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.
Highlights
Malnutrition is a serious public health concern affecting at least half of children under five years of age in developing countries [1–3]
All previous surveys conducted in Pakistan and other parts of the world have assessed the prevalence, trends, and determinants of various standalone forms of nutrition and one type of coexisting forms of malnutrition (CFM)-stunting with overweight and obesity [25,29,35–37]
We found that improved socioeconomic status was associated with significant reductions in the odds of various forms of CFM
Summary
Malnutrition is a serious public health concern affecting at least half of children under five years of age in developing countries [1–3]. Stunting, wasting, underweight, overweight, and obesity are the most common types of malnutrition in children [4]. Children living in Asian and African regions of the world have the highest risk of various forms of malnutrition [5]. There is global concern regarding coexisting forms of malnutrition (CFM) in the same child. The simultaneous presence of stunting together with overweight/obesity represents a contrasting form of malnutrition, demanding interventions that can concurrently manage and control both undernutrition as well as overnutrition [8,9]. The 2018 and 2019 Global Nutrition Report identified two types of CFM in children: Coexistence of wasting with stunting, and of stunting with overweight/obesity [10], while the World Health Organization’s 2020 report described the simultaneous occurrence of stunting and/or wasting among underweight children [11]. Children suffering from more than one form of malnutrition had a 4 to 12-fold higher risk of death compared with healthy children [12]
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