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Nutritional status of children under 5 years old in Namibia: adjusting for poor quality child anthropometry

Maya S Fujimura1,2, Joel Conkle3, Marjorie Van Wyk4

  • 1Department of Community and Global Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.

Journal of Nutritional Science
|August 25, 2022
PubMed

Insights

Accurate child malnutrition assessment is crucial. The PROBIT method is recommended over WHO flags for estimating stunting and wasting prevalence in Namibia, especially with poor data quality, to better target interventions.

Area of Science:

  • Public Health
  • Epidemiology
  • Nutrition Science

Background:

  • Child malnutrition assessment is vital for national health trends and resource allocation.
  • Namibia faces a high prevalence of malnutrition in children under five.
  • Previous data quality issues have hindered accurate malnutrition burden assessment.

Purpose of the Study:

  • To identify optimal methods for estimating child stunting and wasting prevalence in Namibia.
  • To compare the WHO flags and PROBIT estimation methods using datasets with suspected poor data quality.
  • To inform national-level trends and targeted interventions for child malnutrition.

Main Methods:

  • Comparative secondary data analysis of Namibia Demographic and Health Surveys (NDHS) and Namibia Household Income and Expenditure Survey (NHIES).
  • Utilized two prevalence estimation methods: WHO flags (standard) and PROBIT (recommended for poor anthropometry data).
  • Analyzed stunting and wasting prevalence, and trends from 1992 to 2016.

Main Results:

  • PROBIT estimates showed significantly lower prevalence of stunting (20.9%) and wasting (4.2%) compared to WHO flags (30.3% and 11.2%) in NHIES data.
  • PROBIT indicated smaller increases in malnutrition prevalence from 2013-2016 than WHO flags.
  • PROBIT identified specific vulnerable groups (Khoisan ethnic group) and regions (Northern Namibia) with higher malnutrition burden, unlike WHO flags.

Conclusions:

  • The PROBIT method is superior for estimating child stunting and wasting prevalence in Namibia when data quality is compromised.
  • PROBIT provides more accurate trend construction and better identification of high-burden regions and vulnerable populations.
  • Adoption of the PROBIT method will enhance the effectiveness of national malnutrition control strategies in Namibia.

Keywords:
Child anthropometryData qualityNamibiaPROBIT methodWHO flags

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