09 - 1.57 0.28*** 0.22 - 0.35 0.51*** 0.39 - 0.66

Secondary or higher 0.53*** 0.44 - 0.64 0.96 0.76 - 1.20 0.27*** 0.20 - 0.36 0.69 0.46 - 1.06

Birth order ++ First (Ref)

Second thru fourth 1.08 0.95 - 1.24 1.02 0.89 - 1.17 1.09 0.85 - 1.40 1.00 0.77 - 1.30

Fifth or higher 1.36*** 1.17 - 1.58 1.13 0.97 - 1.32 1.40* 1.06 - 1.84 1.02 0.76 - 1.38

Sex of child Male child (Ref)

Female child 0.67*** 0.61 - 0.72 0.65*** 0.59 - 0.71 0.82* 0.68 - 0.99 0.78* 0.63 - 0.96

Observations 14,142 12,755 14,142 12,755

Note: *p<0.05; **p<0.01; ***p<0.001; + n= 13,011; ++ n= 12,755

Continues...
137

Appendix Table A5—Continued

Liberia

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 1.01 0.76 - 1.34 0.99 0.73 - 1.35 0.95 0.54 - 1.66 0.86 0.47 - 1.60

Middle 0.92 0.70 - 1.21 0.86 0.62 - 1.20 0.96 0.53 - 1.73 1.01 0.55 - 1.86

Rich 1.04 0.76 - 1.43 1.02 0.71 - 1.47 0.95 0.54 - 1.67 1.05 0.56 - 1.98

Richest 0.74* 0.55 - 0.99 0.68* 0.47 - 1.00 0.77 0.40 - 1.47 1.08 0.54 - 2.18

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

1.14 0.91 - 1.43 1.31* 1.01 - 1.70 0.72 0.48 - 1.09 0.82 0.50 - 1.34

Wealthy relative to 

community

1.09 0.86 - 1.39 1.21 0.88 - 1.66 0.53* 0.32 - 0.87 0.58 0.33 - 1.04

Maternal 

education +

None (Ref)

Primary 0.87 0.69 - 1.09 0.88 0.68 - 1.13 1.04 0.65 - 1.66 1.01 0.62 - 1.64

Secondary or higher 0.86 0.61 - 1.21 0.89 0.62 - 1.27 1.07 0.59 - 1.93 1.01 0.55 - 1.86

Birth order ++ First (Ref)

Second thru fourth 1.02 0.76 - 1.37 0.98 0.72 - 1.33 0.69 0.38 - 1.27 0.69 0.37 - 1.26

Fifth or higher 1.19 0.85 - 1.68 0.94 0.63 - 1.38 0.77 0.44 - 1.34 0.85 0.47 - 1.54

Sex of child Male child (Ref)

Female child 0.65*** 0.55 - 0.77 0.66*** 0.54 - 0.79 0.74 0.50 - 1.10 0.75 0.49 - 1.15

Observations 2,600 2,243 2,600 2,243

Note: *p<0.05; **p<0.01; ***p<0.001; + n= 2,243

Mali

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.98 0.82 - 1.17 0.98 0.81 - 1.19 0.97 0.73 - 1.30 1.04 0.77 - 1.40

Middle 0.85 0.71 - 1.02 0.86 0.70 - 1.05 1.03 0.77 - 1.39 1.09 0.79 - 1.49

Rich 0.90 0.75 - 1.06 0.90 0.73 - 1.10 0.76 0.56 - 1.02 0.84 0.60 - 1.18

Richest 0.44*** 0.35 - 0.55 0.45*** 0.35 - 0.59 0.72 0.49 - 1.05 0.74 0.49 - 1.12

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.98 0.85 - 1.14 1.18* 1.02 - 1.38 1.09 0.87 - 1.36 1.19 0.94 - 1.51

Wealthy relative to 

community

1.05 0.89 - 1.24 1.22* 1.01 - 1.47 0.87 0.67 - 1.11 0.92 0.68 - 1.25

Maternal 

education +

None (Ref)

Primary 0.78* 0.64 - 0.95 0.83 0.68 - 1.00 0.99 0.73 - 1.32 1.02 0.76 - 1.38

Secondary or higher 0.42*** 0.33 - 0.55 0.53*** 0.40 - 0.71 0.70 0.49 - 1.02 0.74 0.50 - 1.08

Birth order ++ First (Ref)

Second thru fourth 0.95 0.78 - 1.16 0.88 0.72 - 1.07 1.10 0.84 - 1.43 1.05 0.81 - 1.36

Fifth or higher 1.05 0.85 - 1.30 0.87 0.70 - 1.07 0.96 0.73 - 1.25 0.87 0.67 - 1.14

Sex of child Male child (Ref)

Female child 0.93 0.81 - 1.05 0.91 0.79 - 1.04 0.70*** 0.58 - 0.84 0.69*** 0.57 - 0.84

Observations 6,822 6,270 7,067 6,397

Note: *p<0.05; **p<0.01; ***p<0.001; + Stunting n= 6,374; Wasting n=6,522; ++Stunting n= 6,270; Wasting n=6,397

Continues...
138

Appendix Table A5—Continued

Nigeria

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.96 0.79 - 1.16 0.99 0.80 - 1.22 0.74* 0.55 - 1.00 0.70* 0.50 - 0.97

Middle 0.81* 0.67 - 0.98 0.83 0.67 - 1.02 0.70* 0.53 - 0.92 0.67** 0.49 - 0.91

Rich 0.50*** 0.42 - 0.61 0.60*** 0.48 - 0.75 0.58** 0.41 - 0.81 0.58** 0.39 - 0.86

Richest 0.25*** 0.21 - 0.31 0.38*** 0.29 - 0.49 0.46*** 0.34 - 0.63 0.46*** 0.30 - 0.70

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

1.00 0.85 - 1.16 1.19* 1.01 - 1.41 1.13 0.86 - 1.47 1.22 0.92 - 1.63

Wealthy relative to 

community

1.28** 1.09 - 1.51 1.63*** 1.35 - 1.95 1.23 0.91 - 1.66 1.50* 1.07 - 2.10

Maternal 

education +

None (Ref)

Primary 0.53*** 0.45 - 0.63 0.66*** 0.56 - 0.78 0.49*** 0.37 - 0.66 0.61** 0.45 - 0.83

Secondary or higher 0.27*** 0.23 - 0.31 0.44*** 0.37 - 0.52 0.60*** 0.46 - 0.78 0.86 0.61 - 1.21

Birth order ++ First (Ref)

Second thru fourth 1.07 0.93 - 1.24 0.98 0.84 - 1.14 0.86 0.65 - 1.12 0.84 0.64 - 1.11

Fifth or higher 1.47*** 1.26 - 1.71 1.06 0.90 - 1.26 1.07 0.81 - 1.41 0.97 0.73 - 1.29

Sex of child Male child (Ref)

Female child 0.74*** 0.67 - 0.82 0.74*** 0.66 - 0.83 0.74** 0.61 - 0.90 0.77** 0.62 - 0.94

Observations 7,537 6,920 7,579 6,957

Note: *p<0.05; **p<0.01; ***p<0.001; + Stunting n= 7,055; Wasting n=7,092; ++Stunting n= 6,920; Wasting n=6,957

Pakistan

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.62* 0.39 - 0.99 0.60* 0.37 - 0.97 1.35 0.67 - 2.72 1.44 0.68 - 3.05

Middle 0.41*** 0.28 - 0.61 0.44*** 0.28 - 0.69 0.75 0.42 - 1.34 0.84 0.44 - 1.61

Rich 0.29*** 0.19 - 0.44 0.31*** 0.20 - 0.49 0.80 0.42 - 1.55 0.74 0.31 - 1.77

Richest 0.24*** 0.15 - 0.40 0.35*** 0.20 - 0.62 0.40* 0.19 - 0.86 0.34* 0.14 - 0.83

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

1.03 0.71 - 1.49 1.16 0.79 - 1.70 1.65 0.84 - 3.26 2.12* 1.17 - 3.87

Wealthy relative to 

community

0.92 0.65 - 1.31 1.39 0.96 - 2.02 1.25 0.64 - 2.43 1.80 0.94 - 3.44

Maternal 

education +

None (Ref)

Primary 0.65** 0.48 - 0.87 0.85 0.61 - 1.19 0.72 0.36 - 1.41 0.84 0.42 - 1.69

Secondary or higher 0.34*** 0.25 - 0.47 0.55** 0.38 - 0.79 0.58 0.33 - 1.04 1.05 0.53 - 2.06

Birth order ++ First (Ref)

Second thru fourth 1.03 0.79 - 1.35 0.95 0.71 - 1.27 1.04 0.60 - 1.81 1.01 0.57 - 1.78

Fifth or higher 1.59** 1.13 - 2.24 1.14 0.79 - 1.63 1.18 0.62 - 2.24 0.99 0.50 - 1.93

Sex of child Male child (Ref)

Female child 1.03 0.81 - 1.31 1.05 0.82 - 1.34 0.90 0.60 - 1.34 0.98 0.66 - 1.45

Observations 1,862 1,827 1,891 1,846

Note: *p<0.05; **p<0.01; ***p<0.001; + Stunting n= 1,843; Wasting n=1,872; ++Stunting n= 1,827; Wasting n=1,846

Continues...
139

Appendix Table A5—Continued

Senegal

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 0.61*** 0.51 - 0.72 0.62*** 0.52 - 0.74 0.94 0.73 - 1.21 0.92 0.70 - 1.22

Middle 0.52*** 0.42 - 0.64 0.53*** 0.42 - 0.67 1.05 0.79 - 1.39 1.09 0.80 - 1.49

Rich 0.42*** 0.35 - 0.50 0.41*** 0.33 - 0.50 0.81 0.61 - 1.07 0.81 0.59 - 1.12

Richest 0.28*** 0.22 - 0.35 0.27*** 0.21 - 0.34 0.65* 0.47 - 0.91 0.71* 0.51 - 0.99

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.99 0.83 - 1.18 1.23* 1.04 - 1.45 0.76* 0.61 - 0.96 0.80 0.64 - 1.01

Wealthy relative to 

community

0.85 0.71 - 1.02 1.26* 1.02 - 1.55 0.84 0.65 - 1.08 0.88 0.67 - 1.16

Maternal 

education +

None (Ref)

Primary 0.78** 0.65 - 0.93 0.91 0.75 - 1.10 0.87 0.65 - 1.15 0.94 0.72 - 1.22

Secondary or higher 0.71* 0.54 - 0.94 0.93 0.68 - 1.26 0.60** 0.43 - 0.82 0.65* 0.45 - 0.93

Birth order ++ First (Ref)

Second thru fourth 1.08 0.92 - 1.26 1.03 0.86 - 1.22 1.04 0.80 - 1.35 0.97 0.74 - 1.26

Fifth or higher 1.25** 1.06 - 1.47 1.11 0.92 - 1.33 1.30 0.99 - 1.69 1.14 0.87 - 1.50

Sex of child Male child (Ref)

Female child 0.84** 0.75 - 0.94 0.85** 0.75 - 0.96 0.75** 0.64 - 0.90 0.73** 0.60 - 0.88

Observations 7,291 7,154 8,060 7,204

Note: *p<0.05; **p<0.01; ***p<0.001; + Stunting n= 7,404; Wasting n=7,469; ++Stunting n= 7,154; Wasting n=7,204

Zambia

Stunting Wasting

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Unadjusted 

Odds Ratio 95% CI

Adjusted 

Odds Ratio 95% CI

Wealth quintile Poorest (Ref)

Poorest 1.03 0.87 - 1.22 1.08 0.90 - 1.30 0.65* 0.42 - 1.00 0.69 0.41 - 1.18

Middle 0.87 0.72 - 1.04 0.89 0.72 - 1.10 0.89 0.57 - 1.37 0.89 0.52 - 1.54

Rich 0.82* 0.68 - 0.99 0.89 0.72 - 1.12 0.58* 0.37 - 0.90 0.56 0.31 - 1.02

Richest 0.64*** 0.53 - 0.78 0.73** 0.57 - 0.93 0.64 0.40 - 1.01 0.69 0.38 - 1.26

Relative 

community 

wealth

Poor relative to 

community (Ref)

Wealth similar to 

community

0.98 0.85 - 1.14 1.07 0.92 - 1.25 1.05 0.77 - 1.44 1.08 0.77 - 1.53

Wealthy relative to 

community

0.93 0.80 - 1.08 1.04 0.87 - 1.24 0.92 0.64 - 1.34 1.06 0.66 - 1.71

Maternal 

education +

None (Ref)

Primary 0.94 0.78 - 1.13 0.96 0.79 - 1.16 0.66 0.42 - 1.05 0.71 0.44 - 1.15

Secondary or higher 0.68*** 0.54 - 0.85 0.73* 0.57 - 0.94 0.61 0.34 - 1.09 0.68 0.36 - 1.27

Birth order ++ First (Ref)

Second thru fourth 0.92 0.80 - 1.07 0.89 0.77 - 1.03 1.04 0.73 - 1.46 1.01 0.72 - 1.41

Fifth or higher 0.92 0.79 - 1.08 0.84* 0.71 - 0.99 0.99 0.66 - 1.48 0.92 0.62 - 1.36

Sex of child Male child (Ref)

Female child 0.73*** 0.66 - 0.82 0.73*** 0.65 - 0.82 0.90 0.69 - 1.17 0.92 0.69 - 1.21

Observations 6,744 6,138 6,743 6,115

Note: *p<0.05; **p<0.01; ***p<0.001; + Stunting n=6,279; Wasting n=6,259; ++ Stunting n=6,138; Wasting n=6,115
140

Appendix Table A6 Average Marginal Effects (AMEs) and 95% Confidence Intervals (CI) of being a poor household relative to 

being a rich household relative to community on each outcome by country

DRC

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.08*** 0.02 - 0.14 0.26*** 0.17 - 0.36 0.00 -0.01 - 0.02 0.22*** 0.13 - 0.31 0.00 -0.14 - 0.15 0.00 -0.0

Poorest 0.08*** 0.02 - 0.15 0.24*** 0.16 - 0.33 0.00 -0.02 - 0.02 0.24*** 0.14 - 0.34 0.00 -0.14 - 0.15 0.00 -0.0

Middle 0.08*** 0.01 - 0.15 0.19*** 0.12 - 0.26 0.00 -0.02 - 0.03 0.24*** 0.14 - 0.34 0.00 -0.16 - 0.16 0.00 -0.0

Rich 0.08*** 0.02 - 0.15 0.17*** 0.11 - 0.22 0.00 -0.02 - 0.02 0.23*** 0.14 - 0.32 0.00 -0.15 - 0.16 0.00 -0.0

Richest 0.08*** 0.01 - 0.15 0.09*** 0.06 - 0.12 0.00 -0.04 - 0.04 0.19*** 0.12 - 0.27 0.00 -0.15 - 0.16 0.00 -0.0

Observations 6,757 6,757 8,668 2,393 778 3,648 

Note: *p<0.05; **p<0.01; ***p<0.001

DRC

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.11*** 0.00 - 0.21 0.04 -0.01 - 0.09 -0.00 -0.04 - 0.03

Poorest 0.11 -0.00 - 0.22 0.04 -0.01 - 0.09 -0.00 -0.03 - 0.03

Middle 0.11 -0.00 - 0.22 0.04 -0.01 - 0.09 -0.00 -0.04 - 0.03

Rich 0.11 -0.00 - 0.22 0.04 -0.01 - 0.09 -0.00 -0.04 - 0.03

Richest 0.11 -0.00 - 0.22 0.04 -0.01 - 0.09 -0.00 -0.04 - 0.03

Observations 1,348 5,697 5,697

Note: *p<0.05; **p<0.01; ***p<0.001
141

Appendix Table A6—Continued

Ghana

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.05 -0.06 - 0.17 0.08 -0.05 - 0.20 -0.02 -0.07 - 0.03 0.04 -0.10 - 0.18 -0.00 -0.33 - 0.33 0.11 -0.0

Poorest 0.05 -0.05 - 0.15 0.08 -0.05 - 0.20 -0.02 -0.09 - 0.04 0.02 -0.06 - 0.11 -0.00 -0.33 - 0.33 0.11 -0.0

Middle 0.05 -0.04 - 0.14 0.07 -0.05 - 0.19 -0.02 -0.09 - 0.04 0.03 -0.07 - 0.14 -0.00 -0.30 - 0.30 0.11 -0.0

Rich 0.03 -0.03 - 0.10 0.07 -0.04 - 0.17 -0.02 -0.08 - 0.04 0.03 -0.07 - 0.13 -0.00 -0.32 - 0.32 0.09 -0.0

Richest 0.01 -0.01 - 0.03 0.04 -0.02 - 0.10 -0.02 -0.08 - 0.04 0.01 -0.02 - 0.04 -0.00 -0.36 - 0.36 0.08 -0.0

Observations 2,145 2,145 2,997 676 130 522 

Note: *p<0.05; **p<0.01; ***p<0.001

Ghana

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.09 -0.27 - 0.10 -0.04 -0.10 - 0.03 -0.01 -0.03 - 0.02

Poorest -0.10 -0.29 - 0.10 -0.03 -0.09 - 0.03 -0.01 -0.03 - 0.02

Middle -0.10 -0.29 - 0.09 -0.03 -0.08 - 0.02 -0.01 -0.03 - 0.02

Rich -0.10 -0.29 - 0.10 -0.02 -0.05 - 0.01 -0.00 -0.02 - 0.01

Richest -0.09 -0.27 - 0.08 -0.01 -0.03 - 0.01 -0.01 -0.02 - 0.01

Observations 519 4,018 4,000

Note: *p<0.05; **p<0.01; ***p<0.001
142

Appendix Table A6—Continued

Haiti

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.04 -0.06 - 0.13 0.06*** 0.04 - 0.09 -0.01 -0.06 - 0.03 0.17*** 0.06 - 0.28 -0.06 -0.23 - 0.10 0.13*** 0.0

Poorest 0.04 -0.06 - 0.13 0.10*** 0.05 - 0.15 -0.01 -0.06 - 0.04 0.18*** 0.05 - 0.30 -0.06 -0.22 - 0.10 0.13*** 0.0

Middle 0.04 -0.06 - 0.13 0.12*** 0.06 - 0.19 -0.01 -0.06 - 0.03 0.18*** 0.05 - 0.30 -0.05 -0.19 - 0.09 0.16*** 0.0

Rich 0.03 -0.05 - 0.11 0.15*** 0.08 - 0.22 -0.02 -0.07 - 0.04 0.18*** 0.05 - 0.30 -0.06 -0.21 - 0.09 0.17*** 0.0

Richest 0.02 -0.03 - 0.08 0.13*** 0.07 - 0.19 -0.01 -0.06 - 0.03 0.13*** 0.04 - 0.22 -0.07 -0.26 - 0.12 0.17*** 0.0

Observations 2,965 2,965 4,944 844 419 1,296 

Note: *p<0.05; **p<0.01; ***p<0.001

Haiti

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.09 -0.27 - 0.10 -0.04 -0.10 - 0.03 -0.01 -0.03 - 0.02

Poorest -0.10 -0.29 - 0.10 -0.03 -0.09 - 0.03 -0.01 -0.03 - 0.02

Middle -0.10 -0.29 - 0.09 -0.03 -0.08 - 0.02 -0.01 -0.03 - 0.02

Rich -0.10 -0.29 - 0.10 -0.02 -0.05 - 0.01 -0.00 -0.02 - 0.01

Richest -0.09 -0.27 - 0.08 -0.01 -0.03 - 0.01 -0.01 -0.02 - 0.01

Observations 519 4,018 4,000

Note: *p<0.05; **p<0.01; ***p<0.001
143

Appendix Table A6—Continued

Indonesia

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.09*** 0.03 - 0.15 0.16*** 0.09 - 0.23 0.00 -0.02 - 0.03 0.13*** 0.02 - 0.23 -0.08 -0.23 - 0.07 -0.01 -0.0

Poorest 0.06*** 0.02 - 0.09 0.16*** 0.09 - 0.22 0.00 -0.02 - 0.03 0.12*** 0.02 - 0.21 -0.07 -0.21 - 0.06 -0.01 -0.0

Middle 0.05*** 0.02 - 0.08 0.13*** 0.07 - 0.18 0.00 -0.02 - 0.03 0.10*** 0.02 - 0.18 -0.04 -0.14 - 0.05 -0.01 -0.0

Rich 0.04*** 0.02 - 0.06 0.11*** 0.07 - 0.15 0.00 -0.02 - 0.03 0.09*** 0.02 - 0.15 -0.08 -0.25 - 0.08 -0.01 -0.0

Richest 0.02*** 0.01 - 0.03 0.07*** 0.04 - 0.09 0.00 -0.02 - 0.03 0.09*** 0.03 - 0.15 -0.05 -0.14 - 0.05 -0.00 -0.0

Observations 7,527 7,527 17,147 1,790 446 2,810 

Note: *p<0.05; **p<0.01; ***p<0.001

Indonesia

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.10 -0.20 - 0.00 NA NA

Poorest -0.11 -0.22 - 0.00 NA NA

Middle -0.11 -0.22 - 0.00 NA NA

Rich -0.12 -0.23 - 0.00 NA NA

Richest -0.12 -0.24 - 0.00 NA NA

Observations 899

Note: *p<0.05; **p<0.01; ***p<0.001
144

Appendix Table A6—Continued

Kenya

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.00 -0.04 - 0.05 0.11*** 0.07 - 0.15 0.13*** 0.10 - 0.16 0.04 -0.05 - 0.13 -0.00 -0.10 - 0.10 -0.02 -0.0

Poorest 0.00 -0.04 - 0.05 0.14*** 0.09 - 0.19 0.18*** 0.15 - 0.22 0.02 -0.03 - 0.08 -0.00 -0.09 - 0.09 -0.02 -0.0

Middle 0.00 -0.04 - 0.05 0.14*** 0.09 - 0.19 0.18*** 0.14 - 0.22 0.02 -0.03 - 0.07 -0.00 -0.10 - 0.10 -0.02 -0.0

Rich 0.00 -0.04 - 0.05 0.12*** 0.08 - 0.16 0.17*** 0.13 - 0.20 0.02 -0.02 - 0.06 -0.00 -0.10 - 0.10 -0.02 -0.0

Richest 0.00 -0.03 - 0.04 0.07*** 0.04 - 0.09 0.15*** 0.12 - 0.18 0.01 -0.01 - 0.03 -0.00 -0.09 - 0.09 -0.02 -0.0

Observations 8,152 8,152 12,230 2,791 1,195 3,274 

Note: *p<0.05; **p<0.01; ***p<0.001

Kenya

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.11 -0.27 - 0.06 -0.05*** -0.09 - -0.01 -0.06*** -0.09 - -0.02

Poorest -0.11 -0.28 - 0.06 -0.05*** -0.09 - -0.01 -0.03*** -0.04 - -0.01

Middle -0.11 -0.28 - 0.06 -0.05*** -0.08 - -0.01 -0.02*** -0.03 - -0.01

Rich -0.11 -0.29 - 0.06 -0.04*** -0.07 - -0.01 -0.02*** -0.03 - -0.01

Richest -0.10 -0.26 - 0.06 -0.03*** -0.06 - -0.01 -0.01*** -0.02 - -0.00

Observations 585 12,755 12,755

Note: *p<0.05; **p<0.01; ***p<0.001
145

Appendix Table A6—Continued

Liberia

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.15*** 0.06 - 0.24 0.12*** 0.05 - 0.19 0.04*** 0.01 - 0.07 0.31*** 0.19 - 0.44 0.06 -0.14 - 0.25 0.05 -0.0

Poorest 0.13*** 0.05 - 0.21 0.13*** 0.05 - 0.21 0.05*** 0.01 - 0.09 0.31*** 0.18 - 0.44 0.06 -0.15 - 0.27 0.05 -0.0

Middle 0.12*** 0.05 - 0.19 0.13*** 0.05 - 0.21 0.06*** 0.01 - 0.10 0.27*** 0.15 - 0.38 0.06 -0.16 - 0.28 0.05 -0.0

Rich 0.10*** 0.05 - 0.16 0.13*** 0.05 - 0.21 0.07*** 0.01 - 0.13 0.23*** 0.13 - 0.33 0.06 -0.16 - 0.28 0.05 -0.0

Richest 0.07*** 0.03 - 0.12 0.12*** 0.05 - 0.20 0.08*** 0.02 - 0.14 0.16*** 0.08 - 0.24 0.06 -0.16 - 0.28 0.05 -0.0

Observations 2,761 2,761 3,863 961 365 1,552 

Note: *p<0.05; **p<0.01; ***p<0.001

Liberia

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.08 -0.04 - 0.19 0.10 -0.08 - 0.28 -0.04 -0.11 - 0.03

Poorest 0.09 -0.05 - 0.22 0.10 -0.08 - 0.28 -0.04 -0.11 - 0.03

Middle 0.09 -0.05 - 0.22 0.09 -0.07 - 0.24 -0.04 -0.10 - 0.03

Rich 0.09 -0.05 - 0.22 0.09 -0.07 - 0.26 -0.04 -0.11 - 0.02

Richest 0.09 -0.05 - 0.22 0.09 -0.07 - 0.26 -0.03 -0.09 - 0.02

Observations 1,186 497 2,243

Note: *p<0.05; **p<0.01; ***p<0.001
146

Appendix Table A6—Continued

Mali

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or trea

sought for fe

symptom

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 9

Household wealth quintile

Poorest 0.11*** 0.08 - 0.15 0.25*** 0.17 - 0.33 0.05*** 0.02 - 0.07 -0.09 -0.19 - 0.00 -0.08 -0.44 - 0.29 -0.01 -0.1

Poorest 0.14*** 0.09 - 0.18 0.26*** 0.16 - 0.36 0.05*** 0.02 - 0.07 -0.09 -0.18 - 0.00 -0.09 -0.52 - 0.33 -0.01 -0.1

Middle 0.15*** 0.09 - 0.20 0.25*** 0.16 - 0.34 0.06*** 0.02 - 0.09 -0.09 -0.18 - 0.00 -0.09 -0.49 - 0.31 -0.01 -0.0

Rich 0.16*** 0.10 - 0.22 0.21*** 0.14 - 0.28 0.08*** 0.03 - 0.13 -0.08 -0.17 - 0.01 -0.06 -0.34 - 0.23 -0.01 -0.1

Richest 0.16*** 0.11 - 0.22 0.11*** 0.07 - 0.14 0.09*** 0.03 - 0.14 -0.08 -0.17 - 0.01 -0.09 -0.54 - 0.35 -0.01 -0.1

Observations 4,495 4,495 5,963 1,438 86 1,174 

Note: *p<0.05; **p<0.01; ***p<0.001

Mali

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.01 -0.13 - 0.10 -0.04*** -0.09 - -0.00 0.01 -0.02 - 0.03

Poorest -0.01 -0.13 - 0.11 -0.04*** -0.08 - -0.00 0.01 -0.02 - 0.03

Middle -0.01 -0.13 - 0.10 -0.04*** -0.08 - -0.00 0.01 -0.02 - 0.03

Rich -0.01 -0.13 - 0.10 -0.04*** -0.08 - -0.00 0.01 -0.02 - 0.03

Richest -0.01 -0.12 - 0.09 -0.03*** -0.05 - -0.00 0.01 -0.01 - 0.02

Observations 751 6,270 6,397

Note: *p<0.05; **p<0.01; ***p<0.001
147

Appendix Table A6—Continued

Nigeria

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or treatment 

sought for fever 

symptoms

Advice or treatment 

sought for diarrhea

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.08*** 0.05 - 0.11 0.04*** 0.03 - 0.06 0.01*** 0.00 - 0.01 0.07*** 0.03 - 0.11 0.00 -0.18 - 0.19 0.04 -0.03 - 0.11 0.03 -0.06 - 0.11

Poorest 0.10*** 0.06 - 0.14 0.07*** 0.05 - 0.10 0.01*** 0.00 - 0.02 0.09*** 0.03 - 0.15 0.00 -0.17 - 0.18 0.04 -0.02 - 0.10 0.03 -0.05 - 0.11

Middle 0.10*** 0.06 - 0.15 0.10*** 0.06 - 0.13 0.01*** 0.00 - 0.03 0.10*** 0.03 - 0.16 0.00 -0.18 - 0.19 0.04 -0.02 - 0.10 0.03 -0.06 - 0.11

Rich 0.10*** 0.06 - 0.15 0.13*** 0.08 - 0.18 0.02*** 0.00 - 0.05 0.10*** 0.04 - 0.17 0.00 -0.16 - 0.17 0.04 -0.02 - 0.10 0.03 -0.05 - 0.11

Richest 0.08*** 0.04 - 0.11 0.13*** 0.08 - 0.17 0.03 -0.00 - 0.07 0.10*** 0.04 - 0.16 0.00 -0.14 - 0.15 0.03 -0.02 - 0.09 0.02 -0.05 - 0.10

Observations 13,320 13,320 18,485 3,959 565 5,390 2,858

Note: *p<0.05; **p<0.01; ***p<0.001

Nigeria

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.01 -0.06 - 0.07 -0.12*** -0.16 - -0.07 -0.04*** -0.08 - -0.00

Poorest 0.01 -0.06 - 0.07 -0.12*** -0.16 - -0.07 -0.03*** -0.06 - -0.00

Middle 0.00 -0.05 - 0.06 -0.12*** -0.16 - -0.07 -0.03*** -0.06 - -0.00

Rich 0.01 -0.06 - 0.07 -0.11*** -0.15 - -0.07 -0.02*** -0.05 - -0.00

Richest 0.01 -0.08 - 0.09 -0.09*** -0.12 - -0.05 -0.02*** -0.04 - -0.00

Observations 2,098 6,920 6,957

Note: *p<0.05; **p<0.01; ***p<0.001

Continues...
148

Appendix Table A6—Continued

Pakistan

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or treatment 

sought for fever 

symptoms

Advice or treatment 

sought for diarrhea

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.12*** 0.07 - 0.17 0.05 -0.04 - 0.14 0.03 -0.00 - 0.07 0.34*** 0.21 - 0.47 0.14 -0.04 - 0.31 0.09 -0.02 - 0.20 0.03 -0.10 - 0.17

Poorest 0.14*** 0.08 - 0.19 0.05 -0.04 - 0.14 0.03 -0.00 - 0.07 0.31*** 0.18 - 0.44 0.13 -0.04 - 0.30 0.09 -0.02 - 0.20 0.03 -0.10 - 0.16

Middle 0.16*** 0.09 - 0.23 0.05 -0.04 - 0.14 0.04 -0.00 - 0.08 0.28*** 0.16 - 0.39 0.12 -0.03 - 0.27 0.09 -0.02 - 0.19 0.03 -0.10 - 0.17

Rich 0.17*** 0.09 - 0.24 0.04 -0.03 - 0.11 0.04 -0.00 - 0.09 0.18*** 0.10 - 0.26 0.11 -0.02 - 0.25 0.08 -0.02 - 0.18 0.03 -0.10 - 0.17

Richest 0.12*** 0.07 - 0.17 0.02 -0.02 - 0.06 0.04 -0.00 - 0.09 0.09*** 0.04 - 0.13 0.09 -0.02 - 0.19 0.08 -0.02 - 0.17 0.03 -0.10 - 0.16

Observations 3,595 3,595 6,036 1,012 720 1,915 993

Note: *p<0.05; **p<0.01; ***p<0.001

Pakistan

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.21*** -0.38 - -0.04 -0.08 -0.17 - 0.01 -0.04 -0.08 - 0.01

Poorest -0.20*** -0.37 - -0.03 -0.08 -0.17 - 0.01 -0.05 -0.10 - 0.01

Middle -0.21*** -0.38 - -0.04 -0.08 -0.16 - 0.01 -0.03 -0.06 - 0.00

Rich -0.21*** -0.38 - -0.04 -0.07 -0.14 - 0.01 -0.03 -0.06 - 0.00

Richest -0.18*** -0.33 - -0.04 -0.06 -0.13 - 0.00 -0.01 -0.03 - 0.00

Observations 619 1,827 1,846

Note: *p<0.05; **p<0.01; ***p<0.001

Continues...
149

Appendix Table A6—Continued

Senegal

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or treatment 

sought for fever 

symptoms

Advice or treatment 

sought for diarrhea

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.01 -0.04 - 0.06 0.18*** 0.10 - 0.26 -0.00 -0.03 - 0.03 0.12 -0.01 - 0.24 -0.04 -0.21 - 0.12 0.03 -0.04 - 0.11 0.01 -0.07 - 0.08

Poorest 0.01 -0.04 - 0.07 0.18*** 0.09 - 0.26 -0.00 -0.04 - 0.04 0.08 -0.01 - 0.17 -0.07 -0.31 - 0.17 0.04 -0.04 - 0.11 0.01 -0.08 - 0.09

Middle 0.01 -0.04 - 0.07 0.14*** 0.08 - 0.21 -0.00 -0.04 - 0.04 0.04*** 0.01 - 0.08 -0.06 -0.28 - 0.16 0.04 -0.05 - 0.12 0.01 -0.08 - 0.09

Rich 0.01 -0.04 - 0.07 0.10*** 0.06 - 0.15 -0.00 -0.04 - 0.04 0.04*** 0.00 - 0.07 -0.06 -0.27 - 0.15 0.04 -0.05 - 0.12 0.01 -0.08 - 0.09

Richest 0.01 -0.04 - 0.06 0.06*** 0.03 - 0.09 -0.00 -0.04 - 0.04 0.03 -0.00 - 0.06 -0.06 -0.26 - 0.15 0.04 -0.05 - 0.13 0.01 -0.08 - 0.09

Observations 5,119 5,088 7,102 1,593 248 1,523 1,489

Note: *p<0.05; **p<0.01; ***p<0.001

Senegal

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest 0.11*** 0.00 - 0.22 -0.05*** -0.09 - -0.00 0.01 -0.02 - 0.04

Poorest 0.11*** 0.00 - 0.21 -0.04*** -0.07 - -0.00 0.01 -0.01 - 0.04

Middle 0.12*** 0.00 - 0.23 -0.03*** -0.07 - -0.00 0.01 -0.02 - 0.04

Rich 0.11 -0.00 - 0.22 -0.03*** -0.06 - -0.00 0.01 -0.01 - 0.03

Richest 0.12*** 0.00 - 0.23 -0.02*** -0.04 - -0.00 0.01 -0.01 - 0.03

Observations 774 7,154 7,204

Note: *p<0.05; **p<0.01; ***p<0.001

Continues...
150

Appendix Table A6—Continued

Zambia

4+ ANC visits

Delivered in 

health facility

Modern 

contraceptive use

3 doses of 

Pentavalent vaccine

Treatment for ARI 

symptoms

Advice or treatment 

sought for fever 

symptoms

Advice or treatment 

sought for diarrhea

AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.00 -0.05 - 0.05 0.08*** 0.01 - 0.16 0.06*** 0.02 - 0.10 0.08 -0.02 - 0.18 -0.18 -0.50 - 0.15 -0.06 -0.16 - 0.03 -0.02 -0.12 - 0.08

Poorest -0.00 -0.05 - 0.05 0.07*** 0.01 - 0.13 0.07*** 0.01 - 0.12 0.06 -0.01 - 0.13 -0.08 -0.23 - 0.07 -0.05 -0.13 - 0.03 -0.02 -0.11 - 0.07

Middle -0.00 -0.05 - 0.05 0.06*** 0.01 - 0.11 0.07*** 0.01 - 0.12 0.06*** 0.00 - 0.11 -0.15 -0.42 - 0.13 -0.05 -0.13 - 0.03 -0.02 -0.12 - 0.08

Rich -0.00 -0.05 - 0.05 0.06*** 0.01 - 0.11 0.07*** 0.01 - 0.12 0.05 -0.00 - 0.10 -0.15 -0.46 - 0.15 -0.05 -0.14 - 0.03 -0.02 -0.11 - 0.07

Richest -0.00 -0.05 - 0.05 0.03*** 0.01 - 0.06 0.07*** 0.01 - 0.12 0.01 -0.00 - 0.03 -0.14 -0.46 - 0.17 -0.06 -0.15 - 0.04 -0.02 -0.14 - 0.09

Observations 3,790 3,790 5,002 1,338 109 1,151 1,019

Note: *p<0.05; **p<0.01; ***p<0.001

Zambia

Exclusively 

breast-feeding

Stunted child

under 5 years

Wasted child 

under 5 years

AME 95% CI AME 95% CI AME 95% CI

Household wealth quintile

Poorest -0.05 -0.17 - 0.08 -0.01 -0.05 - 0.03 -0.00 -0.03 - 0.02

Poorest -0.05 -0.17 - 0.08 -0.01 -0.05 - 0.03 -0.00 -0.02 - 0.01

Middle -0.04 -0.16 - 0.07 -0.01 -0.05 - 0.03 -0.00 -0.02 - 0.02

Rich -0.04 -0.13 - 0.06 -0.01 -0.05 - 0.03 -0.00 -0.01 - 0.01

Richest -0.04 -0.15 - 0.07 -0.01 -0.04 - 0.03 -0.00 -0.02 - 0.01

Observations 729 6,138 6,115

Note: *p<0.05; **p<0.01; ***p<0.001