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Ratio of severe:moderate wasting and ratio of severe:moderate stunting

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Normal user

28 Feb 2015, 14:45

What is the ratio between severe to moderate wasting and severe to moderate stunting that can be expected in a given population? Any reference?

Mark Myatt

Consultant Epideomiologist

Frequent user

3 Mar 2015, 12:42

What is the ratio between severe to moderate wasting and severe to moderate stunting that can be expected in a given population? Any reference?

I assume you mean ratios of prevalence. Is this right?

I also assume that "severe to moderate" means "severe and moderate" which is just the prevalence of wasting or stunting. Is this right?

The ratio will very likely vary with place, time, age-group, and context. It is easy to find out from simple survey (e.g. SMART) data. As you are interested in "stunting" rather than "stuntedness" you'll probably want to work with data for children aged 6-30 months only.

I hope this is of some help.


Normal user

3 Mar 2015, 13:26

Do you mean the ratio of the prevalence of wasted children to the prevalence of stunted children?

If so, I don't think there is an expected ratio per se. They can be affected by different things.

I'm guessing you're in a place where you've done a nutrition survey and you've got one type of prevalence that's high and the other that's low, or where one has changed and the other hasn't. Like I said, they can be affected by very different things.

Stunting is generally related to factors that affect the child over a long period - like very poor sanitation or a continuous poor diet. It also takes a while for a stunted child who is suddenly put into a better situation to catch up on his growth - if he ever does.

Wasting can happen very quickly, like during a bout of diarrhea, but then also resolve quickly too, once the child is well again. But in some situations, a child can be chronically wasted if the causes of the wasting are not addressed. Since we are talking about prevalence and not a single child, you can also have rapid changes in prevalence in response to changes in factors that affect wasting. Children may be becoming wasted quickly - and then regaining weight quickly while another is becoming wasted, essentially keeping the prevalence the same, with different children passing through this state.

In a normally food secure environment with good sanitation and care that experiences a rapid on-set crisis affecting the care and feeding of children, you'd expect a higher prevalence of children that are wasted than children who are stunted. In a place where there is chronic food insecurity, poor healthcare, poor sanitation, poor care and feeding practices... you'd expect a higher prevalence of children who are stunted than the first scenario - though the prevalence of wasted children might be the same, higher or lower than the first scenario depending on the details of the situation.

Understanding what is causing each in the particular place you are working is key to addressing the prevalence of each - but even if your program is addressing both equally well, don't expect the prevalence of stunted children to improve as quickly as the prevalence of wasted children.

Does that make sense?

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