1. Nutritional Status of Children
Measures, Estimates and Explanations

2. Malnutrition Indicators
Malnutrition indicators: Differ with respect to the stage in one’s life cycle.
Nutritional Status of Children

3. Intra-uterine Undernutrition: Low Birth Weight (LBW)
Cause: Maternal malnutrition:
Effect:
Malnutrition during intra-uterine life.
Retards the growth and development of the foetus during pregnancy.
The foetus is born with birth weight lower than normal.
The cut-off value for birth weight is 2.5 kg(WHO).
Babies born with birth weight <2.5 kg are LBW babies.
Nutritional Status of Children

4. Childhood Malnutrition
Severe consequences if it occurs early in life.
Adverse impact on subsequent growth, morbidity, cognitive development, educational attainment and productivity in adulthood.
Nutritional Status of Children

5. Nutrition status: Children U5
Anthropometric Indicators:
Height-for-age (HFA),
Weight-for-age (WFA),
Weight-for-height (WFH), and
MUAC-for-age.
Most sensitive indicators of food security, vulnerability and overall socio-economic development of a country.
Stunting, Wasting and Underweight.
Z-score classification.
Nutritional Status of Children

6. Malnutrition Indicators
Measure the clinical phenomena of malnutrition.
Standard cutoff points are used internationally to define under nutrition in children 6-59 months.
The cutoff points for nutrition indicators are derived from the WHO child growth standard population (WHO standards) or NCHS reference population (NCHS population).
Nutritional Status of Children

7. Stunting (low height-for-age)
Cause: Chronic under nutrition retards growth of a child by height.
Stunting: child is shorter for its age.
Information requirement: Estimates of height and age.
Nutritional Status of Children

8. Stunting (low height-for-age)
Low HFA identifies past or chronic under nutrition (stunting)
Stunting indicates reduced linear growth
Cannot measure short-term changes in malnutrition
For children <2 yrs of age, the term is length-for-age/LA
For children > 2 yrs age, the index is referred to as height-for-age/HA
Nutritional Status of Children

9. Stunting: Classification
Height-for-age up to -2SD = Normal
Height-for-age <-2SD to -3SD = Moderate
Height-for-age <-3SD = Severe
Nutritional Status of Children

10. Wasting (low weight–for-height)
Cause: Acute, short-run malnutrition
Affects only body weight.
“Wasting” of the body, i.e. loss of body mass compared to the body size.
Indicator: Weight-for-height.
Nutritional Status of Children

11. Wasting (low weight–for-height)
Low WFH identifies current or acute under nutrition (wasting)
Useful when exact age is difficult to determine
- Weight for-length (< 2 yrs) or weight for-height (in > 2 yrs)
Appropriate for examining short-term effects
Nutritional Status of Children

12. Wasting: Classification
Normal weight-for-height: If its weight-for-height is within 2 standard deviations (-2SD) of the median weight-for-height of a reference population.
Moderately wasted: If the weight-for-height falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD).
Severely wasted: If the weight-for-height falls below 3SD of the reference median (<-3SD).
Nutritional Status of Children

13. Wasting: Classification
Weight-for-height up to –2SD = Normal
Weight-for-height <-2SD to –3SD = Moderate
Weight-for-height <-3SD = Severe
Nutritional Status of Children

14. Underweight (low weight-for-age)
Composite indicator of long-term and acute short-term malnutrition.
The body weight may be lost from malnutrition for a long time => low weight-for-age.
Weight may also be lost from acute, short-term malnutrition => low weight-for-age.
Nutritional Status of Children

15. Underweight: Classification
Normal weight-for-age: If weight-for-age is within 2 standard deviations (-2SD) of the median weight-for-age of a reference population.
Moderately underweight: If the weight-for-age falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD).
Severely underweight: If the weight-for-age falls below 3SD of the reference median (<-3SD).
Nutritional Status of Children

16. Underweight: Classification
Weight-for-age up to -2SD = Normal
Weight-for-age <-2SD to -3SD = Moderate
Weight-for-age <-3SD = Severe
Nutritional Status of Children

17. Nutritional Status of Children

18. Mid- Upper Arm Circumference (MUAC)
Low MUAC (<12.5 cm) indicates acute malnutrition among children 6-59 months.
Is relatively easy to measure and a good predictor of immediate risk of death.
Is used for rapid screening of acute malnutrition.
Nutritional Status of Children

19. Nutritional Status of Children

20. Nutritional Status of Children

21. Nutritional Status of Children

22. Food consumption, energy and nutrient intake and nutritional status in rural Bangladesh: Changes from 1981 – 1982 to 1995 – 96
Source: Hels et al. (2003)

23. Nutritional Status of Children

24. Nutritional Status of Children

25. Nutritional Status of Children

26. Nutritional Status of Children

27. Nutritional Status of Children

28. Thank You