Recent Patterns of Stunting and Wasting in Venezuelan Children: Programming Implications for a Protracted Crisis

Susana Raffalli,Carlos Villalobos

doi:10.3389/fsufs.2021.638042

Susana Raffalli, Carlos Villalobos

Open Access

https://doi.org/10.3389/fsufs.2021.638042

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Abstract

This study aims to assess the patterns of wasting and stunting and their concurrence among vulnerable Venezuelan children. We performed an analysis of 46,462 anthropometric records captured by Caritas Venezuela between 2017 and 2019 and relating to children under 5 years old in the poorest parishes. Based on the WHO 2006 child growth standards, we identify 31.7% and 11.5% of the records from 2019 as stunted and wasted, respectively. Our unconditional analysis shows that stunting was more frequent among boys and shows an inverted U-shape association with age. The prevalence of stunting increases from 0.28 in 2017 to 0.32 in 2019. By contrast, the wasting prevalence decreases from 0.15 in 2017 to 0.11 in 2019. The concurrence of stunting and wasting slightly decreases over the same period from 0.045 to 0.039, all three trends being statistically significant. Using multilevel regression models, our conditional analysis shows that the odds of wasted children being stunted are 1.079 times greater than for non-wasted children. Similarly, the odds of stunted children being wasted are 1.085 times greater than for non-stunted children. While age is not statistically associated with stunting, it reduces the likelihood of being wasted. Furthermore, each additional month of age reduces by 1.16% the odds of facing the simultaneous concurrence of stunting and wasting instead of not facing it. The children's sex is also found to have a significant association with the probability of stunting and wasting. The odds of stunting and wasting amongst boys are found to be 1.19 and 1.084 times greater than for girls, respectively. We also found a significant and sizeable association between food insecurity and both stunting and wasting. Although lack of access to clean water is not associated with stunting, it is associated with higher levels of wasting. Protracted humanitarian crisis in Venezuela has brought considerable damage to child growth. Findings have policy and programming implications: stunting should be targeted as a humanitarian priority in protracted crisis, not only to mitigate the growth failure in children facing multiple nutritional deficiencies, but also as an approach for preventing persistent acute malnutrition.

Highlights

Malnutrition and crises go hand in hand: malnutrition both impacts on and is impacted upon by crises
Drivers of Wasting and Stunting Concurrence First, we find that a wasted child is more likely to be stunted
Our findings reveal that both wasting and stunting have been prevalent over the last several years of the protracted crisis in Venezuela, reaching alarming thresholds all over the analyzed period, following an evident pattern of concurrence and responding to strong predictors related to food security, and to age, sex, birth seasonality, and access to water

Summary

Introduction

Malnutrition and crises go hand in hand: malnutrition both impacts on and is impacted upon by crises. Acute malnutrition (wasting) has been used as a marker in several food crisis classification frameworks and is the common criterion for child enrollment in humanitarian programs. Over time in protracted crises, the problem of persistent acute malnutrition becomes increasingly evident and humanitarian programs are caught in a bind. Programs that tend to treat acute malnutrition have limited impact on the underlying causes that contribute to its persistence and on mitigating chronic malnutrition. These issues stimulate both the debate on the performance and efficacy of humanitarian programs and the debate on the challenges for exit strategies and transition from short term humanitarian responses (Young and Marshak, 2017). On the one hand, stunting has a multiplying effect on wasting and mortality risks (ENN, 2020), and on the other hand, due to its well-documented association with impaired physical, cognitive, and socioeconomic development of affected populations, stunting undermines programmatic approaches toward resilience (Galasso and Wagstaff, 2016; WFP ECLAC, 2017)

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