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Topic 20 anthro meaurement

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  • 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 2
  • 3. Thank You
  • 4. 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
  • 5. 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
  • 6. 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
  • 7. 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
  • 8. 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
  • 9. 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
  • 10. 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
  • 11. 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
  • 12. Wasting (low weight–for-height)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
  • 13. 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
  • 14. 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
  • 15. 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
  • 16. 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
  • 17. 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
  • 18. Nutritional Status of Children 18
  • 19. 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
  • 20. Nutritional Status of Children 20
  • 21. Nutritional Status of Children 21
  • 22. Undernutrition trends among <5 children in Bangladesh 80 65.8 68.3 70 60 64.6 57.4 64.2 51 50 51.4 47.8Percent 43 44.6 48.3 40 43.1 42.4 41 30 20 16.7 16.6 14.4 12 12.7 17 13 10 1989/90 1992 1995 2000 2005 2007 2009 Underweight <5 Stunting <5 Wasting <5 MDG target for underweight Source: 1990-2005 CMNS; 2007 BDHS; 2009 HFSNA Nutritional Status of Children 22
  • 23. 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
  • 24. Nutritional Status of Children 24
  • 25. Nutritional Status of Children 25
  • 26. Nutritional Status of Children 26
  • 27. Nutritional Status of Children 27
  • 28. Nutritional Status of Children 28