Nutritional Status
Nutritional Status
Nutritional Status
1. INDICATOR
2. POLICY RELEVANCE
(a) Purpose: The purpose of this indicator is to measure long term nutritional
imbalance and malnutrition resulting in undernutrition (assessed by underweight and
stunting) and overweight.
(c) International Conventions and Agreements: The United Nations World Summit
for Children and the Millennium Development Goals represent international agreements
relevant to this indicator.
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countries committed themselves to give highest priority to sustaining development and
eliminating poverty.
(e) Linkages to Other Indicators: This indicator is closely linked with adequate birth
weight. It is also associated with such socioeconomic and environmental indicators as
squared poverty gap index, access to safe drinking water, infant mortality rate, life
expectancy at birth, national health expenditure devoted to local health care, Gross
Domestic Product (GDP) per capita, environmental protection expenditures as a percent of
GDP, and waste water treatment coverage.
3. METHODOLOGICAL DESCRIPTION
(a) Underlying Definitions and Concepts: An international standard (i.e. the WHO
Child Growth Standards) is used to calculate the indicator prevalences for low weight-for-
age, low height-for-age, and high weight-for-height (1,2). The International Pediatric
Association (IPA), the Standing Committee on Nutrition of the United Nations System
(SCN), and the International Union of Nutritional Sciences (IUNS), have officially endorsed
the use of the WHO standards describing them as an effective tool for detecting and
monitoring both undernutrition and overweight, thus addressing the double burden of
malnutrition affecting populations on a global basis (3-5). The WHO standards may be
used for all children up to five years of age, since the influence of ethnic or genetic factors
on young children is considered insignificant (6).
Low weight-for-age and low height-for-age are defined as less than two standard
deviations below the median of the WHO Child Growth Standards (1,2). High weight-for-
height is defined as more than two standard deviations above the median of the WHO
Child Growth Standards (1,2).
(b) Measurement Methods: The proportion of children under five with low weight-
for-age and low height-for-age can be calculated by using the following formula:
% underweight children = (Numerator/ denominator) x 100
The proportion of children under five with high weight-for-height can be calculated by
using the following formula:
% overweight children = (Numerator/ denominator) x 100
Numerator: number of children under five with weight-for-height above +2 SD
Denominator: total number of children under five measured.
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For height, supine length is measured in children under two years of age, and standing
height in older children (7).
4. ASSESSMENT OF DATA
(a) Data Needed to Compile the Indicator: The data needed to compile this indicator
are the weight, length/height, age and sex of the children in the index populations.
(b) National and International Data Availability and Sources: The data are routinely
collected by ministries of health at the national and subnational levels for most countries.
Other sources are: Demographic and Health Surveys (DHS, www.measuredhs.com);
Multiple Indicators Cluster Surveys (MICS, www.childinfo.org); Living Standards
Measurement Surveys (LSMS, www.worldbank.org/lsms/). All data from these four
sources are being collected and standardized by the WHO Department of Nutrition and
disseminated via the WHO Global Database on Child Growth and Malnutrition web site
www.who.int/nutgrowthdb.
(c) Data References: Available via the WHO Global Database on Child Growth and
Malnutrition web site www.who.int/nutgrowthdb
(a) Lead Agency: The lead agency is the World Health Organization (WHO). At
WHO, the contact point is the Director, Department of Nutrition for Health and
Development; fax no. (41 22) 791 3111.
6. REFERENCES
(a) Readings:
1. de Onis M, Garza C, Onyango AW, Martorell R, editors. WHO Child Growth
Standards. Acta Paediatrica Suppl 2006;450:1-101.
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2. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards:
Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-
for-age: Methods and development. Geneva: World Health Organization, 2006.
4. Standing Committee on Nutrition of the United Nations System. SCN Endorses the
New WHO Growth Standards for Infants and Young Children.
http://www.who.int/childgrowth/endorsement_scn.pdf
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