Zambia Demographic and Health Survey 2001-2002 - Measure DHS

the finding that well nourished young children of all population groups (for which data exist) follow verysimilar growth patterns. The reference populations serve as a point of comparison, facilitating theexamination of differences in the anthropometric status of subgroups in a population and changes innutritional status over time. In any large population, there is variation in height and weight; this variationapproximates a normal distribution.Each of these indices—height-for-age, weight-for-height, and weight-for-age—gives differentinformation about growth and body composition used to assess nutritional status. The height-for-ageindex is an indicator of linear growth retardation. Children whose height-for-age Z-score is below minustwo standard deviations (-2 SD) from the median of the reference population are considered short for theirage (stunted) and are chronically malnourished. Children who are below minus three standard deviations(-3 SD) from the median of the reference population are considered severely stunted. Stunting reflectsfailure to receive adequate nutrition over a long period of time and is also affected by recurrent andchronic illness. Height-for-age, therefore, represents the long-term effect of malnutrition in a populationand does not vary according to recent dietary intake.The weight-for-height index measures body mass in relation to body length and describes currentnutritional status. Children whose Z-scores are below minus two standard deviations (-2 SD) from themedian of the reference population are considered thin (wasted) for their height and are acutelymalnourished. Wasting represents the failure to receive adequate nutrition in the period immediatelypreceding the survey and may be the result of inadequate food intake or a recent episode of illness causingloss of weight and the onset of malnutrition. Children whose weight-for-height is below minus threestandard deviations (-3 SD) from the median of the reference population are considered severely wasted.Weight-for-age is a composite index of height-for-age and weight-for-height. It takes into accountboth acute and chronic malnutrition. Children whose weight-for-age is below minus two standard deviationsfrom the median of the reference population are classified as underweight.In the reference population, only 2.3 percent of children fall below minus two (-2 SD) for each ofthe three indices.Table 11.12 shows the percentage of children under five years classified as malnourished accordingto height-for-age, weight-for-age, and weight-for-height by background characteristics. A total of6,292 children under age five were weighed and measured. Four percent of these children had missinginformation on height or weight, 4 percent had implausibly high or low values for the height and weightmeasurements, and 1 percent had incomplete age information. The following information focuses on the5,784 children under age five for whom complete and plausible anthropometric data were collected.According to the 2001-2002 ZDHS, 47 percent of children under five are stunted and 22 percentseverely stunted. Five percent of children under five were found to be wasted. Only 1 percent areseverely wasted. Results on weight-for-age show that 28 percent of children under five are underweightand 7 percent are severely underweight.180 │ Nutrition among Children and Women