Rationale
Child growth is an internationally accepted outcome reflecting child nutritional status. Child stunting refers to a child who is too short for his or her age and is the result of chronic or recurrent malnutrition. Stunting is a contributing risk factor to child mortality and is also a marker of inequalities in human development. Stunted children fail to reach their physical and cognitive potential. Child stunting is one of the World Health Assembly nutrition target indicators. Child stunting is one of the indicators under Sustainable Development Goal (SDG) indicators target 2.2
Definition
Prevalence of stunting (height-for-age <-2 standard deviation from the median of the World Health Organization (WHO) Child Growth Standards) among children under 5 years of age
Method of measurement
Methods and Guidance: WHO and UNICEF provide recommendations for data collection, analysis and reporting on anthropometric indicators in children under 5 years old. (Recommendations for data collection, analysis and reporting on anthropometric indicators in children under 5 years old. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF), 2019. Licence: CC BY-NC-SA 3.0 IGO. ) Analysis Tool To facilitate re-running of nutritional survey data based on standardized approach, WHO has developed an online tool to analyse child anthropometric data. The WHO Anthro Survey Analyzer aims to promote best practices on data collection, analyses and reporting of anthropometric indicators. It offers analysis for four indicators: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. (WHO Anthro Survey Analyser and other tools) Global Reporting The modelled estimates are the official source used for global reporting on this indicator. (Metadata: SDG 2.2.1)
Method of estimation
Data collection method UNICEF and WHO employ their existing networks to obtain data. WHO relies on the organization’s structure and an expanding network developed following the creation of the WHO Global Database on Child Growth and Malnutrition. For UNICEF, the cadre of dedicated data and monitoring specialists working at national, regional and international levels in 190 countries routinely provides technical support to produce child malnutrition estimates through surveys and administrative systems and analyses for improved programme planning. The World Bank Group provides estimates available through the Living Standard Measurement Surveys (LSMS). Method of computation National estimates from primary sources (e.g., from household surveys) used to generate the JME global estimates are based on standardized methodology using the WHO Child Growth Standards as described in “The UNICEF-WHO-World Bank Joint Child Malnutrition Estimates (JME) standard methodology” (The UNICEF-WHO-World Bank Joint Child Malnutrition Estimates (JME) standard methodology New York: the United Nations Children’s Fund (UNICEF), the World Health Organization and the World Bank, 2024. Licence: CC BY-NC-SA 3.0 IGO. )and WHO Anthro Survey Analyser. The JME global estimates are generated using smoothing techniques and covariates applied to quality-assured national data to derive trends and up-to-date estimates. Worldwide and regional estimates are derived as the respective country averages weighted by the countries’ under-five population estimates (UNPD-WPP latest available edition) using annual JME global estimates for 205 countries. (The UNICEF-WHO-World Bank Joint Child Malnutrition Estimates (JME) standard methodology New York: the United Nations Children’s Fund (UNICEF), the World Health Organization and the World Bank, 2024. Licence: CC BY-NC-SA 3.0 IGO. ) However, estimates are only presented in the cases where a country has input data. In line with WHO’s data principle to use transparent models and methods, all codes used to generate estimates for the latest round and prior rounds are openly available on WHO’s GitHub repository. (UNICEF-WHO-World Bank Joint Child Malnutrition Estimates- Stunting and Overweight Global Health Estimates. )
