Child malnutrition: Stunting among children under 5 years of age
Short name:
Stunting among children under 5 years of age
Data type:
Percent
Indicator Id:
72
Topic:
Risk factors
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
Disaggregation:
Country, regional and worldwide JME global estimates refer to the age group of children under 5 years, sexes combined. Disaggregation are currently not available for the JME global estimates. However, a disaggregated dataset of national primary sources with sub national and stratified estimates (e.g. sex, age groups, wealth, mothers' education, residence) is available.
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).
M&E Framework:
Impact
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).
Method of estimation of global and regional aggregates:
Method of estimation of global and regional aggregates:
Regional aggregates are available for the following classifications: UN, MDG, UNICEF, WHO, The World Bank regions and income groups
Preferred data sources:
Household surveys
Specific population surveys
Surveillance systems; All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999)
Expected frequency of data dissemination:
The UNICEF-WHO-WB Joint Child Malnutrition (JME) group releases country, regional and worldwide estimates at the end of March so that data are available for the SDG report and database. The JME group also maintain a dataset of primary data sources (household surveys) used to generate the JME global estimates.
Expected frequency of data collection:
Data sources are updated in a continuous base to feed into the annual production of global and regional estimates and updated country level dataset released every March
Data sources
For the majority of countries, nationally representative household surveys constitute the primary data source used to generate the JME global estimates. For a limited number of countries data from surveillance systems are also used as a primary data source for generation of the JME global estimates if sufficient population coverage is documented (about 80%). For both types of primary data sources, the child’s length/height and weight measurements have to be collected following recommended standard measuring techniques (WHO/UNICEF 2019).
Limitations:
Survey estimates come with levels of uncertainty due to both sampling error and non-sampling error (e.g., measurement technical error, recording error etc.,). The JME global estimates for stunting take into account estimates of sampling error around survey estimates. While non-sampling error cannot be accounted for or reviewed in full, when available, a data quality review of weight, height and age measurements from household surveys supports compilation of a time series that is comparable across countries and over time.
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