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Comparison of estimates of under-nutrition for pre-school rural Pakistani children based on the WHO standard and the National Center for Health Statistics (NCHS) reference

Bibliographic Data

ID15094173
AuthorsRozina Nuruddin (0000-0002-7223-352X, National University of Singapore, corresponding author), Meng Kin Lim (National University of Singapore), Wilbur C Hadden (0000-0001-8572-2990, National Institute on Aging), Iqbal Azam (0000-0003-0766-4064, Aga Khan University)
Year2009
Volume12
Issue5
Pages716-722
Publication date2009-05-01
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980008002383
PMID18503722
OpenAlexW2116277980
LanguageEN
Citations received5
References cited21

Objective To compare estimates of under-nutrition among pre-school Pakistani children using the WHO growth standard and the National Center for Health Statistics (NCHS) reference. Design Prevalence of stunting, wasting and underweight as defined by WHO and NCHS standards are calculated and compared. Setting The data are from two cross-sectional surveys conducted in the early 1990s, the time frame for setting the baseline for the Millennium Development Goals: (i) National Health Survey of Pakistan (NHSP) assessed the health status of a nationally representative sample and (ii) Thatta Health System Research Project (THSRP) was a survey in Thatta, a rural district of Sindh Province. Subjects In all, 1533 and 1051 children aged 0–35 months from national and Thatta surveys, respectively. Results WHO standard gave a significantly higher prevalence of stunting for both national [36·7 (95 % CI 33·2, 40·2)] and Thatta surveys [52·9 (95 % CI 48·9, 56·9)] compared to the NCHS reference [national: 29·1 (95 % CI 25·9, 32·2) and Thatta: 44·8 (95 % CI 41·1, 48·5), respectively]. It also gave significantly higher prevalence of wasting for the Thatta survey [22·9 (95 % CI 20·3, 25·5)] compared to the NCHS reference [15·7 (95 % CI 13·5, 17·8)]. Differences due to choice of standard were pronounced during infancy and for severely wasted and severely stunted children. Conclusions Pakistan should switch to the robustly constructed and up-to-date WHO growth standard for assessing under-nutrition. New growth charts should be introduced along with training of health workers. This has implications for nutritional intervention programmes, for resetting the country’s targets for Millennium Development Goal 1 and for monitoring nutritional trends

Body mass index · Environmental health · Health statistics · National Health and Nutrition Examination Survey · National standard · Overweight · Population · Underweight · Wasting · Child Nutrition and Water Access · Demography · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare

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Citations per year0.26
Citation span2007 - 2015 (9)
Highly citedNo

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