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 (%

)