Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 20;13(12):4566.
doi: 10.3390/nu13124566.

Prevalence, Trends, and Socioeconomic Determinants of Coexisting Forms of Malnutrition Amongst Children under Five Years of Age in Pakistan

Asif Khaliq  1 , Darren Wraith  1 , Yvette Miller  1 , Smita Nambiar-Mann  2
Affiliations

Prevalence, Trends, and Socioeconomic Determinants of Coexisting Forms of Malnutrition Amongst Children under Five Years of Age in Pakistan

Asif Khaliq et al. Nutrients. .

Abstract

In Pakistan, malnutrition is a chronic issue. Concerns regarding coexisting forms of malnutrition (CFM) in an individual child are emerging, as children suffering from CFM have a 4 to 12-fold higher risk of death compared with healthy children. This study assessed the prevalence, trends, and socioeconomic determinants of various types of CFM using Pakistan Demographic and Health Survey (PDHS) datasets. Data from children aged 0-5 years old, with complete height and weight information, and valid anthropometry, from all regions of Pakistan (except residents of Azad Jammu Kashmir (AJK) and Federally Administered Tribal Areas (FATA), and non-de jure residents), were included. The prevalence of CFM was 30.6% in 2012-2013 and 21.5% in 2017-2018 PDHS. Both PDHSs reported a significantly higher prevalence of CFM in Sindh and Baluchistan compared with other regions of Pakistan. Improved socioeconomic status significantly reduced the odds of various types of CFM, except the coexistence of underweight with wasting. The high prevalence of CFM in Pakistan can be averted by multisectoral collaboration and by integrating nutrition-sensitive and nutrition-specific interventions.

Keywords: Pakistan; children; coexisting form; determinants; malnutrition; prevalence; socioeconomic; trends; under five years.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Child nutritional status assessment based on z-score and anthropometric indices. PDHS = Pakistan Demographic and Health Survey; WRA = Women of Reproductive Age; w/o = Without; Incomplete Anthro. = The dataset has missing information about the child age or sex, or weight, or length/height, or measurement method (standing/recumbent); ∞ = Number of WRA were less than the calculated sample size because of refusal and/or ineligibility and/or inaccessibility due to geopolitical/security issues; Red flag outliers = The z-scores calculated for HAZ/LAZ exceeds over ±6.00 S.D., WHZ exceeds over ±5.00 S.D., and of WAZ must exceed −6.00 and +5.00 S.D., respectively.
Figure 2
Figure 2
Conceptual framework defining the relationship of pediatric malnutrition with socioeconomic status and related factors.
See this image and copyright information in PMC

References

    1. Cederholm T., Jensen G.L., Correia M.I., Gonzalez M.C., Fukushima R., Higashiguchi T., Baptista G., Barazzoni R., Blaauw R., Coats A.J., et al. GLIM criteria for the diagnosis of malnutrition–A consensus report from the global clinical nutrition community. J. Cachexia Sarc. Muscle. 2019;10:207–217. doi: 10.1002/jcsm.12383. - DOI - PMC - PubMed
    1. Ahmed T., Hossain M., Sanin K.I. Global burden of maternal and child undernutrition and micronutrient deficiencies. Ann. Nutr. Metab. 2012;61((Suppl. S1)):8–17. doi: 10.1159/000345165. - DOI - PubMed
    1. Müller O., Krawinkel M. Malnutrition and health in developing countries. Can. Med. Assoc. J. 2005;173:279–286. doi: 10.1503/cmaj.050342. - DOI - PMC - PubMed
    1. Zhang Y.-Q., Li H., Wu H.-H., Zong X.-N. Stunting, wasting, overweight and their coexistence among children under 7 years in the context of the social rapidly developing: Findings from a population-based survey in nine cities of China in 2016. PLoS ONE. 2021;16:e0245455. - PMC - PubMed
    1. Wali N., Agho K., Renzaho A.M.N. Past drivers of and priorities for child undernutrition in South Asia: A mixed methods systematic review protocol. Syst. Rev. 2019;8:189. doi: 10.1186/s13643-019-1112-7. - DOI - PMC - PubMed