Abstract
BackgroundThere are few reports on the nutritional status of Bhutanese children. The objective of this paper is to summarize results from the 2008 National Nutrition Survey and to describe progress achieved during the last two decades.MethodsA cross-sectional survey of 2376 children aged 6 to 59 months was conducted during November-December 2008 to provide national and regional estimates. A multi-stage cluster sampling method was applied and 40 gewogs/thromdes were selected from each region (Western, Central, Eastern). Guidelines on how to measure length/height and weight followed WHO standardized procedures. Data were analysed for consistency and validation using the software WHO Anthro and the WHO SPSS macro. Underweight, stunting, overweight, wasting and thinness were defined based on the WHO Child Growth Standards. Data from 1986-88 and 1999 national surveys were reanalysed using the WHO standards to describe trends in nutritional status.ResultsNationally, 34.9% Bhutanese preschool children are stunted and 10.4% are underweight. Wasting is 4.7%, with severe wasting close to 2% in rural areas, while overweight affects 4.4% of preschool children. While underweight rates are similar across regions, wasting is substantially more prevalent in the Western region and stunting in the Eastern region. Stunting shows a steep rise during the first two years of life, as high as 40%, and levels off thereafter, while wasting is greatest among children aged 6-24 months and subsequently decreases. The prevalence of stunting fell from 60.9% in 1986-88 to 34.9% in 2008, and underweight declined from 34.0% to 10.4% during same period. The percentage of wasted children dropped from 5.2% in 1986-88 to 2.5% in 1999 but then increased to 4.7% in 2008.ConclusionsThere have been major improvements in the nutritional status of Bhutanese children over the past two decades, however, linear growth retardation remains a significant concern. Early identification of growth faltering is essential for improving the effectiveness of public health programs to prevent stunting. Similarly, wasting rates indicate the need for a system to identify children with severe malnutrition in the isolated communities so that they can receive appropriate care.
Highlights
There are few reports on the nutritional status of Bhutanese children
Complete information was available for a total of 2162 children, who were included in the analysis
The prevalence of stunting fell from 60.9% in 1986-88 to 34.9% in 2008, and underweight rates declined from 34.0% in 1986-88 to 10.4% in 2008
Summary
There are few reports on the nutritional status of Bhutanese children. The objective of this paper is to summarize results from the 2008 National Nutrition Survey and to describe progress achieved during the last two decades. Population distribution has been largely determined by the country’s geographical location and its rugged and steep terrain This has obliged people to settle wherever they can find usable land, resulting in a scattered population where most people lack easy access to motor able roads. Between 1960 and 2005, life expectancy rose from 37 years to 66 years, while infant mortality fell from 203 to 40.1 deaths per thousand live births. These gains are primarily the result of basic preventive and curative health services - which cover over 90% of the population - complemented by improved water supply and sanitation [1]
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