Governance Quality, Institutional Stability, and Child Stunting in Sub-Saharan Africa: A Multi-Country Analysis of SDG 16 Pathways, 2015–2024
Abstract:
Child stunting affects over 66 million children in sub-Saharan Africa (SSA), representing 60% of the global burden. While food insecurity, poverty, and climate shocks explain part of this burden, the governance mechanisms linking institutional quality to malnutrition outcomes remain poorly quantified. This study examines whether and through which pathways governance quality and institutional stability (SDG 16) influence child stunting prevalence across 49 SSA countries over the period 2015–2024. Using an unbalanced cross-sectional dataset combining UNICEF/WHO/World Bank Joint Malnutrition Estimates, World Bank Worldwide Governance Indicators (WGI), and 20+ SDG proxy indicators, we employed a series of six nested ordinary least squares (OLS) regression models with progressive covariate adjustment, complemented by principal component analysis (PCA) for governance index construction and k-means clustering for country typology. Results indicate that the composite governance index (ICOMP_GOV_ACP) explains 46.5% of stunting variance in baseline models (M1: R²adj=0.465, F=21.870, p<0.001), but this effect is fully mediated in the parsimonious model (M5: R²adj=0.643, F=21.283, p<0.001) by three proximal determinants: skilled birth attendance (SBA_LAST, β=−0.414, p=0.002), food insecurity (FIES_LAST, β=+0.325, p=0.091), and electricity access (ELEC_LAST, β=−0.327, p=0.116). These findings establish governance as a distal determinant operating through service-delivery pathways, with implications for integrated SDG 16–2–3–7 policy strategies. We accordingly recommend that governance investments be systematically paired with targeted food security programmes and expansion of skilled birth attendance coverage to achieve meaningful reductions in stunting prevalence across sub-Saharan Africa.References:
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