Malnutrition: Number of children who are stunted

Rationale

Child growth is an internationally accepted outcome reflecting child nutritional status. Child stunting refers to a child who is too short for his or her age and is the result of chronic or recurrent malnutrition. Stunting is a contributing risk factor to child mortality and is also a marker of inequalities in human development. Stunted children fail to reach their physical and cognitive potential. Child stunting is one of the World Health Assembly nutrition target indicators.

Definition

Prevalence of stunting (height-for-age <-2 standard deviation from the median of the World Health Organization (WHO) Child Growth Standards) among children under 5 years of age

Method of measurement

Survey estimates are based on standardized methodology using the WHO Child Growth Standards as described elsewhere (Ref: Anthro software manual). Global and regional estimates are based on methodology outlined in UNICEF-WHO-The World Bank: Joint child malnutrition estimates - Levels and trends (UNICEF/WHO/WB 2021 edition).

Method of estimation

Data collection method UNICEF, WHO and the World Bank group jointly review new data sources to update the country level estimates. Each agency uses their existing mechanisms for obtaining data. For UNICEF, the cadre of dedicated data and monitoring specialists working at national, regional and international levels in 190 countries routinely provide technical support for the collection and analysis of nutrition data. UNICEF also relies on a data source catalogue that is regularly updated using data sources from catalogues of other international organizations and national statistics offices. This data collection is done in close collaboration with UNICEF regional offices with the purpose of ensuring that UNICEF global databases contain updated and internationally comparable data. The regional office staff work with country offices and local counterparts to ensure the most relevant data are shared. WHO data gathering strongly relies on the organization’s structure and network established over the past 30 years, since the creation of its global database, the WHO Global Database on Child Growth and Malnutrition, in the late 1980’s (de Onis et al. 2004). The World Bank Group provides estimates available through the Living Standard Measurement Surveys (LSMS) which usually requires re-analysis of datasets given that the LSMS reports often do not tabulate the child malnutrition data Method of computation National estimates from primary sources (e.g., from household surveys) used to generate the JME global estimates are based on standardized methodology using the WHO Child Growth Standards as described in Recommendations for data collection, analysis and reporting on anthropometric indicators in children under 5 years old (WHO/UNICEF 2019) and WHO Anthro Survey Analyser (WHO, 2019). The JME global estimates are generated using smoothing techniques and covariates (McLain et al. 2018) applied to quality-assured national data to derive trends and up-to-date estimates. Worldwide and regional estimates are derived as the respective country averages weighted by the countries’ under-five population estimates (UNPD-WPP latest available edition) using annual JME global estimates for 204 countries (UNICEF-WHO-World Bank 2020).