SOCIOECONOMIC AND DEMOGRAPHIC-FACTORS ARE ASSOCIATED WITH WORLDWIDE PATTERNS OF STUNTING AND WASTING OF CHILDREN

We estimated the variability among nations in the prevalence of stunti ng and wasting, evaluated which national factors are associated with s tunting and wasting and examined the relationship of stunting with was ting. The World Health Organization Global Database on Child Growth, a comprehensive conceptual model and a database of national factors wer e used with variance components and regression analyses. There was sub stantial variability among nations and among provinces within nations. Most national variability for stunting (76%) and wasting (66%) was ex plained by national factors and geographic region. Higher energy avail ability, female literacy and gross product were the most important fac tors associated with lower prevalence of stunting. The association of health expenditures and stunting differed by region. Higher immunizati on rate and, for Asia only, energy availability were the most importan t factors associated with lower prevalence of wasting. Regional differ ences in the relationship between stunting and wasting were accounted for by national factors. Some factors associated with stunting and was ting differ at the national level. Child malnutrition within a househo ld is greatly influenced by issues at national and provincial levels, and intervention should be considered at all three levels.