Post on 05-Jan-2016
Malnutrition across the globe
Regional trendsGlobal trends
Dr Anthony WemakorDept of Community Nutrition
SMHS-UDSOct 2013
Underweight
• Underweight is defined as weight-for-age below -2 SD from the median of the WHO Child Growth Standards
• Underweight is a composite measure of stunting and wasting
• Underweight prevalence in children 0-5 yrs. is an indicator for the “Hunger Target” of MDG 1
No. of Countries – Underweight prevalence (0-5 y)
Region Total n (%)
Improving n (%)
No change n (%)
Deteriorating n (%)
Africa 42 (100) 18 (43) 10 (24) 14 (33)
Asia 25 (100) 14 (56) 10 (40) 1 (4)
South & Central America & Caribbean
19 (100) 6 (32) 11 (58) 2 (11)
Total 86 (100) 38 (44) 31 (36) 17 (20)
Change of 2 percentage points between surveys was taken as improving or deteriorating
Underweight (0-5 y) trends - Africa
1990 1995 2000 2005 20070
5
10
15
20
25
30
25.624.6
23.622.7 22.3
24.323.3
22.321.4 21
10.8 10 9.2 8.5 8.2
11.7 12.1 12.5 13 13.2
25.1 24.4 23.6 22.8 22.521.5 21.1 20.5 19.9 19.6
EasternMiddleNorthernSouthernWesternOverall
Underweight (0-5 y) trends - Asia
1990 1995 2000 2005 20070
10
20
30
40
50
60
16.2
11.58.1
5.6 4.8
49.9
44.6
39.4
34.432.5
30.626.6
22.919.6 18.3
12.810.7 9 7.5 7
33.830
26.423 21.6
EasternSouth-centralSouth-easternWesternOverallPr
eval
ence
(%)
Underweight (0-5 y) trends – Latin America & Caribbean
1990 1995 2000 2005 20070
2
4
6
8
10
12
8.4
6.8
5.5
4.54.1
10.6
8.5
6.8
5.44.9
6.1
5.1
4.23.5 3.2
7.5
6.2
5
4.1 3.8
CaribbeanCentral AmericaSouth AmericaOverall
Prev
alen
ce (%
)
Underweight (0-5 y) trends – Global
1990 1995 2000 2005 20070
5
10
15
20
25
30
35
40
21.5 21.1 20.5 19.9 19.6
33.8
30
26.4
2321.6
7.56.2
5 4.1 3.8
18.517.3 16.2 15.8
28.7
25.722.8
20.3 19.3
1.9 1.8 1.7 1.6 1.5
25.423
20.518.3 17.4
AfricaAsiaLatin America & CaribbeanOceaniaDeveloping CountriesDeveloped CountriesGlobal
Prev
alen
ce (%
)
Progress towards Hunger Goal (MDG1)• Africa has made insufficient progress
• Underweight target for 2015 10.8%• Underweight rate 21.5% (1990) - 19.6% (2007)
• Asia is on track• Underweight target for 2015 16.9%• Underweight rate 33.8% (1990) – 21.6% (2007)• Eastern Asia has met MDG1 Goal
• Latin America has met Goal • Underweight target for 2015 3.8%• Underweight rate 7.5% (1990) – 3.8% (2007)
Stunting
• Stunting is defined as height-for-age below -2 SD from the median of the WHO Child Growth Standards
• Stunting is a result of chronic malnutrition i.e. prolonged food deprivation and/or illness
No. of Countries – Stunting prevalence (0-5 y)
Region Total n (%)
Improving n (%)
No change n (%)
Deteriorating n (%)
Africa 29 (100) 12 (41) 6 (21) 11 (38)
Asia 20 (100) 13 (65) 6 (30) 1 (5)
South & Central America & Caribbean
14 (100) 6 (43) 7 (50) 1 (7)
Total 63 (100) 31 (49) 19 (30) 13 (21)
Change of 2 percentage points between surveys was taken as improving or deteriorating
Stunting (0-5 y) trends - Africa
1990 1995 2000 2005 20070
10
20
30
40
50
60
48.1 47.4 46.7 46 45.745.3 43.8 42.3 40.8 40.3
29.427.4
25.523.7 23
35.4 34.7 34.1 33.5 33.3
38.1 38.1 38.1 38.1 38.140.3 39.8 39.3 38.8 38.5 Eastern
MiddleNorthernSouthernWesternOverallPr
eval
ence
(%)
Stunting (0-5 y) trends - Asia
1990 1995 2000 2005 20070
10
20
30
40
50
60
70
35.9
28.2
21.7
16.3 14.4
60.7
54.6
48.4
42.339.9
47
41.5
36.231.3 29.428.2
25.923.7
21.6 20.9
48.6
43.1
37.732.6 30.6
EasternSouth-centralSouth-easternWesternOverallPr
eval
ence
(%)
Stunting (0-5 y) trends – Latin America & Caribbean
1990 1995 2000 2005 20070
5
10
15
20
25
30
35
15
129.6
7.5 6.9
32.5
28.6
25.1
21.820.620.9
18.316
13.9 13.1
23.7
20.9
18.115.7 14.8
CaribbeanCentral AmericaSouth AmericaOverall
Prev
alen
ce (%
)
Stunting (0-5 y) trends – Global
1990 1995 2000 2005 20070
10
20
30
40
50
60
40.3 39.8 39.3 38.8 38.5
48.6
43.1
37.7
32.630.6
23.720.9
18.115.7 14.8
39.8 39.1 38.5 38.2
44.440.1
36.132.5 31.2
6 6 6 6 6
39.736.3
32.929.7 28.5
AfricaAsiaLatin America & CaribbeanOceaniaDeveloping CountriesDeveloped CountriesGlobal
Prev
alen
ce (%
)
Low birth weight (LBW)
• LBW is defined as birth weight less than 2,500g • Highly correlated with perinatal and neonatal morbidity and
mortality• Reduction of LBW will contribute to attainment of the MDG4
No. of Countries – LBW 1997-2007Region Total n
(%)Improving n (%)
No change n (%)
Deteriorating n (%)
Sub-Saharan Africa
28 (100) 9 (32) 13 (46) 6 (21)
Middle East & North Africa
4 (100) - 3 (75) 1 (25)
Asia 10 (100) 4 (40) 4 (40) 2 (20)
Latin America & Caribbean
15 (100) 3 (20) 8 (53) 4 (27)
Total 60* (100) 17 (28) 30 (50) 13 (22)
*Includes 3 newly created StatesChange of 2 percentage points between surveys was taken as improving or deteriorating
Incidence of LBW - Africa
East Central North Southern West Overall0
2
4
6
8
10
12
14
16
18
1516
12
15
17
1516
15
1112
16
1413.512.3
15.314.6
15.414.3
1980s1990s2000s
Inci
denc
e (%
)
Incidence of LBW - Asia
East South South east West Overall0
5
10
15
20
25
30
35
40
7
34
18
12
22
9
32
15
11
21
5.9
27.1
11.6
15.418.3
1980s1990s2000s
Inci
denc
e (%
)
Incidence of LBW – Latin America & Caribbean
Caribbean Central America South America Overall0
2
4
6
8
10
12
14
16
1415
1213
12 12
1011
13.7
10.19.6 10
1980s1990s2000s
Inci
denc
e (%
)
Incidence of LBW – Global
Africa Asia Latin America & Caribbean
Less developed countries
0
5
10
15
20
25
15
22
13
20
14
21
11
19
14.3
18.3
10
16.5
1980s1990s2000s
Inci
denc
e (%
)
Vitamin A Deficiency (VAD)
• Assessed using serum retinol concentration• VAD: low serum retinol <20µg/dl or <0.7µmol/l
VA Deficiency trends - Africa
1990 1995 2000 2005 20070
5
10
15
20
25
30
35
40
45
50
43.7 43.241.5
39.537.5
40.842.8
45.8 45.842.5
32.629.4
24.921.9 22.4
37.2
27 27.7 27.325
45 45.5 44.442.4
40.441.4 40.6 39.538
36.4
EastCentralNorthSouthernWestOverallPr
eval
ence
(%)
VA Deficiency trends - Asia
1990 1995 2000 2005 20070
10
20
30
40
50
60
17.1 17.215.3
11.4 10.6
55.2
49.747.9
44.7 44.4
29.326.4
23.5 22.2 21.2
27.8
2124.5
21.7 20.9
37.335.2 33.8
31.8 31.4EastSouth-centralSouth-eastWestOverallPr
eval
ence
(%)
VA Deficiency – South and Central America & Caribbean
1990 1995 2000 2005 20070
5
10
15
20
25
19.1
16.718.3
16.215
17.2
14.313.3
12.2 12.9
19.6
16
13.111.7
10.6
19.1
15.6
13.512.1 11.5
CaribbeanCentral AmericaSouth AmericaOverall
Prev
alen
ce (%
)
VA Deficiency trends – Global
1990 1995 2000 2005 20070
5
10
15
20
25
30
35
40
4541.4 40.6 39.5 38
36.437.335.2 33.8
31.8 31.4
19.115.6
13.5 12.1 11.5
36.434.6 33.2
31.3 30.7
Africa AsiaSou and Cen America & Caribbean Overall
Prev
alen
ce (%
)