Child malnutrition - PAHO/WHO | Pan American Health Organization

ENLACE CHILD MALNUTRITION GLOBAL CHILD MALNUTRITION ANEMIA BREASTFEEDING MONITORING BFHI TECHNICAL NOTES ABOUT

Nutrition is critical for health and development. Good nutrition is related to improved infant, child, and maternal health, stronger immune systems, safer pregnancy and childbirth, lower risk of noncommunicable diseases, and healthy longevity. Malnutrition, in every form, presents significant threats to human health during the life cycle. As a consequence of malnutrition, nowadays most countries of the Region of the Americas --especially, low- and middle-income countries--, face a double burden of malnutrition that includes both undernutrition and overweight.

This topic aims to provide data and information that allow readers to understand the situation and trends of key indicators of child malnutrition in countries of the Americas.

This interactive visualization presents the level and trends from 2000 to 2020 of a set of six malnutrition indicators in children under-five years of age, including the prevalence of stunting, wasting, severe wasting, overweight, and underweight, as well as low birth weight newborns in countries of the region. Use the navigation tool, located at the top of the visualization, to move across components (level, trends, and data), and filters to show data from a specific indicator.

SUMMARY OF MAIN FINDINGS

Prevalence of stunted children under-five years of age

Global nutrition target 2025: 40% reduction in the number of children under-5 who are stunted, relative to the level in 2012.

In 2020, the regional number of stunted children decreased by 11% from 7.3 million (95% confidence interval [CI]: 7.1–7.6) in 2012 to 6.5 million (95% CI: 6.0–7.1) in 2020.
Regionwide in 2020, the prevalence of stunted children decreased by 9.2% from 9.8% (95% CI:9.4–10.2) in 2012 to 8.9% (95% CI: 8.2–9.7) in 2020.
Nationally, the prevalence of stunted children in2020 varies from 42.8% (95% CI: 36.8–49.1) in Guatemala to 1.6% (95% CI: 1.2–2.0) in Chile.
In 2020, the top 20% of countries with the highest prevalence are Guatemala, Ecuador, Haiti, Honduras, Panama, and Nicaragua.
Three countries in the Region (Trinidad and Tobago, Costa Rica, and Jamaica) had an increasing trend in the prevalence of stunted children.

Prevalence of low birth weight newborns

Global nutrition target 2025: 30% reduction in low birth weight, relative to the level in 2012.

In 2015, the regional prevalence of low birth weight newborns was 8.5% (95% CI: 7.6–9.8), substantially lower than the global level.
The regional rate of change remains stagnant from 8.5% (95% CI: 7.6–9.8) in 2012 to 8.5% (95% CI: 7.6–9.8) in 2015.
In 2015, the prevalence of low birth weight newborns across countries varied from a high 15.6% (95% CI:12.2–19.6) in Guyana to a low 5.3% (95% CI: 5.2–5.4) in Cuba.
In 2015, the top 20% of countries with the highest prevalence of low birth weight are Guyana (15.6%), Suriname (14.7%), Jamaica (14.6%), Bahamas (13.1%), Trinidad and Tobago (12.4%), and Dominican Republic (11.3%).

Prevalence of overweight children under-five years of age

Global nutrition target 2025: No increase in childhood overweight, relative to the level in 2012.

In 2020, the regional prevalence of overweight in children under-five years of age was 8.0% (95% CI: 6.8–9.3).
The regional prevalence of overweight increased by 3.9% from 7.7% (95% CI: 8.6 – 7.0) in 2012 to 8.0% (95% CI: 6.8–9.3) in 2020
Nationally in 2020, the prevalence of overweight ranged from 12.9% (95% CI: 9.0–18.2) in Argentina to 3.7% (95% CI: 2.5–5.4) in Haiti.
The prevalence of overweight in children under five years of age is increasing in 18 out of 29 countries with available data. These 18 countries are currently off-track to achieving the set target, requiring significant efforts.
Eleven countries out of 29 with available data (five with constant trends and six with downwards trends) are on track to achieve or already achieved the target, but all countries have levels above 3%.
The countries with the greatest prevalence of overweight in children in the Americas are Argentina, Paraguay, Canada, Barbados, Trinidad and Tobago, and Panama.

Prevalence of wasted children under-five years of age

Global nutrition target 2025: reduce and maintain childhood wasting to less than 5%, relative to the level in 2012.

Based on the most recent available data, the prevalence of wasted children under-five years of age in the Region varies from 6.8% (95% CI: 4.5–10.0) in Barbados to 0.1% (95% CI: 0.0–0.1) in the United States of America.
Four countries in the Region –Barbados (6.8%, Guyana (6.4%), Trinidad and Tobago (6.4%), and Suriname (5.5%)– are not achieving the target of prevalence less than 5%.

Suggested citation

Prevalence of child malnutrition in countries of the Americas. ENLACE data portal. Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, 2022.

DATA CLASSIFICATION

In the map and horizontal bar chart, the data is presented in five classes created using the quantile classification method. Each class contains 20% of countries, which is easy to interpret. The quintile intervals are labeled sequentially from Quintile 1, also called the bottom quintile which includes the lowest fifth (0 to 20%) of data points to Quintile 5 (or top quintile), which includes the top fifth (80% to 100%) of data points.

DATA SOURCE AND METHODS

This topic used data from the UNICEF/WHO/World Bank Group joint child malnutrition estimates 2021 edition, which was published by the World Health Organization.

The UNICEF-WHO-World Bank JME Working Group (JME) was established in 2011 to address the call for harmonized child malnutrition estimates that would be instrumental in benchmarking progress on child malnutrition. The JME provided estimates for stunting, wasting, severe wasting, underweight and overweight, as well as a detailed description of the methodology. In brief, JME produces country-level modeled estimates for stunting and overweight based on updated methodology (4) developed by the JME Working Group and the University of South Carolina. The regional and global figures for stunting and overweight are based on these country model outputs, while they remain based on the previously applied sub-regional model for wasting and severe wasting. (2, 3) Additional work is ongoing to update methods for wasting and severe wasting for which available data are not as stable as for stunting and overweight (see section about regional and global estimates on page 27 of the JME child malnutrition estimates 2021 edition).

The JME process for the 2021 edition involved the following steps: (i) updating the country dataset of primary sources (e.g., national household surveys); (ii) application of a country level model for stunting and overweight to generate annual estimates; (iii) generation of regional and global aggregates for stunting, wasting, severe wasting and overweight; and (iv) consultation with countries before finalizing and disseminating the 2021 estimates.

The data sources and key parts of the JME methodology for child malnutrition estimation are described in more detail in the JME child malnutrition estimated 2021.

FORMS OF MALNUTRITION

Stunting refers to a child who is too short for his or her age. Children affected by stunting can suffer severe irreversible physical and cognitive damage that accompanies stunted growth. The devastating consequences of stunting can last a lifetime and even affect the next generation.

Wasting refers to a child who is too thin for his or her height. Wasting is the result of recent rapid weight loss or the failure to gain weight. A child who is moderately or severely wasted has an increased risk of death, but treatment is possible.

Overweight refers to a child who is too heavy for his or her height. This form of malnutrition results when energy intakes from food and beverages exceed children’s energy requirements. Being overweight increases the risk of diet-related noncommunicable diseases later in life.

Low birth weight newborns

This topic and visualization also draw data from the Joint Low Birthweight Estimates - Levels and trends 2000–2015 developed by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), in collaboration with the London School of Hygiene and Tropical Medicine and Johns Hopkins University.

This is the first time such estimates have been made available globally, making it possible to track progress and support various initiatives including the World Health Assembly (WHA) Nutrition Targets, the Every Newborn Action Plan and the Global Strategy for Women's Children's and Adolescents' Health.

In total 1,447 data points for 148 countries (1,218 administrative data points from 96 countries, with 1,026 high coverage and 192 moderate coverage; and 229 adjusted survey estimates from 86 countries) were used. Country input data were obtained through systematic searches of National Statistical Office and Ministry of Health websites, from websites of the household survey programs of Multiple Indicator Cluster Surveys and Demographic and Health Surveys and from data gathered during an extensive country consultation.

The detailed methodology is described in Blencowe H, et al. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 2019. DOI: https://dx.doi.org/10.1016/S2214-109X(18)30565-5.

DATA DOWNLOAD

You can download estimates for each indicator directly from the WHO Global Health observatory (GHO) in MS Excel or CSV formats:

Stunting, overweight, underweight, and wasting and severe wasting in children under five years of age (number in millions and prevalence), Join Malnutrition Child Estimates, WHO GHO portal
Low birth weight, prevalence (%) in the WHO GHO.
Low birth weight (in thousands) in the WHO GHO.

You can also download the data directly from the visualization, following the steps:

Go to the Data component of the visualization,
Use filters to select data of interest,
Click on the Download button located at the bottom-right corner of the visualization, and
Follow the steps from the dialogue.

World Health Organization, United Nations Children's Fund (‎UNICEF)‎ & World Bank. (‎2021)‎. Levels and trends in child malnutrition: UNICEF / WHO / The World Bank Group joint child malnutrition estimates: key findings of the 2021 edition. World Health Organization.
Available online: https://apps.who.int/iris/handle/10665/341135
United Nations Children’s Fund, World Health Organization, International Bank for Reconstruction and Development/The World Bank, UNICEF-WHO-World Bank Group Joint Child Malnutrition Estimates, UNICEF, New York; WHO, Geneva; World Bank, Washington, DC, 2012.
de Onis, Mercedes et al., ‘Methodology for estimating regional and global trends of child malnutrition’, International Journal of Epidemiology, vol., 33, no. 6, December 2004, pps. 1260–1270, https://doi.org/10.1093/ije/dyh202, accessed April 2022.
McLain, Alexander, Frongillo, Edward, Feng, Juan and Elaine Borghi, ‘Prediction intervals for penalized longitudinal models with multisource summary measures: an application to childhood malnutrition’, Statistics in Medicine, vol. 38, no. 6, March 2019, pps. 1002–1012, https://doi.org/10.1002/sim.8024, accessed April 2022.
FAO, IFAD, PAHO, UNICEF and WFP. 2021. Latin America and the Caribbean – Regional Overview of Food Security and Nutrition 2021: Statistics and trends. Santiago, FAO. https://doi.org/10.4060/cb7497en, accessed April 2022.

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