Sudeep Shrestha1,2, Andrew L Thorne-Lyman1,2,3, Swetha Manohar1,2, Binod Shrestha2, Sumanta Neupane2, Ruchita Rajbhandary2, Raman Shrestha2, Rolf Dw Klemm1,4, Bareng As Nonyane2, Ramesh K Adhikari2,5, Patrick Webb2,6, Keith P West7,2. 1. Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 2. Nutrition Innovation Lab, Kathmandu, Nepal. 3. Harvard T.H. Chan School of Public Health, USA. 4. Helen Keller International, New York, NY, USA. 5. Kathmandu Medical College, Kathmandu, Nepal. 6. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. 7. Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. kwest1@jhu.edu.
Abstract
BACKGROUND AND OBJECTIVES: Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional status following the earthquake in Nepal in 2015. METHODS AND STUDY DESIGN: A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. RESULTS: Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. CONCLUSIONS: Two midyear surveys in Nepal revealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunting noted in previous years. The same period saw a slight reduction in wasting and improved household food security.
BACKGROUND AND OBJECTIVES: Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional status following the earthquake in Nepal in 2015. METHODS AND STUDY DESIGN: A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. RESULTS: Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. CONCLUSIONS: Two midyear surveys in Nepal revealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunting noted in previous years. The same period saw a slight reduction in wasting and improved household food security.
Authors: Monica M Pasqualino; Andrew L Thorne-Lyman; Swetha Manohar; Angela Kc; Binod Shrestha; Ramesh Adhikari; Rolf D Klemm; Keith P West Journal: Curr Dev Nutr Date: 2021-05-21
Authors: Grace Namirembe; Robin Shrestha; Patrick Webb; Robert Houser; Dale Davis; Kedar Baral; Julieta Mezzano; Shibani Ghosh Journal: Int J Health Policy Manag Date: 2022-03-01
Authors: Elena T Broaddus-Shea; Andrew L Thorne-Lyman; Swetha Manohar; Bareng A S Nonyane; Peter J Winch; Keith P West Journal: Curr Dev Nutr Date: 2018-06-29
Authors: Andrew L Thorne-Lyman; Angela K C; Swetha Manohar; Binod Shrestha; Bareng A S Nonyane; Sumanta Neupane; Shiva Bhandari; Rolf D Klemm; Patrick Webb; Keith P West Journal: PLoS One Date: 2018-11-07 Impact factor: 3.240
Authors: Elena T Broaddus-Shea; Swetha Manohar; Andrew L Thorne-Lyman; Shiva Bhandari; Bareng A S Nonyane; Peter J Winch; Keith P West Journal: Nutrients Date: 2020-01-18 Impact factor: 5.717