To What Extent Does Political Corruption Impact Malnutrition In Children?

Abstract

Political corruption influences various state welfare sectors, thereby impacting various socio-economic and public health areas, which affect millions of people around the globe. One of these focus areas is malnutrition among children, which this research design proposal investigates the relationship into. With support of existing literature in related fields and publicly available data, this work aims to answer the following question: to what extent does political corruption affect malnutrition in children? The research offers insight to the hypotheses through the literature review, research question, methodology, theoretical expectations, study populations, and conclusion.

Introduction

Over many centuries, political systems in numerous countries have moved away from hierarchal structures where one exclusive individual, or sometimes even a few elites, are prioritized over the rest of the people in that country. Societies have embraced change for systems where the welfare of communities are brought into the spotlight, in order to raise the overall global standard of living by allowing for better and more universal education as well as improving general public health. Included here are worldwide campaigns to eradicate preventable deaths and illnesses related nutrition and food security. However, unfortunately to this day, many people, and children in particular, remain heavily affected by diseases that could have and can be prevented, such as those relating to malnutrition (Weininger, 2018). A few examples of such illnesses include “cystic fibrosis, chronic obstructive pulmonary disease, chronic kidney failure, chronic heart failure, cancer, and inflammatory bowel disease” among others (What is disease-related malnutrition?, n.d.). However, while the circumstances of various countries are, inherently different (through factors like history, geography, or available resources to name a few) this paper explores whether countries that experience higher levels of corruption in their political system also see higher occurrences of malnutrition in children.

Literature Review

In a 2011 study, a team of researchers published an article titled “Corruption Kills: Estimating the Global Impact of Corruption on Children’s Deaths” in which they scrutinized the impact of political corruption on child mortality. Prior to the study, scholarly literature existed in support of the notion that corruption has a negative impact on the deaths of children, though the team wanted to gain further insight (Hanf et al., 2011). By using a multivariate model, they found that corruption lead to an estimated minimum of 140,000 deaths of children. A significant variable in the study was “the percentage of people with improved sanitation”. This may be interpreted as overall sanitation including hygiene practices in health services, but also relating to cleanliness around water resources leading to water-borne diseases. The authors of the study warn that “without paying regard to the anti-corruption mechanisms needed to ensure” improved sanitation practices, global trends could continue to result in more deaths of children around the globe, while also allowing for more corrupt government practices to occur (Hanf et al, 2011).

They elaborate by stating that, “in the developing world, 80 per cent of health problems can be linked back to inadequate water and sanitation” (Hanf et al., 2011). These staggering findings relate to my thesis of corruption impacting malnutrition in all persons (thus of course including children), which I wish to recreate with some changes in this research. (This is further elaborated in the Methodology section of this paper.)

In a similar study published in The Pan African Medical Journal in 2015, Florence Nguzi Uchendu and Thaddeus Olatunbosun Abolarin examine corruption and its impact on food security and life expectancy in developing countries. Based on their findings, they write, “improvement in government policies to discourage corrupt practices, promote good governance, primary healthcare, mechanized agriculture, household food security, availability of portable water, and nutrition education at [the] community level should be embraced to eradicate malnutrition in developing countries.” They attribute corruption as being a factor which influences “socio-political problems” in developing countries. Here, a consequence of these problems is the negative influence on overall food security and life expectancy (Uchendu & Abolarin, 2015). Like “Corruption Kills”, I wish to further investigate the socio-political element of nutrition as influenced by corruption on its impact on children’s deaths and will reference Uchendu & Abolarin’s work. Their findings offer indirect support for my hypothesis, which would be tested in my multivariate model (to which I write more about in the Methodology section of this paper).

Lastly, another significant study relating to the topic of my research is Rebekah Burroway’s “Democracy and child health in developing countries” published in the International Journal of Comparative Sociology in 2016. As measures of child health, Burroway scrutinizes diarrhea and malnutrition across 52 countries by conducting a multivariate analysis model with control variables including level of education, socio-economic factors, and household wealth in her regression model. The results of her study suggest that democracy does not have a significant effect on health; though GDP, water sanitation, and socio-economic factors do. Interestingly, her research findings contrast with existing literature, and instead “support a small but growing” collection of recent studies that closely reexamine the previously established relationship between democracy and health (Burroway, 2016).

Research Question

Given existing literature and interest for politics and public health, the fundamental research question of this work is: to what extent does political corruption impact malnutrition in children?

Before presenting the paper’s hypotheses, it is crucial to conceptualize terms that are central to this paper. These are specified below:

• Child: a human being below the age of five (5) years. (While the United Nations Convention on the Rights of the Child or UNCRC defines children as “human beings below 18 years of age” [United Nations, 1989], I limit the scope in my research paper on basis of willingness to investigate into the effect of political corruption on infants and young children exclusively.)
• Corruption: “The manipulation of policies, institutions and rules of procedure in the allocation of resources and financing by political decision makers, who abuse their position to sustain their power, status, and wealth” (Transparency International, n.d.).
• Malnutrition: “Deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients” (World Health Organization, 2016). While malnutrition may refer to “undernutrition” or “overweight, obesity, and diet-related noncommunicable diseases”, only the former reference is meant throughout this paper when labeled as malnutrition. Unless otherwise specified, it includes stunting, wasting, underweight, and micronutrient deficiencies and insufficiencies (World Health Organization, 2016).

Methodology

Similar to the Hanf et al. and Uchendu & Abolarin publications, the research design for this project is a quantitative, population-based study with all necessary data available online and accessible for public use. More specifically, the study relies on the Borrow-A-Method research approach modeled in likes of the “Corruption Kills” publication. Here similarities include the style in which the multivariate regression is constructed in order to determine whether a significant correlation between the variables exists.

To measure the independent variable, corruption, Hanf et al. and Uchendu & Abolarin used Transparency International’s Corruption Perceptions Index or CPI. The index observes 180 countries around the world, ranking them on a scale of perceived corruption as determined by specialists and businesspeople (Transparency International e.V., 2018). Then a score between 0 and 100 is assigned to the country as its rank, where 0 indicates a country is highly corrupt while 100 indicates a country is very clean (Transparency International e.V., 2018).

To measure the dependent variable, malnutrition in children, this project draws time-pooled, country data from the World Bank databank.

Hanf et. al control for “socio-economic conditions, vaccination coverage, health service level, undernutrition, climate, war and natural disasters, and the interaction between political context and corruption in their estimation of child deaths affected by corruption” (Hanf et. al, 2011). In my study, I too would control for “health service level, [omission of undernutrition] climate, war and natural disasters, and the interaction between political context and corruption” as these variables could potentially confound the relationship between political corruption and malnutrition. This is because the lack of access to health services could worsen the impact of malnutrition, where as climate could affect the availability of staple foods in given areas thus potentially contributing to undernutrition. Similarly, times of war and natural disasters could hinder the access to food supplies or affect agriculture in given areas, while the interaction between political context and corruption could also be an influencing factor on corruption affecting malnutrition.

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The empirical process performed by Hanf et al. used log transformations of the dependent variable, 2008 data of child deaths per 1000 births for 178 countries. The researchers then performed a Focused Principal Components Analysis to interpret the correlation between all quantitative variables (Hanf et al., 2011). They looked closer at the six variables that were most significant, those being: “the log of health expenditure per capita, the log of GDP per capita, the percentage of people with access to improved sanitation, the dependency ratio, the food supply, and the perceived corruption” (Hanf et al., 2011). They also looked at variables that correlated most with CPI, which were “the health expenditure per capita, the GDP per capita, civil liberties index, the food supply, the political rights index, and the percentage of rural people” (Hanf et al., 2011). Next they executed multivariate regressions, including significant variables in the model to determine their results, which they checked afterwards for measurement errors like homoscedasticity and multicollinearity.

Due to statistical shortcomings on my part, my research would include more basic models. Using the same strategy, I would recreate testing for significant variables impacting the dependent and independent variables, then using these in a multivariate regression to test for the correlation between malnutrition in children and political corruption. Finally, I would also examine whether the models include measurement errors. When reporting the results, it would then crucial to explain which variables were significant to have been included in the regression model and what their importance to the outcome is. Here it would also be essential to make note of variables that have been operationalized for the purpose of the study and to explain how and why this was done.

Theoretical Expectations

Based on existing literature pertaining to corruption and measures of public health, I would expect the regression model to confirm the existence of a positive correlation between higher levels of corruption (or lower CPI scores) and higher levels of malnutrition among children. I anticipate these results on basis that more corruption leads to less government investment in societal welfare initiatives such as education, healthcare service, and/or the sanitation sector (Burroway, 2016). Thus, this would thus allow for less food security in given areas, which could likely result in more malnutrition.

Another point to consider in relation to this topic is: where are the politics? Countries with higher levels of corruption, such as many African countries, are often former colonies that have “irresponsible and greedy leadership” and mismanage “state and public properties” (Alemazung, 2010). Many of these countries, such as Somalia, South Sudan, Sudan, and Libya ranked among the most corrupt countries according to the CPI in 2017. Not coincidentally, Somalia, South Sudan, and Sudan are also in urgent need of “access, funding, and security” for humanitarian relief according to a United Nations report describing the dire situation of children affected by cholera and diarrhea (United Nations, 2017). The report further elaborates that in South Sudan, a country of 12.5 million people, “1.1 million are malnourished” and “almost 290,000 children suffer from severe acute malnutrition”.

Other countries ranking at the bottom of the 2017 CPI list include Syria, Yemen, and Afghanistan and are not much different in their public health circumstances. On account of former Western involvement in these countries, the aftermath of political turmoil could perhaps be seen as other plausible explanatory factors to the public health issues experienced.

Study Population & Samples

The populations of interest to this study are the 10 highest-ranking countries of the 2017 CPI and the 10 lowest-ranking countries of the 2017 CPI. I chose these as study populations as they would likely show the greatest differences between political corruption and malnutrition among children, if a correlation is found.

In 2017, 10 highest-ranking countries on the Corruption Perceptions Index were New Zealand, Denmark, Finland, Norway, Switzerland, Singapore, Sweden, Canada, Luxembourg, and the Netherlands. The 10 lowest-ranking countries were Equatorial Guinea, Guinea-Bissau, North Korea, Libya, Sudan, Yemen, Afghanistan, Syria, South Sudan, and Somalia (Transparency International e.V., 2018).

Purpose of Study

The purpose of this study is to gain more insight on the relationship between corruption and its impact on one measure of public health. With a continuously growing global population, the importance of eradicating preventable diseases while establishing regional food security is progressively gaining international attention and is highlighted by this research.

As a first step in determining the magnitude of the relationship between the 10 most and least corrupt countries and the impact on malnutrition on children, this paper serves as a research design proposal for a potentially larger scale project in the future. While there is no international “easy fix” for the political corruption of any sovereign state, there exist countless ways to have indirect influence for improving dire situations. Thus, there is great potential for small positive outcomes that can develop into larger, longer-lasting effects. Therefore, I list points of interest if this project were to be expanded in the future. In that event, I would wish to explore: 1. What would this project look like on a larger scale? (Looking at the 50 most and least corrupt countries rather than 10.) 2. In countries with the highest levels of political corruption, are existing policies to eradicate malnutrition impeded by current government practices? 3. In those same countries, are present international organizations effective in providing humanitarian aid? Or is their work impeded by the politics of a country? 4. Given current trends, is the rate and severity of malnutrition increasing or decreasing? In the event of change, what is driving it?

Conclusion

In conclusion, the aim of this research design proposal is to look closer into the relationship between political corruption and malnutrition in children. Based on the results of the study, various theories could be proposed on what national and international actions could be taken to remedy the ailing concern.

It is also important to make notice of the shortcomings of this paper. These include, and are not limited to the brevity of this proposal affecting the operationalization explanation of variables, an absence of clear and defined causal inference, as well as the shortage of complete data for the dependent variable, and of course the lack of complete knowledge on statistics for regression model construction. Nevertheless, as this paper is a research proposal, it is a work in progress on a topic that continues to be relevant and of interest to me.

Finally, the politics of a country continue to play a huge role in the allocation of resources and welfare programs available to people. While much literature already exists on democracy and corruption affecting public health and various measures of it, I would hope to further investigate this topic in the future with a particular focus on child nutrition. Thus, for a future project, exploring the extent of corruption on malnutrition remains of vital interest to me. By using a Borrow-A-Method approach to model my regression, it would certainly be gain further insight on the hypotheses and study populations. Lastly, the outcome of this study can offer various recommendations into improved national policies or international access and distribution of humanitarian aid for what can be done to help thousands of children and people worldwide that are suffering from preventable deaths and illnesses pertaining to malnutrition.

References

1. What is disease-related malnutrition?. (n.d.). Retrieved from http://www.nutricia.ie/articles/what_is_disease-related_malnutrition#
2. Alemazung, J. A. (2010, January). Post-Colonial Colonialism: An Analysis of International Factors and Actors Marring African Socio-Economic and Political Development. Retrieved from https://www.researchgate.net/publication/228429413_Post-Colonial_Colonialism_An_Analysis_of_International_Factors_and_Actors_Marring_African_Socio-Economic_and_Political_Development
3. Burroway, R. (2016, November 30). Democracy and child health in developing countries. Retrieved from https://journals.sagepub.com/doi/abs/10.1177/0020715216676514
4. Hanf, M., Van-Melle, A., Fraisse, F., Roger, A., Carme, B., & Nacher, M. (2011, November 2). Corruption Kills: Estimating the Global Impact of Corruption on Children Deaths. Retrieved from https://journals.plos.org/plosone/s/journal-information
5. Transparency International e.V. (2018, February 21). Corruption Perceptions Index 2017. Retrieved from https://www.transparency.org/news/feature/corruption_perceptions_index_2017
6. Transparency International e.V. (n.d.). What is Corruption?. Retrieved from https://www.transparency.org/what-is-corruption#define
7. Uchendu, F. N., & Abolarin, T. O. (2016, February 6). Corrupt practices negatively influenced food security and live expectancy in developing countries. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458312/
8. United Nations. (1989, November 20). Convention on the Rights of the Child. Retrieved from https://www.ohchr.org/en/professionalinterest/pages/crc.aspx
9. United Nations. (2017, July 4). Rising cholera, diarrhoea and malnutrition 'deadly' for children in Yemen, South Sudan, Somalia and Sudan, warns UNICEF. Retrieved from https://news.un.org/en/story/2017/07/560872-rising-cholera-diarrhoea-and-malnutrition-deadly-children-yemen-south-sudan
10. Weininger, J. (2018, November 26). Nutritional disease. Retrieved from https://www.britannica.com/science/nutritional-disease
11. World Health Organization. (2016, July 8). What is malnutrition?. Retrieved from https://www.who.int/features/qa/malnutrition/en/