Prevalence and Patterning of Multiple Malnutrition in Young - PowerPoint PPT Presentation

Bristol University 12 th April 2018 Measuring and Mapping the Prevalence and Patterning of Multiple Malnutrition in Young Children Dr Marco Pomati and Dr Shailen Nandy School of Social Sciences, Cardiff University

Overview • Measuring and Mapping the Prevalence and Patterning of Multiple Malnutrition in Young Children in West and Central Africa • Failure to grow and develop along expected trajectories • National and time distribution • Factors behind changes and lack of change

Conventional Indicators of (child) undernutrition • Wasting – low weight for height (W/H) • Reflects recent/acute undernutrition • Stunting – low height for age (H/A) • Reflects longer term/chronic undernutrition • Underweight – low weight for age (W/A) • MDG1 target indicator

A - No Failure B-Wasted Only C-Wasted & Underweight D-Wasted, Stunted & Underweight E-Stunted & Underweight F-Stunted Only

A - No Failure B-Wasted Only C-Wasted & Underweight D-Wasted, Stunted & Underweight E-Stunted & Underweight F-Stunted Only

Multiple Malnutrition and Mortality McDonald et al. (2013) show experience of multiple anthropometric deficits has a raised mortality risk, up to 12x for triple failure (compared to no failure). Pooled HRs (95% CIs) for 25 anthropometric status and all-cause mortality 20 15 10 5 0 Wasted, Underweight Stunted+ Wasted+Under No failure Stunted only Wasted only Stunted+ only Underweight weight Underweight Upper CI 1 1.8 3.6 4.0 4.3 7.1 19.6 Lower CI 1 1.2 1.5 1.6 2.6 3.1 7.7 Pooled Mortality HR 1 1.5 2.3 2.5 3.4 4.7 12.3 Source: McDonald, C.M., et al. (2013), The effect of multiple anthropometric deficits on child mortality: meta-analysis of individual data in 10 prospective studies from developing countries. American Journal of Clinical Nutrition, 97(4): p. 896-901.

Svedberg, 2000

Nigeria 25 20 15 Stunted & Underweight % 10 5 0 1990 2003 2008 2013 E-Stunted & Underweight F-Stunted Only

Nigeria 25 20 15 Stunted & Underweight % 10 Wasted & Underweight Wasted only 5 Wasted, Stunted & Underweight 0 1990 2003 2008 2013 B-Wasted Only C-Wasted & Underweight D-Wasted, Stunted & Underweight E-Stunted & Underweight F-Stunted Only Y-Underweight Only

7,000,000 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 1990 2003 2008 2013 B-Wasted Only C-Wasted & Underweight D-Wasted, Stunted & Underweight E-Stunted & Underweight F-Stunted Only Y-Underweight Only

Nigeria (2013) Wasted & Stunted & Underweight Stunted & Underweight Wasted & Underweight Underweight Stunted Wasted No Failure 0% 10% 20% 30% 40% 50% 60% 70% Rural Urban

Multiple malnutrition (MM), poverty, morbidity and mortality Clear relationship between poverty and pattern of malnutrition (Children U5 yrs, India NFHS, 2005 data)

Conclusion • Focus on occurrence of multiple forms of anthropometric failures at the same time • Aim:  Give overall balanced view of improvements and lack of  Decompose changes in multiple malnutrition