Underweight or stunting as an indicator of the MDG on poverty and hunger

The prevalence of underweight among underfives, based on anthropometric surveys is used as one of the two hunger related indicators for tracking progress towards MDG-1. The measurement of height in addition to weight allows a more refined classification of anthropometric failure, which dissects underweight in its two components (stunting and wasting). Because height captures long term growth performance more specifically than weight, an international consensus is emerging to favour stunting among underfives over underweight as the indicator of choice to monitor MDG-1. This paper looks into the interconnectedness of the three indicators and proposes new methods of charting results. First, for plotting z-score values for individual children and/or for groups a so-called ‘Anthro Graph’ is proposed. Secondly, for plotting prevalence percentages (for groups) a so-called ‘Anthro Prevalence Graph’ is useful. And lastly, the basic idea behind these graphs leads to a special type of cross-tabulation (called ‘Antro Table’) for the presentation of various kinds of results by anthropometric categories. This table can be used to present in a disaggregated manner either the prevalence percentages of undernutrition themselves or the results of an explanatory or concomitant variable. Application of the ‘Anthro Prevalence Graph’ to various levels of survey data is shown to be useful in charting trends or comparisons of undernutrition. Application of the ‘Antro Table’ to survey data from Kenya confirms the reliability of underweight as a sound overall indicator of child growth, while the prevalence of stunting (low height) remains a useful additional indicator that can help attribute any trends in underweight to chronic and/or acute undernutrition.