Malnutrition in children is a pathological condition resulting from deficiency, excess or imbalance of food intake. Its most common form in West and Central Africa is chronic malnutrition, which affects one third of children under five [1]. Chronic malnutrition can be recognized in children by their relatively small size for their age, hence the term “stunting” used for the same condition. It has harmful short and long term health effects [2, 3]. It reduces the physical and intellectual capacities of children, thus affecting their productivity even in adulthood [4]. These harmful consequences and the widespread of malnutrition have led Governments to commit to reduce the number of chronically malnourished children under five by 40% by 2025 (compared to 2012 levels) [5], and to eliminate it completely by 2030 [6]. A good knowledge of the factors associated with chronic malnutrition is essential to achieve these goals.
A review of empirical studies shows that child, household, and community-related factors are associated with chronic child malnutrition [7–15]. Child gender is one of the factors associated with chronic malnutrition. The effect of gender most often leads to a higher risk of chronic malnutrition in boys compared to girls and is widely shared in West and Central Africa [10, 12, 13, 15–21]. Besides, the reasons given in previous studies to explain these gender inequalities are not always scientifically supported [22]. Among these reasons, it appears that the greater risk of chronic malnutrition among boys is partly related to a higher frequency of premature births (a major factor of poor health) among male births compared to female births, or to a higher prevalence of illnesses among boys in early life [11, 23, 24]. Thus, the fact that girls are less frequently ill than boys may explain why boys are more likely to be stunted.
Mothers’ level of education is also a critical factor in child health. In developing countries, more than half of the reduction in child mortality between 1990 and 2009 was attributed to improvements in the education of women of reproductive age [25]. Its effects on chronic child malnutrition have also been demonstrated in several studies. For example, for the period ranging from 2000 to 2021, we found thirteen studies showing that the mothers’ low level of education is a risk factor for the occurrence of chronic malnutrition in children in West and Central African countries [11–13, 15, 16, 20, 26–32].
Through its action mechanism, maternal education would reduce children’s vulnerability to disease. Indeed, compliance with good hygiene and sanitation practices reduces the frequency of diseases in children. Since educated mothers generally have good hygiene and sanitation practices, this could help reduce the incidence of disease in their children, both boys and girls [33]. Therefore, by helping to reduce the prevalence of disease, maternal education could mitigate the effects of a child’s gender on his or her propensity to suffer from chronic malnutrition. A systematic review which showed that the gender effect on chronic malnutrition is only significant in children from disadvantaged socioeconomic backgrounds (including children of uneducated mothers) seems to support this assumption of the existence of a mitigating effect of maternal education [24]. However, to the best of our knowledge, this ability of maternal education to mitigate gender inequalities of chronic malnutrition has not yet been empirically proven, especially in Sub-Saharan Africa. This paper therefore aims at filling this knowledge gap by analyzing the moderating effect of maternal education on child’s gender-related vulnerability to chronic malnutrition in Burkina Faso.