MEASURE DHS assists countries worldwide in the collection and use of data to monitor and evaluate 

population, health, and nutrition programs. Funded by the U.S. Agency for International Development 

(USAID), MEASURE DHS is implemented by ORC Macro in Calverton, Maryland. 

The main objectives of the MEASURE DHS project are: 

1) to provide decisionmakers in survey countries with information useful for informed policy choices, 

2) to expand the international population and health database, 

3) to advance survey methodology, and 

4) to develop in participating countries the skills and resources necessary to conduct high-quality demographic and health surveys. 

Information about the MEASURE DHS project or the status of MEASURE DHS surveys is available 

on the Internet at http://www.measuredhs.com or by contacting: 

ORC Macro 

11785 Beltsville Drive 

Suite 300 

Calverton, MD 20705 USA 

Telephone: 301-572-0200 

Fax: 301-572-0999 

E-mail: reports@orcmacro.com
DHS Comparative Reports No. 10 

Nutritional Status of Children:

Results from the Demographic and

Health Surveys 1994-2001 

Altrena Mukuria 

Jeanne Cushing 

Jasbir Sangha 

ORC Macro 

Calverton, Maryland, USA 

December 2005 
This publication was made possible through support provided by the U.S. Agency 

for International Development under the terms of Contract No. HRN-C-00-97-

00019-00. The opinions expressed herein are those of the authors and do not 

necessarily reflect the views of the U.S. Agency for International Development. 

Editor: Sidney Moore 

Report production: John Chang 

Recommended citation: 

Mukuria, Altrena, Jeanne Cushing, and Jasbir Sangha. 2005. Nutritional Status of Children: Results from 

the Demographic and Health Surveys 1994-2001. DHS Comparative Reports No. 10. Calverton, Maryland: 

ORC Macro. 
Contents

Tables and Figures........................................................................................................................................ v

Preface.......................................................................................................................................................... ix

Acknowledgements...................................................................................................................................... xi

Executive Summary ................................................................................................................................... xiii

Introduction .................................................................................................................................................. 1

Data and Methods ........................................................................................................................................ 3

2.1 Sample of Children................................................................................................................. 4

Findings ........................................................................................................................................................ 7

3.1 Infant and Under-Five Mortality............................................................................................ 7

3.2 Contribution of Undernutrition to Mortality......................................................................... 9

3.3 Malnutrition Rates.................................................................................................................. 9

3.3.1 Levels of Undernutrition............................................................................................ 9

3.3.2 Patterns of Undernutrition ........................................................................................ 9 

3.3.3 Severity of Undernutrition....................................................................................... 12 

3.3.4 Distribution of Z-scores .......................................................................................... 12 

3.3.5 Age Distribution of Undernutrition ........................................................................ 18 

3.3.6 Levels of Overnutrition............................................................................................ 19 

3.4 Influences on the Nutritional Status of Children ................................................................. 26

3.4.1 Basic Influences........................................................................................................ 26

3.4.2 Underlying Social and Economic Influences........................................................... 29

3.4.2.1 Mother’s Education ................................................................................................. 31

3.4.2.2 Mother’s Work Status.............................................................................................. 35

3.4.2.3 House Flooring Status ............................................................................................. 39

3.4.2.4 Sanitation Facilities.................................................................................................. 43

3.4.2.5 Source of Drinking Water ....................................................................................... 47 

3.4.3 Underlying Biological and Behavioral Influences.................................................... 51 

3.4.3.1 Characteristics of Mothers....................................................................................... 51

3.4.3.2 Child Characteristics ............................................................................................... 62

3.4.3.3 Immediate Influences............................................................................................... 92

Summary and Conclusions ....................................................................................................................... 101

References ................................................................................................................................................. 103 

Appendix A............................................................................................................................................... 107 

Contents iii

Tables and Figures 

Table 2.1 Demographic and Health Surveys included in this report........................................... 3 

Table 2.2 DHS indicators used in this report .............................................................................. 4 

Figure 3.1 Infant and Under-Five Mortality Rates....................................................................... 8 

Figure 3.2 Levels of stunting and underweight among children age 0-35 months, 

Demographic and Health Surveys, 1994-2001.......................................................... 10 

Figure 3.3 Levels of wasting among children age 0-35 months.................................................. 11 

Figure 3.4 Percentage of children age 0-35 months who are moderately stunted 

and severely stunted.................................................................................................... 13 

Figure 3.5 Percentage of children age 0-35 months who are moderately wasted 

and severely wasted..................................................................................................... 14 

Figure 3.6 Percentage of children age 0-35 months who are moderately underweight 

and severely underweight ........................................................................................... 15 

Figure 3.7 Distribution of height-for-age, weight-for-height, and weight-for-age 

Z-scores among children age 3-35 months................................................................ 16 

Figure 3.8 Levels of stunting by child’s age group....................................................................... 20 

Figure 3.9 Levels of wasting by child’s age group........................................................................ 21 

Figure 3.10 Levels of underweight by child’s age group................................................................ 22 

Figure 3.11 Distribution of mean Z-scores for height-for-age, weight-for-height, 

and weight-for-age among children age 3-35 months............................................... 23 

Figure 3.12 Percentage of overweight (weight-for-height) children age 0–35 months ................ 25 

Figure 3.13 Conceptual framework for child nutritional status .................................................... 27 

Figure 3.14 Levels of stunting by urban-rural residence ............................................................... 28 

Figure 3.15 Levels of wasting by urban-rural residence ................................................................ 30 

Figure 3.16 Levels of underweight by urban-rural residence ........................................................ 31 

Figure 3.17 Levels of stunting among children age 0-35 months by mother’s education............. 32 

Figure 3.18 Levels of wasting among children age 0-35 months by mothers’ education.............. 33 

Figure 3.19 Levels of underweight among children age 0-35 months by mother’s education...... 34 

Figure 3.20 Levels of stunting among children age 0-35 months by mother’s work status .......... 36 

Figure 3.21 Levels of wasting among children age 0-35 months by mother’s work status ........... 37 

Figure 3.22 Levels of underweight among children age 0-35 months by mother’s work status ... 38 

Tables and Figures v
Figure 3.23 Levels of stunting among children age 0-35 months by flooring status .................... 40 

Figure 3.24 Levels of wasting among children age 0-35 months by flooring status ..................... 41 

Figure 3.25 Levels of underweight among children age 0-35 months by flooring status ............. 42 

Figure 3.26 Percentage of children age 0-35 months who are stunted, by type of household 

sanitation facility ........................................................................................................ 44 

Figure 3.27 Percentage of children age 0-35 months who are wasted by type of sanitation 

facility ......................................................................................................................... 45 

Figure 3.28 Percentage of children age 0-35 months who are underweight by type of 

household sanitation facility....................................................................................... 46 

Figure 3.29 Percentage of children age 0-35 months who are stunted, by source of 

drinking water ............................................................................................................ 48 

Figure 3.30 Percentage of children age 0-35 months who are wasted, by source of 

drinking water ............................................................................................................ 49 

Figure 3.31 Percentage of children age 0-35 months who are underweight, by source of 

drinking water ............................................................................................................ 50 

Figure 3.32 Percentage of children age 0-35 months who are stunted, by mother’s 

nutritional status......................................................................................................... 52 

Figure 3.33 Percentage of children age 0-35 months who are wasted, by mother’s 

nutritional status......................................................................................................... 53 

Figure 3.34 Percentage of children age 0-35 months who are underweight, by mother’s 

nutritional status......................................................................................................... 54 

Figure 3.35 Percentage of children age 0-35 months who are stunted, by antenatal care 

visits............................................................................................................................ 56 

Figure 3.36 Percentage of children age 0-35 months who are wasted, by antenatal care 

visits............................................................................................................................ 57 

Figure 3.37 Percentage of children age 0-35 months who are underweight, by 

antenatal care visits..................................................................................................... 58 

Figure 3.38 Levels of stunting among children age 0-35 months by mother’s age 

at delivery ................................................................................................................... 59

Figure 3.39 Levels of wasting among children age 0-35 months by mother’s age 

at delivery ................................................................................................................... 60

Figure 3.40 Levels of underweight among children age 0-35 months by mother’s 

age at delivery ............................................................................................................. 61 

Figure 3.41 Levels of stunting among children age 0-35 months by mother’s perceived 

size of child at birth.................................................................................................... 63 

Figure 3.42 Levels of wasting among children age 0-35 months by mother’s perceived 

size of child at birth.................................................................................................... 64 

vi Tables and Figures
Figure 3.43 Levels of underweight among children age 0-35 months by mother’s perceived 

size of child at birth.................................................................................................... 65 

Figure 3.44 Levels of stunting among children age 0-35 months by sex of a child ...................... 66 

Figure 3.45 Levels of wasting among children age 0-35 months by sex of child .......................... 67 

Figure 3.46 Levels of underweight among children age 0-35 months by sex of child .................. 68 

Figure 3.47 Levels of stunting among children age 0-35 months by birth order.......................... 70 

Figure 3.48 Levels of wasting among children age 0-35 months by birth order........................... 71 

Figure 3.49 Levels of underweight among children age 0-35 months by birth order................... 73 

Figure 3.50 Levels of stunting among children age 0-35 months by length of preceding 

birth interval............................................................................................................... 75

Figure 3.51 Levels of wasting among children age 0-35 months by length of preceding 

birth interval............................................................................................................... 76

Figure 3.52 Levels of underweight among children age 0-35 months by length of 

preceding birth interval .............................................................................................. 77 

Figure 3.53 Percentage of children age 12-23 months with a measles vaccination....................... 79 

Figure 3.54 Levels of stunting among children age 0-35 months by measles 

vaccination status........................................................................................................ 80 

Figure 3.55 Levels of wasting among children age 0-35 months by measles 

vaccination status........................................................................................................ 81 

Figure 3.56 Levels of underweight among children age 0-35 months by measles 

vaccination status........................................................................................................ 82 

Figure 3.57 Levels of stunting among children age 0-35 months by vaccination status ............... 84 

Figure 3.58 Levels of wasting among children age 0-35 months by vaccination status ................ 85 

Figure 3.59 Levels of underweight among children age 0-35 months by vaccination status ........ 86 

Figure 3.60 Exclusive Breastfeeding status of children under 6 months....................................... 88 

Figure 3.61 Complementary feeding status of children age 6-9 months ...................................... 89 

Figure 3.62 Median duration of exclusive breastfeeding, predominant breastfeeding, and 

any breastfeeding........................................................................................................ 91 

Figure 3.63 Prevalence of ARI among children age 4-23 months by stunting ............................. 93 

Figure 3.64 Prevalence of ARI among children age 4-23 months by wasting .............................. 94 

Figure 3.65 Prevalence of ARI among children age 4-23 months by underweight ...................... 95 

Figure 3.66 Prevalence of diarrhea among children age 4-23 months by stunting ....................... 97 

Figure 3.67 Prevalence of diarrhea among children age 4-23 months by wasting ........................ 98 

Tables and Figures vii
Figure 3.68 Prevalence of diarrhea among children age 4-23 months by underweight ................ 99 

Table A.3.1 Infant and under-five mortality rates ....................................................................... 107

Table A.3.2 Contribution of undernutrition to under-five mortality .......................................... 108

Table A.3.3 Undernutrition among young children .................................................................... 109

Table A.3.4 Height-for-age Z-scores among young children ..................................................... 110

Table A.3.5 Weight-for-height Z-scores among young children................................................ 111 

Table A.3.6 Weight-for-age Z-scores among young children..................................................... 112

Table A.3.7 Undernutrition by child's age group......................................................................... 113

Table A.3.8 Nutritional status of young children......................................................................... 114

Table A.3.9 Overweight children age 0–35 months .................................................................... 115

Table A.3.10 Undernutrition by urban-rural residence.................................................................. 116 

Table A.3.11 Undernutrition by mother's education ..................................................................... 117

Table A.3.12 Undernutrition by mother's work status .................................................................. 118

Table A.3.13 Undernutrition by flooring status............................................................................. 119

Table A.3.14 Undernutrition by type of sanitation facility ............................................................ 120 

Table A.3.15 Undernutrition by source of drinking water............................................................. 121 

Table A.3.16 Undernutrition by mother's nutritional status.......................................................... 122 

Table A.3.17 Undernutrition by antenatal care visits..................................................................... 123

Table A.3.18 Undernutrition by mother's age at delivery.............................................................. 124 

Table A.3.19 Undernutrition by mother's perceived size of child at birth..................................... 125 

Table A.3.20 Undernutrition by sex of child ................................................................................. 126

Table A.3.21 Undernutrition by birth order .................................................................................. 127

Table A.3.22 Undernutrition by length of preceding birth interval............................................... 128 

Table A.3.23 Undernutrition by measles vaccination status .......................................................... 129

Table A.3.24 Undernutrition by vaccination status ....................................................................... 130

Table A.3.25 Breastfeeding status of children under 6 months..................................................... 131

Table A.3.26 Breastfeeding status of children age 6-9 months ..................................................... 132

Table A.3.27 Median duration and frequency of breastfeeding..................................................... 133

Table A.3.28 Undernutrition by ARI status .................................................................................. 134

Table A.3.29 Undernutrition by diarrhea status ............................................................................ 135

viii Tables and Figures
Preface

One of the most significant contributions of the MEASURE DHS program is the creation of an internationally comparable body of data on the demographic and health characteristics of populations in developing countries. The DHS Comparative Reports series examines these data across countries in a comparative framework. The DHS Analytical Studies series focuses on specific topics. The principal objectives of 

both series are to provide information for policy formulation at the international level and to examine individual country results in an international context. Whereas Comparative Reports are primarily descriptive, Analytical Studies take a more analytical approach. 

The Comparative Reports series covers a variable number of countries, depending on the availability of 

data sets. Where possible, data from previous DHS surveys are used to evaluate trends over time. Each 

report provides detailed tables and graphs organized by region. Survey-related issues such as questionnaire 

comparability, survey procedures, data quality, and methodological approaches are addressed as needed. 

The topics covered in Comparative Reports are selected by MEASURE DHS staff in conjunction with 

the U.S. Agency for Internationl Development. Some reports are updates of previously published reports. 

It is anticipated that the availability of comparable information for a large number of developing countries will enhance the understanding of important issues in the fields of international population and 

health by analysts and policymakers. 

Martin Vaessen 

Project Director 

Preface ix

Acknowledgements

The authors would like to thank Fred Arnold, Noah Bartlett, Monica Kothari, Robert Johnston, Shea 

Rutstein, and Vinod Mishra for their work in reviewing the data for the report. The editing and production 

assistance of Sidney Moore, John Chang, Justin Faulkenburg, and Katherine Senzee is appreciated.

Acknowledgements xi

Executive Summary 

This report reviews the nutritional status of children under 3 years of age in 41 developing countries. Nutritional status is based on anthropometric measurements of height and weight of children taken during 

household interviews conducted by the Demographic and Health Surveys (DHS) program between 1994 

and 2001. Five regions are included in this report: sub-Saharan Africa (23 countries), North Africa/West 

Asia/Europe (4 countries), Latin America and the Caribbean (7 countries), Central Asia (3 countries), 

and South/Southeast Asia (4 countries). 

Malnutrition includes both under- and overnutrition. Although this report focuses primarily on undernutrition (stunting, wasting, and underweight), the prevalence of overweight is also reported. Important 

differentials of undernutrition, such as age, are presented. Using a conceptual framework for child nutritional status adapted from UNICEF, this report explores variables representing four key influences (basic; 

underlying social and economic; underlying biological and behavioral; and immediate). As background to 

the report, tables on infant and under-five mortality rates and the contribution of undernutrition to mortality are included. 

DHS continues to find high levels of undernutrition in all the countries surveyed. In 31 of the 41 

countries, more than 20 percent of the children are stunted, with 9 of the countries having stunting rates 

of 40 percent or more. The South/Southeast Asia region has the highest rates of stunting and underweight (40 percent or more), followed by sub-Saharan Africa (about 30 percent). The remaining three 

regions have stunting rates around 20 percent and underweight rates between 10 percent and 15 percent. 

Although undernutrition is of much concern in developing countries, childhood obesity is increasing 

worldwide. The prevalence of overweight (weight-for-height) in children under three years is particularly 

noticeable in the Latin America and Caribbean region (almost 6 percent) and Central Asia (5 percent). 

South/Southeast Asia has the lowest level of overweight among the regions (2 percent). 

Differentials in background variables provide insights into patterns of undernutrition. Undernutrition 

is age dependent. Children younger than 6 months and those age 24-35 months have lower rates of undernutrition than children age 6-23 months. Undernutrition accelerates from 4 to 23 months of age. Undernutrition is more prevalent in rural than urban areas. This differential may be due to differences in social and economic conditions in urban and rural areas, such as mother’s education, work status, and 

availability of water and sanitation facilities. These underlying influences operate to predict higher rates of 

stunting and underweight but are not strongly associated with wasting rates. Children of working mothers 

and mothers with primary or less education have higher rates of undernutrition. Likewise, children living 

in households with unfinished floors, without flush toilets, and without access to piped water have higher 

rates of undernutrition. 

Biological and behavioral influences related to mother and child are also important for child nutrition. 

Higher rates of undernutrition are found for children whose mothers are undernourished. Antenatal care 

(at least one clinic visit) is negatively related to child nutrition (stunting and underweight). The influence 

of mother’s age at delivery varies by region and undernutrition indicator. Children of younger mothers 

(under 20 years) have higher rates of stunting and underweight in sub-Saharan Africa and North Africa/West Asia/Europe, but children of older mothers (35 years or more) have higher rates of stunting 

and underweight in Latin America and the Caribbean, Central Asia, and South/Southeast Asia. Wasting 

rates show no consistent pattern by region or mother’s age. 

Executive Summary xiii
Prevalence of undernutrition by child’s characteristics, such as size at birth, sex, birth order, and preceding birth interval, was also examined. Babies being very small at birth (as perceived by the mother) is 

related to poor nutritional status. Females tend to have better nutritional status than males in most regions. However in South/Southeast Asia, males are somewhat less likely to be stunted or underweight 

than females. Higher birth order is related to poor nutritional status (particularly stunting). A preceding 

birth interval of less than 24 months is related to poor nutritional status, but first births and intervals of 

48 months or longer are associated with lower rates of stunting and underweight. 

Other biological and behavioral factors include vaccination history and feeding practices. Children age 

12-23 months who are vaccinated against measles have lower rates of undernutrition than those who are 

not; and children age 12-23 months who have completed “other vaccinations” have lower rates of undernutrition than children who have not received any vaccinations. However, having completed one or more 

measles vaccinations is the best predictor of lower undernutrition rates. Feeding practices were used only 

as descriptors of behaviors across countries and regions. In children under six months of age, the prevalence of exclusive breastfeeding is highest in South/Southeast Asia (45 percent) and lowest in subSaharan Africa (22 percent). The North Africa/West Asia/Europe and Central Asia regions do not have 

DHS data on infant feeding practices in some of the countries. Bottle-feeding is low among breastfed 

babies in all of the regions except Latin America and the Caribbean, where 60 percent or more of breastfed infants under six months are also bottle-fed. Children age 6-9 months are expected to be fed solids in 

addition to breast milk (complementary feeding). Sub-Saharan Africa has the highest rates of complementary feeding at age 6-9 months (71 percent), and the Latin America and Caribbean region has the 

lowest (about 54 percent). The median duration of breastfeeding is about 15 months in Latin America 

and the Caribbean and in North Africa/West Asia/Europe. South/Southeast Asia and sub-Saharan Africa have the longest breastfeeding durations, 27 and 21 months, respectively. The international recommendation is that children continue to breastfeed through two years of age. 

This report examines the association between undernutrition and two major childhood diseases—acute 

respiratory infection (ARI) and diarrhea. Higher rates of ARI and diarrhea were expected among undernourished children. However, a weak association was found between undernutrition and the prevalence of 

ARI and diarrhea in children. Moreover, the results are not consistent across countries and regions. The 

results are more consistent for diarrhea than ARI, with higher rates of diarrhea among children who are 

wasted or underweight. 

To conclude, improved health services, water sources, and sanitation facilities, as well as immunizations, are important for the prevention and treatment of childhood illnesses and the improvement of the 

nutritional status of children. Policies and programs that impact basic and underlying social and economic 

influences should improve conditions that support chronic undernutrition. Although the developing regions of the world share similar problems related to poverty, there are significant country and regional 

differences in the prevalence of undernutrition and the factors that influence child nutritional status. 

Therefore, policies and program interventions need to be tailored to the needs of each country and region. 

This report provides country and regional comparative data that can be used for policymaking, program 

planning, and monitoring purposes. 

xiv Executive Summary
1

Introduction 

hild malnutrition continues to be a major public health problem in developing countries around the 

world. This report presents data on the status of child nutrition in 41 countries included in the 

Demographic and Health Surveys (DHS) program between 1994 and 2001. DHS collects anthropometric and related data that enable a comparative exploration of key indicators that influence the nutritional 

status of children. 

C

Nutritional status is primarily determined by a child’s growth in height and weight and is directly influenced by food intake and the occurrence of infections. Food intake is not only a result of food availability at the household level but also of dietary quality and quantity and feeding practices. Optimal infant 

feeding practices, which include breastfeeding and timely complementary feeding, contribute to the level 

of food intake in infants and young children (Brown et al., 1998). In addition, acute and chronic infections have a major impact on nutritional status because they impair growth by limiting macro- and micronutrient intake and utilization (Stephensen, 1999). 

Nutritional anthropometry—the measurement of size, weight, and proportions of the body—provides 

the primary indicators of past and present nutritional and health status of children. Anthropometric 

measures used in this report include weight, standing height, and recumbent length (used for children 

under two years of age). In combination, anthropometric indices can distinguish between stunting (low 

stature), wasting (thinness), and under- and overweight. Each indicator gives a different perspective on 

the nutritional status of children. Chronic (stunting) and acute (wasting) nutritional problems and general 

health and nutritional status (under- and overweight) can be assessed at the population level through 

these measures. 

The assessment of nutritional status is based on the rationale that in a well-nourished population, there 

are statistically predictable distributions of children’s height and weight at a given age. The variations in 

height and weight approximate a normal distribution. To examine differences in the anthropometric 

status of various populations and subpopulations, a standard reference population is used for comparison. 

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) 

recommend the international reference population that is based on the United States National Center for 

Health Statistics (NCHS) standard. The use of this reference population is based on the premise that 

young children of all population groups have similar genetic potential for growth. 

Each of the three indicators for undernutrition is expressed in standard deviations (Z-scores) from the 

mean of the reference population. Deviations of the indicators below -2 standard deviations (SD) indicate 

that the children are moderately or severely affected, while deviations below -3 SD indicate that the children are severely affected. 

The prevalence and severity of undernutrition among children age 0-35 months, regional differences, 

infant and under-five mortality, infant feeding patterns, and infectious diseases are reported here. In addition, important differentials in maternal and child demographic characteristics, child health care, and maIntroduction 1
ternal nutritional status are explored by child nutritional status. Basic and underlying social and economic 

differentials, including urban and rural residence, water and sanitation, mother’s work status, and household flooring, are examined as proxies for household economic status. 

2 Introduction
2

Data and Methods 

h

w

e Demographic and Health Surveys (DHS) is the 

orld’s largest survey program, collecting nationally 

representative data on women age 15-49 years, men age 

15-59 years, and children under 5 years of age. More 

than 160 surveys have been conducted in over 70 countries of sub-Saharan Africa, North Africa/West 

Asia/Europe, South/Southeast and Central Asia, and 

Latin America and the Caribbean. Some countries have 

conducted two or more surveys at intervals of three to six 

years. The United States Agency for International Development has provided most of the funding for these 

surveys. Because of funding priorities, surveys are conducted in selected countries. 

T Table 2.1

Demographic and Health Surveys included in 

this report 

Country Year of survey 

Sub-Saharan Africa 

Benin 1996 

Burkina Faso 1998-99 

Cameroon 1998 

Central African Republic 1994-95 

Chad 1996-97 

Comoros 1996 

Côte d’Ivoire 1994 

Eritrea 1995 

Ethiopia 2000 

Gabon 2000 

Ghana 1998 

Data presented in this report are based on the results 

of surveys conducted in 41 countries between 1994 and 

2001 (Table 2.1). Sub-Saharan Africa has the largest 

number of countries with completed surveys (23), followed by Latin America and the Caribbean (7), 

South/Southeast Asia (4) and North Africa/West 

Asia/Europe (4), and Central Asia (3). Since the data 

are not representative in all regions, this report can provide only limited comparisons within regions and suggested differences across regions. The main purpose of 

this report is to update information on the indicators of 

child nutrition in the developing regions of the world. 

Guinea 1999 

Kenya 1998 

Madagascar 1997 

Malawi 2000 

Mali 1995-96 

Mozambique 1997 

Niger 1998 

Tanzania 1999 

Togo 1998 

Uganda 2000-01 

Zambia 1996 

Zimbabwe 1999 

North Africa/West Asia/Europe 

Egypt 2000 

Jordan 1997 

Turkey 1998 

Yemen 1997 

Central Asia 

In each country, information is collected at the 

household level and the individual level. At the household level, information is collected on basic characteristics of members of the household, structure of the dwelling, anthropometric measures of women and children, 

anemia testing of women and children, salt testing for 

iodization, and water supply and sanitation facilities, 

among others. 

Kazakhstan 1999 

Kyrgyz Republic 1997 

Uzbekistan 1996 

South/Southeast Asia 

Bangladesh 2000 

Cambodia 2000 

India 1998-99 

Nepal 1996 

Latin America/Caribbean 

Bolivia 1998 

Brazil 1996 

The individual questionnaire for women allows for Colombia 2000 

the collection of information on marriage, fertility, fertility preferences, family planning, infant and under-five 

mortality, maternal mortality, maternal and child health, 

Dominican Republic 1996 

Guatemala 1998-99 

Haiti 2000 

Peru 2000 

Data and Methods 3
infant and young child feeding, childhood diseases, vaccinations, women’s status, and women’s attitudes 

and practices regarding the prevention of sexually transmitted diseases and HIV/AIDS. The indicators 

included in this report are shown in Table 2.2. 

Table 2.2 

DHS indicators used in this report 

Indicator 

Key child 

survival and 

nutrition 

indicators 

Underlying Underlying 

social and biological and 

Basic Immediate economic behavioral 

influences influences influences influences 

Child survival 

Infant and under-5 mortality x 

Contribution of malnutrition 

to mortality x 

Nutritional status 

Malnutrition rates (stunting, 

wasting, underweight, and 

overweight) x 

Age distribution of 

undernutrition x 

DIFFERENTIALS IN UNDERNUTRITION 

Residence 

Urban-rural x 

Education 

Maternal education x 

Employment 

Maternal work status x 

Household assets 

House flooring status x 

Water sanitation 

Sanitation facilities x 

Source of drinking water x 

Maternal characteristics

Maternal nutritional status 

Antenatal care 

Mother’s age at delivery 

x 

x 

 x 

Child characteristics 

Size at birth x 

Sex x 

Birth order x 

Preceding birth interval x 

Feeding practices x 

Vaccination history x 

Recent illnesses x 

Nutritional status indicators used in this report are based on anthropometric measurements of children. 

Vaccination data are derived from inspection of immunization cards or mothers’ reports for those children 

whose cards were not seen. Calculations for other health indicators are based on questions asked of mothers for each child. The infant and under-five mortality rates and demographic factors are derived from 

birth histories of the mothers interviewed. 

2.1 Sample of Children 

The sample comprises children born between the date of interview and three to six years preceding the 

survey in each country. All children in households selected to be surveyed were less than five years of age 

for most surveys and less than three years of age for some countries prior to 1996. For the countries surveyed since 1999, the children were under six years of age. To make the data comparable and to include as 

4 Data and Methods
many countries as possible, analyses were carried out on data for children under three years of age at the 

time of the survey. The results are based on children for whom height and weight measurements were 

recorded. Sample sizes ranged from 354 in the 1999 DHS survey in Kazakhstan to 24,600 in the 1998-99 

National Family Health Survey in India. The average sample size is about 3,500 children. 

Data and Methods 5

3

Findings

hildren in developing countries make up a large proportion of the deaths among children under five 

years of age around the world. Infectious diseases such as acute respiratory infection, diarrhea, malaria, and measles account for over 50 percent of childhood deaths (UNICEF, 1998). Undernutrition 

compromises child health, making children susceptible to illness and death. This synergistic relationship 

between undernutrition and infection is widely recognized (Scrimshaw et al., 1968; Tomkins and Watson, 1993). Even if a child is mildly undernourished, the mortality risk is increased. Infant mortality (under-one-year rate) is commonly used as a measure of infant health and is a sensitive indicator of the socioeconomic conditions of a country. Under-five mortality is largely a result of infectious diseases and 

neonatal deaths in developing countries and is related to the availability and accessibility of health services 

(Mahy, 2003). 

C

3.1 Infant and Under-Five Mortality 

Although mortality among infants and children has decreased in most countries since the mid-1980s, the 

decline has recently slowed, stopped, or reversed itself in sub-Saharan Africa (Rutstein, 2000). All of the 

countries in Africa have infant mortality rates above 50 deaths per 1,000 live births (Table A.3.1 and Figure 3.1)1

. Infant mortality runs from 57 per 1,000 in Gabon and Ghana to 135 per 1,000 in Mozambique. 

Under-five mortality runs from 89 per 1,000 in Gabon to 274 per 1,000 in Niger (Table A.3.1). 

Countries in North Africa/West Asia/Europe have lower infant mortality rates than countries in subSaharan Africa. Jordan has the lowest rate in the region (29 per 1,000) and Yemen has the highest rate 

(75 per 1,000). Under-five mortality is also somewhat lower in this region than in sub-Saharan Africa, 

with Jordan again having the lowest rate (34 per 1,000) and Yemen having the highest rate (105 per 

1,000) (Figure 3.1). 

Infant and child mortality rates vary considerably in the Latin America and the Caribbean region. Colombia has the lowest rates for both infant (21 per 1,000) and under-five mortality (25 per 1,000). Haiti 

has the highest rates for both infant and under-five mortality (80 and 119 per 1,000, respectively) (Figure 

3.1). 

As a region, Central Asia has some of the lowest rates of infant and child mortality. Uzbekistan has an 

infant mortality rate of 49 per 1,000, and the Kyrgyz Republic and Kazakhstan have rates of 61 and 62 

per 1,000, respectively. Unlike other regions, the infant and under-five mortality rates in Central Asia do 

not vary much across countries. Uzbekistan has the lowest rate of under-five mortality (59 per 1,000), and 

the Kyrgyz Republic has the highest rate (72 per 1,000) (Figure 3.1). 

South/Southeast Asia has rates similar to those at the lower end of the range in Africa. Bangladesh has 

the lowest infant mortality rate (66 per 1,000), and Cambodia has the highest rate (95 per 1,000). Under-

 

1 Tables mentioned in Chapters 3 and 4 are located in Appendix A.

Findings 7
five mortality rates run from a low of 94 per 1,000 in Bangladesh to a high of 124 per 1,000 in Cambodia 

(Figure 3.1). 

Figure 3.1 

Infant and Under-Five Mortality Rates, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa

0

50

100

150

200

250

300

Gabon 2000

Zimbabwe 1999

Comoros 1996

Ghana 1998

Kenya 1998

Eritrea 1995

Togo 1998

Uganda 2000-01

Tanzania 1999

Côte d’Ivoire 1994

Cameroon 1998

CAR 1994-95

Madagascar 1997

Ethiopia 2000

Benin 1996

Guinea 1999

Malawi 2000

Chad 1996-97

Zambia 1996

Mozambique 1997

Burkina Faso 1998-99

Mali 1995-96

Niger 1998

Deaths per 1,000

0

20

40

60

80

100

120

140

Jordan 1997

Egypt 2000

Turkey 1998

Yemen 1997

Uzbekistan 1996

Kazakstan 1999

Kyrgyz Rep. 1997

Bangladesh 2000

India 1998-99

Nepal 1996

Cambodia 2000

Colombia 2000

Peru 2000

Brazil 1996

Dominican Rep. 1996 

Guatemala 1998-99

Bolivia 1998

Haiti 2000

Deaths per 1,000

Infant Mortality Under-five Mortality

North 

Africa/West 

Asia/ 

Europe 

Central 

Asia 

South/

Southeast 

Asia 

Latin 

America/ 

Caribbean 

8 Findings
3.2 Contribution of Undernutrition to Mortality 

Undernutrition plays an important role in mortality. Almost 50 percent of all deaths among children are 

associated with undernutrition (Rice et al., 2000). Even if a child is only mildly undernourished, the mortality risk is increased. Because the prevalence of mild to moderate undernutrition is high, it contributes 

to a larger proportion of deaths than severe undernutrition. Table A.3.2 shows the contribution of undernutrition to under-five mortality based on the Pelletier model (Pelletier et al., 1994). 

In sub-Saharan Africa, undernutrition contributes substantially to under-five mortality, from 28 percent in Zimbabwe to 61 percent in Eritrea. Overall for the region, about 42 percent of early childhood 

deaths are related to undernutrition. As seen in Table A.3.2, the majority of this effect is not due to severe 

undernutrition as would be expected, but is mostly due to the effects of mild to moderate undernutrition. 

With only four countries represented in North Africa/West Asia/Europe the contribution of undernutrition to under-five mortality shows a wide mix, from a low of 9 percent in Egypt to a high of 56 percent in 

Yemen, demonstrating the broad differences in living standards among the countries in the region. In 

Central Asia there is a range of more than 20 percentage points between Kazakhstan (10 percent) and 

Uzbekistan (32 percent) in the contribution of undernutrition to under-five mortality. The Kyrgyz Republic is in between (18 percent). South/Southeast Asia is consistently high: undernutrition contributes to 

over half of all deaths among children under five years. Overall, India has the highest rate, with undernutrition contributing to 72 percent of under-five deaths. The Latin America and Caribbean region shows 

two patterns: in one group of countries, undernutrition contributes to 11 to 16 percent of under-five 

deaths, and in the second group, which is made up of Haiti and Guatemala, undernutrition contributes to 

30 and 37 percent of under-five deaths, respectively. 

3.3 Malnutrition Rates 

3.3.1 Levels of Undernutrition 

DHS surveys indicate that high levels of undernutrition continue to exist among young children in all the 

countries represented (Table A.3.3). In 31 of the 41 countries, more than 20 percent of children are 

stunted (too short for their age). The median level of stunting across all countries is 30 percent, and 9 out 

of 41 countries have stunting rates higher than 40 percent. In sub-Saharan Africa, stunting prevalence 

ranges from 20 percent in Ghana to 48 percent in Madagascar. North Africa/West Asia/Europe has 

prevalence rates that vary from 7 percent in Jordan to 46 percent in Yemen. In Central Asia, stunting 

prevalence ranges from 10 percent in Kazakhstan to 31 percent in Uzbekistan. In South/Southeast Asia, 

the variation is not as wide: from 37 percent of children in Cambodia to 48 percent in Nepal. The Latin 

America and Caribbean region also shows a wide variation in stunting rates, from 10 percent in Brazil to 

42 percent in Guatemala. 

3.3.2 Patterns of Undernutrition 

Undernutrition (stunting and underweight) among young children is compared by region in Figure 3.2 

and Table A.3.3. While patterns are discernible, comparisons between regions need to be viewed with 

caution because of the large number of African countries and the small number of countries in the other 

regions. Nevertheless, two patterns emerge. Sub-Saharan Africa and South/Southeast Asia, for the most 

part, have about equally high rates of stunting and underweight in most countries. Latin America and the 

Caribbean and Central Asia have rates of underweight that are about half the stunting rates in most countries. There is no discernible pattern in the North Africa/West Asia/Europe region, other than higher 

rates of stunting than underweight. 

Findings 9
Figure 3.2 

Levels of stunting and underweight among children age 0-35 months, Demographic and Health 

Surveys, 1994-2001 

South/

Southeast

Asia 

Central

Asia 

North Africa/ 

West Asia 

Europe 

Latin 

America/ 

Caribbean 

Sub-Saharan Africa

0

10

20

30

40

50

60

Gabon 2000

Zimbabwe 1999

Kenya 1998

Cameroon 1998

Côte d’Ivoire 1994

Uganda 2000-01

Ghana 1998

Togo 1998

Zambia 1996

Guinea 1999

Comoros 1996

Mozambique 1997

Central African Rep. 1994-95

Malawi 2000

Benin 1996

Tanzania 1999

Burkina Faso 1998-99

Chad 1996-97

Mali 1995-96

Madagascar 1997

Eritrea 1995

Ethiopia 2000

Niger 1998

Percent

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Peru 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-999

Percent

Stunted Underweight

Figure 3.3 shows children’s levels of wasting, a measure of weight-for-height that is a seasonally affected 

indicator of current nutritional status. This indicator is influenced by illness, food availability, and feeding 

patterns. With lower rates of underweight accompanying moderately high rates of stunting, for the most 

part, children are short although not necessarily thin. However, Asian and African countries surveyed 

10 Findings
have short and thin children as a result of high rates of stunting and wasting. In countries with rates of 

underweight exceeding rates of stunting by more than 2 percent, there are exceptionally high (over 10 

percent) rates of wasting. In these countries, there are probably many children who are very thin but not 

too short for their age (Table A.3.3). 

Figure 3.3 

Levels of wasting among children age 0-35 months, Demographic and Health Surveys, 1994-2001 

 Sub-Saharan Africa

0

5

10

15

20

25

30

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Tanzania 1999

Kenya 1998

Central African Rep. 1994-95

Zimbabwe 1999

Madagascar 1997

Malawi 2000

Mozambique 1997

Comoros 1996

Côte d’Ivoire 1994

Guinea 1999

Togo 1998

Ethiopia 2000

Ghana 1998

Benin 1996

Eritrea 1995

Burkina Faso 1998-99

Chad 1996-97

Niger 1998

Mali 1995-96

Percent

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast

Asia 

Latin 

America/ 

Caribbean 

0

2

4

6

8

10

12

14

16

18

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Colombia 2000

Peru 2000

Dominican Rep. 1996

Bolivia 1998

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent

Findings 11
3.3.3 Severity of Undernutrition 

Tables A.3.4 through A.3.6 show the Z-score distributions for the indices of undernutrition—stunting 

(height-for-age), wasting (weight-for-height), and underweight (weight-for-age)—in all the countries 

surveyed. Figures 3.4 through 3.6 show the percentage of children with moderate undernutrition (Zscores of -2.01 to -3.00 SD from the mean) and severe undernutrition (Z-score below -3.00 SD) for 

stunting, wasting, and underweight, respectively. In most countries and in all regions, moderate stunting 

occurs at a higher rate than severe stunting. However, there is a difference of two percentage points or less 

between the rates of severe stunting and the rates of moderate stunting in 8 of 23 countries in subSaharan Africa, Yemen in North Africa/West Asia/Europe, and India in South/Southeast Asia. In 7 

countries, severe stunting is 20 percent or higher. 

Table A.3.5 and Figure 3.5 show that moderate wasting is much more prevalent than severe wasting in 

all of the regions. A similar pattern is observed for underweight (Table A.3.6 and Figure 3.6), except that 

for underweight, the differences between severe and moderate are not so large.

3.3.4 Distribution of Z-scores 

Providing another picture of children’s nutritional status, Figure 3.7 shows the distribution of the three 

Z-scores for selected countries in each region. Ethiopia, Ghana, Mali, and Zimbabwe were chosen as examples for sub-Saharan Africa. In these countries, all measures of undernutrition are shifted to the left of 

the normal curve; however, the degree of shift varies. In Ethiopia, the weight-for-age and height-for-age 

curves are shifted farther to the left than is the weight-for-height curve. Since the data indicate that the 

children are short and thin for their ages, it appears that for their heights their weights are not as skewed. 

Nevertheless, undernutrition is very serious; a large percentage of Ethiopian children are stunted and underweight. Zimbabwe has a bimodal distribution, with a group of children falling within the normal distribution, and another group with high rates of stunting, wasting, and underweight falling just to the left 

of the normal curve. Further investigation is required to determine the characteristics of these two groups 

of children.

In North Africa/West Asia/Europe (Figure 3.7), curves for Egypt are similar to the normal curve, but 

the weight-for-height curve is skewed to the right, indicating a larger proportion of overweight children 

(A.3.7). Yemen’s curves are skewed to the left, showing higher levels of undernutrition for all measures. 

12 Findings
Figure 3.4 

Percentage of children age 0-35 months who are moderately stunted and severely stunted, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

Gabon 2000

Ghana 1998

Guinea 1999

Togo 1998

Mali 1995-96

Côte d’Ivoire 1994

Zimbabwe 1999

Burkina Faso 1998-99

Benin 1996

Chad 1996-97

Cameroon 1998

Central African Rep. 1994-95

Kenya 1998

Eritrea 1995

Mozambique 1997

Comoros 1996

Niger 1998

Uganda 2000-01

Malawi 2000

Ethiopia 2000

Zambia 1996

Tanzania 1999

Madagascar 1997

Percent

0

5

10

15

20

25

30

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Uzbekistan 1996

Kyrgyz Rep. 1997

Cambodia 2000

India 1998-99

Bangladesh 2000

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent

Severe Moderate

Latin America/

Caribbean 

South/

Southeast Asia 

North Africa/ 

West Asia/ 

Europe 

Central

Asia

Sub-Saharan Africa 

Findings 13
Figure 3.5 

Percentage of children age 0-35 months who are moderately wasted and severely wasted, 

Demographic and Health Surveys, 1994-2001 

0

2

4

6

8

10

12

14

16

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Zimbabwe 1999

Kenya 1998

Mozambique 1997

Tanzania

1999

Malawi 2000

Central African Rep. 1994-95

Comoros 1996

Madagascar 1997

Côte d’Ivoire 1994

Guinea 1999

Togo 1998

Ethiopia 2000

Ghana

1998

Benin 1996

Eritrea 1995

Burkina Faso 1998-99

Chad 1996-97

Niger 1998

Mali 1995-96

Percent

Sub-Saharan Africa 

Latin America/

Caribbean 

Central

Asia

South/

West Asia/ Southeast Asia 

Europe 

North Africa/ 

0

2

4

6

8

10

12

14

16

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

Cambodia 2000

India 1998-99

Peru 2000

Colombia 2000

Dominican Rep. 1996

Bolivia 1998

Guatemala 1998-99

Brazil 1996

Haiti 2000

Percent

Severe Moderate

14 Findings
Figure 3.6 

Percentage of children age 0-35 months who are moderately underweight and severely underweight, Demographic and Health Surveys, 1994-2001 

South/

Southeast Asia 

North Africa/ 

West Asia/ 

Europe

Central

Asia

Latin America/

Caribbean 

Sub-Saharan Africa

0

5

10

15

20

25

30

35

Gabon 2000

Zimbabwe 1999

Kenya 1998

Mozambique 1997

Cameroon 1998

Côte d’Ivoire 1994

Comoros 1996

Togo 1998

Uganda 2000-01

Zambia 1996

Ghana 1998

Guinea 1999

Central African Rep. 1994-95

Malawi 2000

Benin 1996

Burkina Faso 1998-99

Tanzania 1999

Mali 1995-96

Chad 1996-97

Eritrea 1995

Madagascar 1997

Ethiopia 2000

Niger 1998

Percent

0

5

10

15

20

25

30

35

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

India 1998-99

Nepal 1996

Bangladesh 2000

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Peru 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent

Severe Moderate

Findings 15
In Central Asia (Figure 3.7), Kazakhstan’s curves are close to the normal curve. In the Kyrgyz Republic, 

the weight-for-height curve is skewed to the right, indicating that there are children who are overweight, 

whereas the height-for-age and weight-for-age curves are skewed to the left, indicating stunting and underweight. 

South/Southeast Asia curves are widely skewed to the left, indicating high rates of undernutrition in 

both India and Cambodia (Figure 3.7). Curves for India are more skewed to the left than those for Cambodia, indicating higher rates of undernutrition in India than in Cambodia. 

Figure 3.7 

Distribution of height-for-age, weight-for-height, and weight-for-age Z-scores among children age 

3-35 months, Demographic and Health Surveys, 1994-2001 

16 Findings

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

Z - sc or e

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

Ethiopia Ghana 

Mali Zimbabwe 

Sub-Saharan Africa 
Figure 3.7 (continued)

Distribution of height-for-age, weight-for-height, and weight-for-age Z-scores among children age 

3-35 months, Demographic and Health Surveys, 1994-2001 

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

Z-scor e reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

Egypt 

Kazakhstan Kyrgyz Republic 

Cambodia India 

Yemen 

Central Asia 

South/Southeast Asia

North Africa/West Asia/Europe 

Findings 17
Figure 3.7 (continued)

Distribution of height-for-age, weight-for-height, and weight-for-age Z-scores among children age 

3-35 months, Demographic and Health Surveys, 1994-2001 

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Percent

0

5

10

15

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

reference population height-for-age

weight-for-height weight-for-age

Haiti Percent Peru 

Latin America/Caribbean 

In Latin America and the Caribbean (Figure 3.7), Peru has a high percentage of well-nourished children, as evidenced by a right-skewed curve for weight-for-height. However, there are high rates of stunting, with the height-for-age curve having its center between -1 and -2 SD. Weight-for-age is only 

slightly skewed to the left. Haiti’s curve differs from Peru’s in that the weight-for-height curve is very 

close to the normal curve, with a slight skewing to the left. Left-skewed curves in weight-for-age and 

weight-for-height indicate considerable prevalence of wasting and underweight in Haiti, whereas in Peru, 

there is a higher prevalence of stunting. 

3.3.5 Age Distribution of Undernutrition 

Levels of undernutrition are shown for children age 0 to 35 months, by age group in Table A.3.7. The 

age groups are based on WHO recommendations for appropriate child feeding (Pan American Health 

Organization, 2003). Infants from birth through six months are expected to be exclusively breastfed 

(breast milk only, no other fluids or foods). Infants are recommended to begin eating solids (complementary foods) at around six months of age through nine months, with continued breastfeeding through two 

years of age and beyond while eating a nutritionally adequate diet. The infant feeding patterns indicate 

that the lowest rates of stunting, wasting, and underweight are found among children less than six months 

of age (Figures 3.8 through 3.10, respectively). The highest rates of stunting are observed among children 

over one year of age (i.e., age 13-24 months and/or 25 months or more) in all regions (Figure 3.8). 

In sub-Saharan Africa, the lowest rates of wasting are among children under six months of age, followed by those age 25 months or more. Wasting increases from the period of the introduction of solid 

foods (age six months) through the second year of life (Figure 3.9). This is probably due to higher rates of 

illness among children during this period. In Latin America and the Caribbean, the data show less striking differences in wasting patterns across age groups, except in Haiti where the pattern is similar to that 

of sub-Saharan Africa. 

The pattern is less consistent in the Asian regions. In most countries, children age 10-24 months have 

higher rates of wasting than other children, with the exception of Uzbekistan, where the rates are highest 

for children under 10 months of age. This may be due to differences in infant feeding patterns; however, 

18 Findings
the data on infant feeding in Uzbekistan could not be analyzed because the sample of children was not 

comparable to the samples in other countries.

Countries in North Africa/West Asia/Europe have patterns similar to those in Latin America and the 

Caribbean, except in Yemen, where the patterns are more like those in the countries of South/Southeast 

Asia and sub-Saharan Africa. Underweight patterns, by age of child, are similar to stunting patterns in 

most cases (Figure 3.10). 

Mean Z-scores for the three nutritional status indexes for children age 0-35 months are shown in Table A.3.8. The graphs in Figure 3.11 show the mean Z-scores for 12 selected countries. Since the number 

of cases at each age is small, a three-point moving average was calculated. The graphs show that in most 

countries, the prevalence of low weight-for-height reaches its nadir between 12 and 18 months and then 

finds a plateau through 36 months of age. On the other hand, low height-for-age increases rapidly from 

birth to 18 to 24 months. It then decreases and begins to level off between 24 and 30 months and further 

declines again after that. The weight-for-age graph usually falls between the wasting and stunting lines. 

For most countries in this report, all of the curves fall below a mean Z-score of 0. However in Egypt, 

Peru, and the Kyrgyz Republic, the weight-for-height lines are around or above a mean Z-score of 0. In 

Egypt and Peru, children start out with weight-for-height Z-scores around 0 (a little chubby). The Zscores decline a little with age but through 36 months of age stay clearly above 0 (Figure 3.11). Also in 

the Kyrgyz Republic, children start out a little heavy but lose their baby fat around six months when their 

weight-for-height Z-scores stabilize at a mean of about 0. 

3.3.6 Levels of Overnutrition 

While undernutrition is the major concern in developing countries, childhood obesity is increasing 

worldwide. The prevalence of overweight (defined as a weight-for-height Z-score above 2 SD from the 

mean of the reference population) in children less than three years of age is particularly noticeable in the 

Latin America and the Caribbean countries, followed by countries in Central Asia and North Africa/West Asia/Europe (Table A.3.9 and Figure 3.12). 

The proportion of overweight children in sub-Saharan Africa ranges from a low of less than 1 percent 

in Niger and Eritrea to a high of 9 percent in Zimbabwe. In 13 of 23 countries in sub-Saharan Africa, less 

than 3 percent of children are overweight, and in only two countries is the rate over 5 percent. The countries in South/Southeast Asia have the lowest rates: in all four countries, less than 3 percent of the children surveyed are overweight. In Latin America and the Caribbean, the proportion overweight ranges 

from a low of 2 percent in Haiti to a high of 8 percent in Bolivia and Peru. In Central Asia, the rate 

ranges from 3 percent in Kazakhstan to 14 percent in Uzbekistan. In North Africa/West Asia/Europe, it 

ranges from 2 percent in Yemen to 13 percent in Egypt. 

Findings 19
Figure 3.8 

Levels of stunting by child’s age group, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa

0

10

20

30

40

50

60

70

Ghana 1998

Togo 1998

Gabon 2000

Eritrea 1995

Burkina Faso 1998-99

Mali 1995-96

Cameroon 1998

Comoros 1996

Central African Rep 1994-95

Chad 1996-97

Côte d’Ivoire 1994

Zimbabwe 1999

Niger 1998

Guinea 1999

Kenya 1998

Uganda 2000-01

Benin 1996

Tanzania 1999

Zambia 1996

Ethiopia 2000

Malawi 2000

Mozambique 1997

Madagascar 1997

Percent

0

10

20

30

40

50

60

70

Turkey 1998

Jordan 1997

Egypt 2000

Yemen 1997

Kyrgyz Rep 1997

Kazakhstan 1999

Uzbekistan 1996

Bangladesh 2000

Cambodia 2000

Nepal 1996

India 1998-99

Brazil 1996

Peru 2000

Colombia 2000

Haiti 2000

DominicanRep 1996

Bolivia 1998

Guatemala 1998-99

Percent 

0-5 Months 6-9 Months 10-12 Months 13-24 Months 25 Months or more

Central

Asia 

North Africa/

West Asia/ 

Europe 

Latin America/

Caribbean 

South/

Southeast 

Asia 

20 Findings
Figure 3.9 

Levels of wasting by child’s age group, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa

0

5

10

15

20

25

30

35

Cameroon 1998

Zambia 1996

Uganda 2000-01

Gabon 2000

Madagascar 1997

Mozambique 1997

Central African Rep 1994-95

Ghana 1998

Tanzania 1999

Côte d’Ivoire 1994

Ethiopia 2000

Comoros 1996

Kenya 1998

Malawi 2000

Togo 1998

Benin 1996

Eritrea 1995

Niger 1998

Guinea 1999

Chad 1996-97

Burkina Faso 1998-99

Zimbabwe 1999

Mali 1995-96

Percent 

0

5

10

15

20

25

30

35

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Bangladesh 2000

Nepal 1996

Cambodia 2000

India 1998-99

Colombia 2000

Peru 2000

DominicanRep 1996

Guatemala 1998-99

Haiti 2000

Bolivia 1998

Brazil 1996

Percent 

0-5 Months 6-9 Months 10-12 Months 13-24 Months 25 Months or more

Central

Asia 

North Africa/ 

West Asia/ 

Europe 

Latin America/

Caribbean

South/

Southeast 

Asia 

Findings 21
Figure 3.10 

Levels of underweight by child’s age group, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa

0

10

20

30

40

50

60

70

Ghana 1998

Zimbabwe 1999

Gabon 2000

Cameroon 1998

Kenya 1998

Uganda 2000-01

Togo 1998

Tanzania 1999

Central African Rep 1994-95

Zambia 1996

Burkina Faso 1998-99

Chad 1996-97

Côte d’Ivoire 1994

Mozambique 1997

Madagascar 1997

Comoros 1996

Guinea 1999

Malawi 2000

Eritrea 1995

Ethiopia 2000

Benin 1996

Niger 1998

Mali 1995-96

Percent 

0

10

20

30

40

50

60

70

Jordan 1997

Egypt 2000

Turkey 1998

Yemen 1997

Kyrgyz Rep 1997

Kazakhstan 1999

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

Nepal 1996

India 1998-99

Brazil 1996

Peru 2000

Colombia 2000

DominicanRep 1996

Bolivia 1998

Guatemala 1998-99

Haiti 2000

Percent 

0-5 Months 6-9 Months 10-12 Months 13-24 Months 25 Months or more

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

22 Findings
Figure 3.11 

Distribution of mean Z-scores for height-for-age, weight-for-height, and weight-for-age among 

children age 3-35 months, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa 

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Ethiopia

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Ghana

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Mali

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Zimbabwe Ethiopia Zimbabwe 

Ghana Mali 

North African/West Asia/Europe 

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Egypt

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Yemen Egypt Yemen 

Findings 23
Figure 3.11 (continued)

Distribution of mean Z-scores for height-for-age, weight-for-height, and weight-for-age among 

children age 3-35 months, Demographic and Health Surveys, 1994-2001 

South/Southeast Asia

Latin America/Carribean

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Peru

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Haiti

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Kazakhstan

Central Asia

Kazakhstan KKyrgyz Republic yrgyz Republic 

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Cambodia

Mean Z-score

-3

-2

-1

0

1

2

0 6 12 18 24 30 36

ht/age wt/ht wt/age

Cambodia India India

Haiti Peru 

24 Findings
Figure 3.12 

Percentage of overweight (weight-for-height) children age 0–35 months, Demographic and Health 

Surveys, 1994-2001 

0

2

4

6

8

10

12

14

16

Niger 1998

Eritrea 1995

Burkina 1998-99

Mali 1995-96

Benin 1996

Togo 1998

Cote-d’Ivoire 1994

Chad 1996-97

Ethiopia 2000

Madagascar 1997

Ghana 1998

Tanzania 1999

Central African Rep 1994-95

Guinea 1999

Uganda 2000-01

Mozambique 1997

Zambia 1996

Comoros 1996

Gabon 2000

Malawi 2000

Cameroon 1998

Kenya 1998

Zimbabwe 1999

Percent

Sub-Saharn Africa

0

2

4

6

8

10

12

14

16

Yemen 1997

Turkey 1998

Jordan 1997

Egypt 2000

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Bangladesh 2000

Nepal 1996

India 1998-99

Cambodia 2000

Haiti 2001

Dominican Rep. 1996

Colombia 2000

Guatemala 1998-99

Brazil 1996

Bolivia 1998

Peru 2000

Percent

Central

Asia 

North Africa/ 

West Asia/ 

Europe 

Latin America/

Caribbean 

South/

Southeast 

Asia 

Findings 25
3.4 Influences on the Nutritional Status of Children 

Adapting the United Nations Children’s Fund (UNICEF) framework for nutrition (Figure 3.13), this 

report examines influences on child nutritional status (UNICEF, 1998). Immediate influences that lead 

to undernutrition include infectious diseases and inadequate food intake. These factors reflect other underlying biological and behavioral factors as well as socioeconomic conditions at the household, community, and national levels. Food availability, access to health services, health-related behaviors, and the environment are supported by the political, economic, and ideological structures in a country. This section 

discusses the relationships of these various factors and their influence on the nutritional status of children. 

Area of residence (urban or rural) is a basic influence on child nutritional status. Underlying social and 

economic influences are represented by mother’s education, house construction (flooring), water sources, 

sanitation facilities, and mother’s work status. Underlying biological and behavioral influences include 

immunization status, maternal and child characteristics, and feeding patterns that are more proximate 

influences on child nutrition. Immediate influences on nutrition are represented by micronutrient 

status/supplementation and reporting of recent bouts of acute respiratory infection and diarrhea. Although many factors, including poverty, affect the nutritional status of children, the variables included in 

this report are those that were collected by the majority of the surveys. 

3.4.1 Basic Influences 

Whether a child is undernourished is as much a consequence of factors at the national, regional, and 

community levels as it is a consequence of individual household conditions. 

3.4.1.1 Urban-Rural Residence 

The classification of urban and rural places of residence is based on the definitions used by the national 

statistical offices in each country. Therefore, the size of towns and cities defined as urban may differ from 

one country to another. 

There are consistent differences in undernutrition based on residence (Table A.3.10). Although the 

magnitude of the difference varies in almost all countries, stunting is considerably more common in rural 

areas than in urban areas (Figure 3.14). Uzbekistan is the only country surveyed where stunting prevalence 

is slightly greater in urban areas than in rural areas. 

26 Findings
Figure 3.13 

Conceptual framework for child nutritional status 

Findings 27
Figure 3.14 

Levels of stunting by urban-rural residence, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Ghana 1998

Togo 1998

Guinea 1999

Gabon 2000

Benin 1996

Zimbabwe 1999

Cote d'Ivoire1994

Cameroon 1998

Burkina Faso 1998-99

Kenya 1998

Mali 1995-96

Comoros 1996

Uganda 2000-01

Chad 1996-97

Cent Afr Rep 1994-95

Mozambique 1997

Eritrea 1995

Tanzania 1999

Niger 1998

Zambia 1996

Ethiopia 2000

Malawi 2000

Madagascar 1997

Percent

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Dominican Rep 1996

Colombia 2000

Brazil 1996

Haiti 2000

Bolivia 1998

Peru 2000

Guatemala 1998-99

Percent 

Urban Rural

Central

Asia 

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

Sub-Saharan Africa 

28 Findings
Wasting is also more common in rural areas than in urban areas in most countries (Figure 3.15). In 

sub-Saharan Africa, two countries have a higher prevalence of wasting in urban areas than in rural areas: 

Mozambique (10 percent in urban areas and 7 percent in rural areas) and Comoros (10 percent in urban 

areas and 8 percent in rural areas) (Table A.3.10). In 5 of the 23 countries in sub-Saharan Africa, urbanrural differences are minimal or nonexistent. In Latin America and the Caribbean, the urban-rural difference in prevalence of wasting is generally small. In Haiti, which has the highest prevalence of wasting in 

the region (6 percent), wasting is higher in urban areas than in rural areas. In the other three regions, the 

prevalence of wasting is higher in rural areas than in urban areas of all countries except Kazakhstan and 

the Kyrgyz Republic. 

As with stunting, in most countries, the prevalence of underweight is higher in rural areas than in urban areas (Figure 3.16). In 14 of the 23 countries in sub-Saharan Africa, the urban-rural difference is over 

10 percentage points, with Malawi and Niger having almost a 20 percentage point difference. Comoros is 

the only country in sub-Saharan Africa where the rates of underweight are about the same in urban and 

rural areas. Among other regions, the urban-rural differential in percent underweight is particularly noticeable for Nepal in South/Southeast Asia region and Guatemala and Peru in Latin America and the 

Caribbean. Kazakhstan is the only country where percent underweight is higher in urban areas than in 

rural areas. 

The reasons for the urban-rural differences in undernutrition may be due to differences in some of the 

more proximate influences. Improved accessibility to food (in and out of season) and health care in urban 

areas may explain some of these differences. In addition, differences in women’s education, availability of 

water and sanitary facilities, socioeconomic status, women’s decisionmaking power, access and utilization 

of antenatal and delivery care, as well as differences in quality of complementary feeding and immunization rates all contribute to improved nutritional status of urban children (Smith et al., 2004). 

3.4.2 Underlying Social and Economic Influences 

The following variables are proxies for social and economic influences on child undernutrition: mother’s 

education and work status, house flooring, sanitation facilities and source of drinking water. Mother’s 

education may indicate the economic level, but it also demonstrates a mother’s knowledge level and ability 

to adequately care for her child. A mother’s work status may also indicate her economic level. House 

flooring, sanitation facilities, and source of drinking water reflect household living conditions and thus 

suggest economic influences beyond cash availability. In addition, these conditions reflect environmental 

conditions that may influence illness and undernutrition.

A recently developed wealth index may better represent underlying social and economic influences on 

child nutrition in future comparative analyses (Rutstein and Johnson, 2004). In addition, multivariate 

analyses of the determinants of undernutrition would provide better insights into the relative importance 

of these influences. 

Findings 29
Figure 3.15 

Levels of wasting by urban-rural residence, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Tanzania 1999

Mozambique 1997

Kenya 1998

Comoros 1996

Malawi 2000

Madagascar 1997

Cent Afr Rep 1994-95

Cote d'Ivoire1994

Zimbabwe 1999

Guinea 1999

Togo 1998

Ethiopia 2000

Ghana 1998

Benin 1996

Eritrea 1995

Burkina Faso 1998-99

Chad 1996-97

Niger 1998

Mali 1995-96

Percent

0

5

10

15

20

25

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Bangladesh 2000

Nepal 1996

India 1998-99

Cambodia 2000

Colombia 2000

Peru 2000

Dominican Rep 1996

Bolivia 1998

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent

Urban Rural

Europe Asia 

Sub-Saharan Africa 

Central Latin America/ 

Caribbean 

South/

Asia Southeast 

North Africa/ 

West Asia/ 

30 Findings
Figure 3.16 

Levels of underweight by urban-rural residence, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Zimbabwe 1999

Gabon 2000

Kenya 1998

Cameroon 1998

Uganda 2000-01

Comoros 1996

Guinea 1999

Ghana 1998

Cote d'Ivoire1994

Togo 1998

Mozambique 1997

Zambia 1996

Malawi 2001

Cent Afr Rep 1994-95

Benin 1996

Tanzania 1999

Burkina 1998-99

Chad 1996-97

Madagascar 1997

Mali 1995-96

Ethiopia 2000

Eritrea 1995

Niger 1998

Percent

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

Nepal 1996

India 1998-99

Colombia 2000

Dominican Rep 1996

Brazil 1996

Peru 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent

Urban Rural

Sub-Saharan Africa 

Central

Asia 

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

South/

Asia 

Southeast 

Findings 31
3.4.2.1 Mother’s Education 

Mother’s education is defined as the highest level of schooling attended, but not necessarily completed. 

The three levels are no education, primary, and secondary or more (Table A.3.11). As expected, there is 

an inverse relationship between the mother’s education and child undernutrition across all regions. The 

higher the level of education, the lower the prevalences of childhood stunting and underweight (Figures 

3.17 and 3.19, respectively). Wasting does not have this universal response (Figure 3.18). For example, in 

Mozambique, children of mothers with secondary or higher levels of education are more likely to be 

wasted than children of less-educated mothers. The Central Asian countries are not included because 

there is no variability in mother’s education: almost all of the mothers fall into the secondary and higher 

level of education. 

Figure 3.17 

Levels of stunting among children age 0-35 months by mother’s education, Demographic and 

Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Gabon 2000

Ghana 1998

Guinea 1999

Togo 1998

Benin 1996

Cote d'Ivoire 1994

Burkina Faso 1998-99

Mali 1995-96

Zimbabwe 1999

Chad 1996-97

Cent Afr Rep 1994-95

Comoros 1996

Cameroon 1998

Uganda 2000-01

Mozambique 1997

Tanzania 1999

Eritrea 1995

Niger 1998

Kenya 1998

Ethiopia 2000

Zambia 1996

Madagascar 1997

Malawi 2000

Percent

0

10

20

30

40

50

60

Jordan 1997

Egypt 2000

Turkey 1998

Cambodia 2000

Bangladesh 2000

Nepal 1996

India 1998-99

Brazil 1996

Dominican Rep 1996

Haiti 2000

Colombia 2000

Bolivia 1998

Peru 2000

Guatemala 1998-99

Percent

No Education Primary Secondary or higher

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

South/

Asia 

Southeast 

32 Findings
Figure 3.18 

Levels of wasting among children age 0-35 months by mothers’ education, Demographic and 

Health Surveys, 1994-2001 

0

5

10

15

20

25

30

Gabon 2000

Uganda 2000-01

Madagascar 1997

Mozambique 1997

Cent Afr Rep 1994-95

Cameroon 1998

Zambia 1996

Comoros 1996

Tanzania 1999

Malawi 2000

Cote d'Ivoire 1994

Kenya 1998

Zimbabwe 1999

Guinea 1999

Ethiopia 2000

Togo 1998

Benin 1996

Ghana 1998

Eritrea 1995

Burkina Faso 1998-99

Chad 1996-97

Niger 1998

Mali 1995-96

Percent

0

5

10

15

20

25

30

Jordan 1997

Turkey 1998

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Dominican Rep 1996

Bolivia 1998

Peru 2000

Colombia 2000

Guatemala 1998-99

Brazil 1996

Haiti 2000

Percent

No Education Primary Secondary or higher

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

Sub-Saharan Africa 

Findings 33
Figure 3.19 

Levels of underweight among children age 0-35 months by mother’s education, Demographic and 

Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Cambodia 2000

Nepal 1996

Bangladesh 2000

India 1998-99

Brazil 1996

Colombia 2000

Dominican Rep 1996

Haiti 2000

Bolivia 1998

Peru 2000

Guatemala 1998-99

Percent

No Education Primary Secondary or higher

0

10

20

30

40

50

60

Gabon 2000

Cote d'Ivoire 1994

Zimbabwe 1999

Guinea 1999

Comoros 1996

Togo 1998

Ghana 1998

Mozambique 1997

Benin 1996

Uganda 2000-01

Cent Afr Rep 1994-95

Malawi 2000

Zambia 1996

Kenya 1998

Tanzania 1999

Cameroon 1998

Burkina Faso 1998-99

Mali 1995-96

Chad 1996-97

Madagascar 1997

Eritrea 1995

Ethiopia 2000

Niger 1998

Percent

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

Sub-Saharan Africa 

34 Findings
3.4.2.2 Mother’s Work Status 

In each survey, women were asked, “Aside from your own housework, are you currently working?” In 20 

of the 23 countries surveyed in sub-Saharan Africa, 40 percent or more women of reproductive age (15-49 

years) reported that they were currently working (Mukuria et al., 2005). This report finds that mother’s 

work status has an impact on the nutritional status of children. For most countries, undernutrition is 

higher among children of working mothers than children whose mothers are not working (Table A.3.12). 

This may be due to the high poverty rates in these countries, which are reflected in women’s need to work 

and its relationship to children’s nutritional status. However, if poverty is the major influencing factor, it 

may also affect the quality of alternative child care that a working mother is able to access. Other research 

has found that the characteristics of the caregiver have a stronger influence on child nutritional status 

when socioeconomic factors are controlled (Begin et al., 1998). When mothers work outside of the home, 

having inadequate alternative child care has a negative impact on child nutritional status (Lamontagne et 

al., 1998). 

In 15 of the 23 countries surveyed in sub-Saharan Africa, there were higher rates of stunting among 

children whose mothers worked than among those whose mothers did not work (Figure 3.20). This is 

consistent with previous research that found children of working mothers had a significantly lower 

height-for-age Z-score (stunting) than children of nonworking mothers (Toyama et al., 2001). However, 

the types of work in which mothers were engaged differentiated between the poverty avoiders, who 

worked in the informal sector, and the income enhancers, who worked in the formal sector. The real influence of mother’s work on the nutritional status of her child was related to the type of work she did, 

which reflected her economic status. 

Findings 35
Figure 3.20 

Levels of stunting among children age 0-35 months by mother’s work status, Demographic and 

Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Benin 1996

Ghana 1998

Guinea 1999

Côte d’Ivoire 1994

Gabon 2000

Togo 1998

Cameroon 1998

Central African Rep 1994-95

Zimbabwe 1999

Tanzania 1999

Mali 1995-96

Burkina Faso 1998-99

Kenya 1998

Mozambique 1997

Uganda 2000-01

Comoros 1996

Chad 1996-97

Zambia 1996

Eritrea 1995

Niger 1998

Madagascar 1997

Malawi 2000

Ethiopia 2000

Percent

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Cambodia 2000

Nepal 1996

Bangladesh 2000

India 1998-99

Brazil 1996

Colombia 2000

Dominican Rep 1996

Peru 2000

Haiti 2000

Bolivia 1998

Guatemala 1998-99

Percent

Not working Working

Central

Asia 

North Africa/

West Asia/ 

Europe 

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

Sub-Saharan Africa 

36 Findings
There is no one discernible relationship between wasting and mother’s work status in sub-Saharan 

countries. There were almost as many countries (9 of 23) with higher rates of wasting among children of 

women who worked as there were countries (10 of 23) with higher rates of wasting among children of 

women who did not work. Six countries had about equal rates of wasting among children of mothers who 

worked and mothers who did not work (Table A.3.12 and Figure 3.21). As with stunting, underweight 

rates were higher among children of working mothers in 14 of 23 countries (Table A.3.12 and Figure 

3.22). 

Figure 3.21 

Levels of wasting among children age 0-35 months by mother’s work status, Demographic and 

Health Surveys, 1994-2001 

0

5

10

15

20

25

Gabon 2000

Cameroon 1998

Uganda 2000-01

Central African Rep 1994-95

Zambia 1996

Zimbabwe 1999

Kenya 1998

Madagascar 1997

Malawi 2000

Côte d’Ivoire 1994

Comoros 1996

Mozambique 1997

Tanzania 1999

Guinea 1999

Ethiopia 2000

Ghana 1998

Togo 1998

Benin 1996

Burkina Faso 1998-99

Eritrea 1995

Chad 1996-97

Niger 1998

Mali 1995-96

Percent 

0

5

10

15

20

25

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

Cambodia 2000

India 1998-99

Colombia 2000

Peru 2000

Bolivia 1998

Dominican Rep 1996

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

Not working Working

Central

Asia

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Sub-Saharan Africa 

Latin America/

Caribbean 

Findings 37
Figure 3.22 

Levels of underweight among children age 0-35 months by mother’s work status, Demographic 

and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Gabon 2000

Zimbabwe 1999

Cameroon 1998

Uganda 2000-01

Central African Rep 1994-95

Kenya 1998

Mozambique 1997

Côte d’Ivoire 1994

Zambia 1996

Ghana 1998

Guinea 1999

Benin 1996

Togo 1998

Malawi 2000

Tanzania 1999

Comoros 1996

Burkina Faso 1998-99

Madagascar 1997

Chad 1996-97

Mali 1995-96

Ethiopia 2000

Eritrea 1995

Niger 1998

Percent

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep 1997

Uzbekistan 1996

Cambodia 2000

Nepal 1996

India 1998-99

Bangladesh 2000

Brazil 1996

Peru 2000

Colombia 2000

Dominican Rep 1996

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent

Not working Working

Latin America/

Caribbean 

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Central

Asia 

Sub-Saharan Africa 

Europe 

38 Findings
In six of seven countries surveyed in Latin America and the Caribbean, over 40 percent of women surveyed reported that they were working (Mukuria et al., 2005). Only two countries, Peru and Bolivia, have 

slightly higher rates of stunting (Figure 3.20) among children of working mothers than among children of 

nonworking mothers. In five of seven countries, wasting rates are about the same, regardless of whether 

the mother worked or not (Figure 3.21); and in five of seven countries, rates of underweight are slightly 

higher among children of mothers who do not work compared with children whose mothers do work 

(Figure 3.22). Other factors may be involved in the patterns observed in the Latin America and Caribbean countries. For example, poor women may not have the education or skills needed to obtain work 

outside of the home.

In the Central Asia region, around 40 percent of women surveyed reported that they were working 

(Mukuria et al., 2005). In two of the three countries, the Kyrgyz Republic and Uzbekistan, higher rates of 

stunting exist among children of working mothers, compared with children of nonworking mothers (Figure 3.20). In the same two countries, however, children of nonworking mothers have a higher rate of 

wasting than children of working mothers (Figure 3.21). There are only slightly different rates of underweight among the children of working mothers and nonworking mothers (Figure 3.22). Kazakhstan rates 

contrast directly with those of the other two countries on all three measures of undernutrition, and the 

rates of undernutrition are much lower in Kazakhstan than in any of the other countries surveyed in Central Asia. 

In the South/Southeast Asia region, all indicators point to higher rates of undernutrition among children whose mothers work than among those whose mothers do not, except in Bangladesh, where wasting 

rates are about the same, regardless of the mother’s work status (Figures 3.20 through 3.22). In this region, the proportion of women who reported themselves as working varies widely from 23 to 77 percent 

(Mukuria et al., 2005).

In North Africa/West Asia/Europe, the rates of stunting, wasting, and underweight do not vary much 

by mother’s work status in most cases, except in Turkey and Yemen, where wasting is more prevalent 

among children of nonworking mothers than children of working mothers. 

3.4.2.3 House Flooring Status 

In this study, the type of flooring of the residence serves as a proxy for household economic level (Table 

A.3.13). To explore the relationship between this variable and child nutritional status, the study categorized flooring into two groups: finished flooring and unfinished flooring, the latter being rudimentary and 

natural flooring. The data on flooring status are not available for India, and Jordan has fewer than 25 

cases of unfinished flooring, so the percentages are suppressed (Figures 3.23 through 3.25). 

As expected, stunting rates are higher among children who live in households with unfinished flooring 

than among those who live in households with finished flooring. 

Wasting rates present a less consistent pattern. In sub-Saharan Africa, 19 of the 23 countries have 

higher rates of wasting among children who live in households with unfinished flooring than among children who live in households with finished flooring. 

Findings 39
Figure 3.23 

Levels of stunting among children age 0-35 months by flooring status, Demographic and Health 

Surveys, 1994-2001 

Sub-Saharan Africa 

0

10

20

30

40

50

60

Gabon 2000

Ghana 1998/99

Tanzania 1999

Mali 1996

Togo 1998

Guinea 1999

Kenya 1998

Mozambique 1997

Cote d'Ivoire 1994

Cameroon 1998

Benin 1996

Zimbabwe 1999

Eritrea 1995

Burkina Faso 1999

Comoros 1996

Chad 1997

Uganda 2000

Ethiopia 2000

CAR 1994

Zambia 1996

Malawi 2000

Niger 1998

Madagascar 1997

Percent 

Latin America/

Caribbean 

Central

Asia 

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

0

10

20

30

40

50

60

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Republic 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

Nepal 1996

Brazil 1996

Peru 2000

Dominican Rep 1996

Colombia 2000

Haiti 2000

Bolivia 1998

Guatemala 1998-99

Percent 

Finished Unfinished

40 Findings
In the Latin America and Caribbean region, which has some of the lowest wasting rates of all the regions, 

higher rates of wasting are also evidenced among children living in households with unfinished flooring in 

all countries except Haiti, where the rate of wasting is slightly higher among those who live in households 

with a finished floors. Most countries in the North Africa/West Asia/Europe region have the same pattern, except Turkey, where the wasting rate is higher among children living in households with finished 

flooring. Unexpectedly, Kazakhstan in Central Asia, and Cambodia in South/Southeast Asia have higher 

rates of wasting among children living in households with finished flooring than unfinished flooring (Table A.3.13). It should be noted that in this region a large percentage of households have flooring made of 

wood planks. For this analysis, wood planks are included in natural flooring. 

Figure 3.24 

Levels of wasting among children age 0-35 months by flooring status, Demographic and Health 

Surveys, 1994-2001 

Sub-Saharan Africa 

0

5

10

15

20

25

Uganda 2000

Gabon 2000

Cameroon 1998

Zambia 1996

CAR 1994

Kenya 1998

Madagascar 1997

Comoros 1996

Malawi 2000

Zimbabwe 1999

Tanzania 1999

Cote d'Ivoire 1994

Mozambique 1997

Ethiopia 2000

Eritrea 1995

Chad 1997

Guinea 1999

Benin 1996

Togo 1998

Ghana 1998/99

Niger 1998

Burkina Faso 1999

Mali 1996

Percent 

0

5

10

15

20

25

Turkey 1998

Egypt 2000

Yemen 1997

Kyrgyz Republic 1997

Kazakhstan 1999

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

Cambodia 2000

Peru 2000

Colombia 2000

Dominican Rep 1996

Bolivia 1998

Brazil 1996

Guatemala 1999

Haiti 2000

Percent 

Finished Unfinished

Latin America/

Caribbean

Central 

Asia

South/ 

Southeast 

Asia

North Africa/ 

West Asia/ 

Europe

Sub-Saharan Africa 

Latin America/

Caribbean 

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

Findings 41
The pattern of underweight by household flooring status is similar to that of stunting, with higher rates 

of underweight among children who live in households with unfinished flooring than children who live in 

households with finished flooring, except in Turkey and Kazakhstan. In Turkey, there is small difference 

in rates of underweight by flooring status; whereas in Kazakhstan, the rate of underweight is slightly 

higher among children who live in households with finished flooring than among children who live in 

households with unfinished floors. The latter may be a reflection of the higher rates of underweight 

among children living in urban areas than in rural areas of this country (Figure 3.25). 

Figure 3.25 

Levels of underweight among children age 0-35 months by flooring status, Demographic and 

Health Surveys, 1994-2001 

Sub0

10

20

30

40

50

60

Gabon 2000

Zimbabwe 1999

Kenya 1998

Malawi 2000

Uganda 2000

Cameroon 1998

Mozambique 1997

Zambia 1996

Comoros 1996

CAR 1994

Tanzania 1999

Cote d'Ivoire 1994

Guinea 1999

Ghana 1998/99

Togo 1998

Benin 1996

Ethiopia 2000

Eritrea 1995

Mali 1996

Burkina Faso 1999

Chad 1997

Madagascar 1997

Niger 1998

Percent 

Sub-Saharan Africa Saharan Africa

0

10

20

30

40

50

60

Egypt 2000

Turkey 1998

Yemen 1997

Kyrgyz Republic 1997

Kazakhstan 1999

Uzbekistan 1996

Cambodia 2000

Nepal 1996

Bangladesh 2000

Peru 2000

Brazil 1996

Dominican Rep 1996

Bolivia 1998

Colombia 2000

Haiti 2000

Guatemala 1999

Percent 

South/

t 

a 

Finished Unfinished

Latin America/ 

C

Central

Asia Southeas

Asi

North 

Af aribbean 

Asia/ Europe 

rica/ West 

42 Findings
3.4.2.4 Sanitation Facilities 

Diarrhea and parasitic infections, particularly intestinal helminthic infections (hookworms and roundworms), are extremely prevalent in children living in poor sanitary conditions. In undernourished children, deworming leads to improvements in growth. DHS surveys do not collect data on these parasitic 

conditions, but all surveys collect information on water and sanitation. There are plans to collect deworming information in future surveys. 

f sanitation facility a household has reflects its economic status, and poor households are less 

 diarto undernutrition. According to the WHO and UNICEF Joint Monitorg Programme for Water Supply and Sanitation, sanitation technologies consist of two categories: imThe type o

likely to have adequate toilet facilities. Inadequate sanitation facilities result in an increased risk of

rheal disease, which contributes 

in

proved and unimproved. Improved sanitation facilities include connection to a public sewer system or 

septic system, simple and improved pit latrines, and pour-flush pit latrines. Unimproved facilities include 

latrines that are manually removed, public latrines and open latrines. In this report, “no facility” is included in the unimproved category (WHO and UNICEF, 2000). 

According to the DHS data, infants and young children from households with unimproved sanitation 

facilities are at greater risk of being undernourished than are children from households with improved 

facilities (Table A.3.14). Children age 0-35 months living in households with unimproved toilet facilities 

are more likely to be stunted in all the countries surveyed, except Madagascar, where the prevalence of 

stunting is higher among children living in households with improved sanitation facilities (Figure 3.26). 

The pattern is less consistent for wasting (Figure 3.27). In 17 of 22 sub-Saharan countries—Comoros 

was not included because there were fewer than 25 cases in the unimproved category—there are higher 

rates of wasting among those who live in households with unimproved facilities. However, in two countries (Mozambique and Zimbabwe) there is almost no difference, and in three countries (Ghana, Tanzania, and Gabon) there are slightly higher rates of wasting among children living in households with improved facilities. 

In most countries of North Africa/West Asia/Europe and South/Southeast Asia, there are higher rates 

of wasting among children in households with unimproved facilities (Figure 3.27). However, in Egypt 

and Bangladesh, there is almost no difference in wasting rates by type of sanitation facility. The Central 

Asian countries have very few children living in households with unimproved sanitation facilities and, 

therefore, were not included in this analysis. 

In Latin America and the Caribbean, four of the seven countries have higher rates of wasting among 

children who live in households with unimproved sanitation facilities (Figure 3.27). In the other three 

countries, Bolivia, Dominican Republic, and Haiti, the rates of wasting are about the same, regardless of 

the type of sanitation facility available to the household. 

The rates for underweight by type of sanitation facility are similar to the rates for stunting. There are 

higher rates of underweight among children who live in households with unimproved sanitation facilities, 

except in Gabon and Tanzania, where the rates are higher among children who live in households with 

improved sanitation facilities (Figure 3.28). 

Findings 43
Figure 3.26 

Percentage of children age 0-35 months who are stunted, by type of household sanitation facility, 

Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa 

60

10

20

30

40

50

Percent 

0

Togo 1998

Guinea 1999

Benin 1996

Ghana 199

C

8

ôte d'Ivoire 1994

Gabon 2000

Zimbabwe 1999

Eritrea 199

urk

5

ina Faso 19

B

Central A

98-99

Cameroon 1998

Kenya 1998

Mali 1995-96

Chad 199

fri

6-97

can Rep. 1994-95

Niger 199

M

8

ozambique 1997

Ethiopia 2000

Uganda 2000-01

Zambia 1996

Tanzania 1999

Malawi 2000

Madagascar 1997

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

0

10

20

30

40

50

rcent 

60

Turkey 1998

Egypt 2000

Yemen 199

n

Dominic

Co

Gu

7

Cambodia 2000

India 2000

Nepal 1996

Ba gladesh 2000

an Rep. 1996

Brazil 1996

lombia 2000

Hait 2000

Peru 2000

Bolivia 1998

atemala 1999

Pe

Improved Unimproved

Europe 

44 Findings
Figure 3.27 

0

5

10

15

20

Gabon 2000

Uganda 2000-01

Cameroon 1998

Zambia 1996

Madagascar 1997

Zimbabwe 1999

Kenya 1998

Tanzania 1999

Central African Rep. 1994-95

Côte d'Ivoire 1994

Malawi 2000

Mozambique 1997

Ethiopia 2000

Togo 1998

Guinea 1999

Benin 1996

Eritrea 1995

Ghana 1998

Burkina Faso 1998-99

Niger 1998

Chad 1996-97

Mali 1995-96

Percent 

25

0

5

10

15

20

25

Turkey 1998

Egypt 2000

Yemen 1997

Nepal 1996

Bangladesh 2000

India 2000

Cambodia 2000

Peru 2000

Colombia 2000

Dominican Rep. 1996

Bolivia 1998

Brazil 1996

Guatemala 1999

Hait 2000

Percent 

Improved Unimproved

Latin America/ 

Sub-Saharan Africa 

South/

Southeast 

North Africa/ 

West Asia/ Caribbean 

Europe Asia 

Findings 45
Figure 3.28 

Percentage of children age 0-35 months who are underweight by type of household sanitation facility, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Zimbabwe 1999

Gabon 2000

Togo 1998

Kenya 1998

Côte d'Ivoire 1994

Guinea 1999

Cameroon 1998

Benin 1996

Mozambique 1997

Ghana 1998

Uganda 2000-01

Zambia 1996

Central African Rep. 1994-95

Malawi 2000

Eritrea 1995

Burkina Faso 1998-99

Tanzania 1999

Chad 1996-97

Ethiopia 2000

Niger 1998

Mali 1995-96

Madagascar 1997

Percent 

Sub-Saharan Africa 

0

10

20

30

40

50

60

Egypt 2000

Turkey 1998

Yemen 1997

Cambodia 2000

India 2000

Nepal 1996

Bangladesh 2000

Brazil 1996

Dominican Rep. 1996

Peru 2000

Colombia 2000

Bolivia 1998

Hait 2000

Guatemala 1999

Percent 

Improved Unimproved

Latin

Caribbean 

So

Southe

Asia 

Nor

West

Europe 

uth/ America/ th Africa/ 

 Asia/ ast 

46 Findings
3.4.2.5 Source of Drinking Water 

The data collected on household source of drinking water were divided into improved and unimproved 

categories based on the guidelines of the WHO and UNICEF Joint Monitoring Programme for Water 

Supply and Sanitation (Table A.3.15 and Figures 3.29 through 3.31). Improved water sources include 

piped water, public taps, protected wells and springs, boreholes, and rainwater. Unimproved sources include surface water, unprotected wells and springs, bottled water, and tanker truck or vendor-supplied 

water. Although the quality of the water is not in question, bottled water is included in unimproved water 

sources because the reliability and quantity of bottled water are not ensured for adequate consumption. 

For the most part, improved water sources correlate with lower rates of undernutrition. 

In all but three countries (the Dominican Republic, Guatemala, and Egypt), children living in households with unimproved water sources have a higher prevalence of stunting than those living in households 

with improved water sources (Figure 3.29). The difference in stunting rates by water source is small in 

Chad, Burkina Faso, Guinea, Mali, and Togo in sub-Saharan Africa; in Uzbekistan in Central Asia; and 

in Bangladesh, Cambodia, and India in South/Southeast Asia. 

Wasting rates are less consistent by source of drinking water. In 14 of the 23 countries in sub-Saharan 

Africa, the rates of wasting are higher among children living in households with unimproved water 

sources. However, in six countries, there is little or no difference, and in three countries (Comoros, Chad, 

and Mozambique) the rates of wasting are higher among children who live in households with improved 

water sources. In North Africa/West Asia/Europe, there appears to be no distinction in wasting rates by 

water source, except in Yemen, where the rate is noticeably higher among children living in households 

with unimproved water sources. Children in Central Asian countries have higher wasting rates in households with unimproved water sources, except for Kazakhstan, where there is little difference in the wasting rate by water source (Figure 3.30).

In two of the seven countries in Latin America and the Caribbean, there are higher rates of wasting 

among children who live in households with unimproved water sources. However, in Guatemala, the rates 

of wasting are higher among children who live in households with improved water sources. There is little 

difference in wasting by water source in the remaining countries (Figure 3.30). 

Underweight rates are mostly higher among children living in households with unimproved water 

sources than in households with improved water sources (Figure 3.31). In two countries in sub-Saharan 

Africa, Guinea and Chad, the rates of underweight are about the same for the two types of water sources. 

Findings 47
Figure 3.29 

Percentage of children age 0-35 months who are stunted, by source of drinking water, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Gabon 2000

Ghana 1998

Côte d'Ivoire 1994

Togo 1998

Guinea 1999

Benin 1996

Kenya 1998

Zimbabwe 1999

Cameroon 1998

Mozambique 1997

Central African Rep. 1994-95

Mali 1995-96

Burkina Faso 1998-99

Zambia 1996

Eritrea 1995

Uganda 2000-01

Comoros 1996

Tanzania 1999

Chad 1996-97

Niger 1998

Ethiopia 2000

Malawi 2000

Madagascar 1997

Percent 

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Peru 2000

Haiti 2000

Bolivia 1998

Guatemala 1998-99

Percent 

Improved Unimproved

Latin America/

Caribbean 

Central

Asia 

South/ 

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Sub-Saharan Africa 

48 Findings
Figure 3.30 

Percentage of children age 0-35 months who are wasted, by source of drinking water, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Madagascar 1997

Kenya 1998

Central African Rep. 1994-95

Tanzania 1999

Malawi 2000

Zimbabwe 1999

Côte d'Ivoire 1994

Comoros 1996

Mozambique 1997

Togo 1998

Ghana 1998

Guinea 1999

Ethiopia 2000

Eritrea 1995

Benin 1996

Burkina Faso 1998-99

Niger 1998

Chad 1996-97

Mali 1995-96

Percent 

0

5

10

15

20

25

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

Cambodia 2000

India 1998-99

Peru 2000

Colombia 2000

Bolivia 1998

Dominican Rep. 1996

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

Improved Unimproved

Latin America/

Caribbean 

Central

Asia 

South/ 

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Sub-Saharan Africa 

Findings 49
Figure 3.31 

Percentage of children age 0-35 months who are underweight, by source of drinking water, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Gabon 2000

Zimbabwe 1999

Kenya 1998

Mozambique 1997

Zambia 1996

Cameroon 1998

Côte d'Ivoire 1994

Uganda 2000-01

Ghana 1998

Central African Rep. 1994-95

Togo 1998

Malawi 2000

Comoros 1996

Guinea 1999

Benin 1996

Tanzania

1999

Burkina Faso 1998-99

Madagascar 1997

Eritrea 1995

Mali 1995-96

Chad 1996-97

Ethiopia 2000

Niger 1998

Percent 

Sub-Saharan Africa 

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Nepal 1996

Bangladesh 2000

India 1998-99

Brazil 1996

Peru 2000

Dominican Rep. 1996

Colombia 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent 

North Africa/ 

West Asia/ 

Europe 

Latin America/

Caribbean 

Central

Asia 

South/ 

Southeast 

Asia 

Improved Unimproved

50 Findings
In North Africa/West Asia/Europe, there are small differences between rates of underweight by source 

of drinking water. Yemen is an exception, with a prevalence of underweight that is 10 percentage points 

higher among children living in households with unimproved water sources. On the other hand, in Egypt 

the difference is small, but the rate is higher among children living in households with improved water 

sources (Figure 3.31). 

Two of the three countries of Central Asia demonstrate a higher rate of underweight among children 

living in households with unimproved water sources. In Kazakhstan, however, children living in households with improved water sources are slightly more likely to be underweight (Figure 3.31). 

In South/Southeast Asia, although the rates of underweight are higher for children living in households with unimproved water sources, the differences are small (Figure 3.31). 

In Latin America and the Caribbean, five of the seven countries have higher rates of underweight 

among children in households with unimproved water sources. In the Dominican Republic, the rate is 

about the same for the two groups of children, and in Guatemala, the rate is higher among children living 

in households with improved water sources than among children in households with unimproved water 

sources (Figure 3.31). 

3.4.3 Underlying Biological and Behavioral Influences 

3.4.3.1 Characteristics of Mothers 

Maternal Nutritional Status 

A mother’s nutritional status has important implications for her own health status as well as the health 

status of her children. A woman who has poor nutritional status has a greater risk of giving birth to a low 

birth weight baby. Intrauterine growth retardation (IUGR) accounts for more than two-thirds of low 

birth weight babies in developing countries (Black, 1999). Infants born with IUGR have a greater chance 

of growth retardation in childhood and have an increased risk of illness, a major contributor to undernutrition. (Ramakrishnan et al., 1999). 

Maternal nutritional status is typically measured by the body mass index (BMI). The BMI is calculated 

as a ratio of weight to height squared (kg/m2

). Incorporating both height and weight, the BMI provides a 

better measure of nutritional status than height or weight alone. A BMI of less then 18.5 in women is 

considered undernutrition. 

In most of the countries included in this analysis, higher rates of stunting are found among children 

age 0-35 months whose mothers are undernourished (BMI <18.5) than among children whose mothers 

are adequately nourished (BMI 18.5 to 24.9) (Table A.3.16 and Figure 3.32) Infants of overweight mothers (BMI 25) have the lowest rates of stunting. An exception is Burkina Faso, where stunting rates are 

about the same for all levels of maternal nutritional status. In five countries (Benin, Ghana, Mozambique, 

Jordan, and Uzbekistan), rates of stunting are about the same for children of well-nourished mothers as 

for children of undernourished mothers. In Uzbekistan, stunting is highest among children of overweight 

women (Table A.3.16 and Figure 3.32). 

Findings 51
Figure 3.32 

Percentage of children age 0-35 months who are stunted, by mother’s nutritional status, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

70

Ghana 1998

Gabon 2000

Benin 1996

Togo 1998

Côte d'Ivoire 1994

Zimbabwe 1999

Burkina Faso 1998-99

Guinea 1999

Mali 1995-96

Cameroon 1998

Mozambique 1997

Kenya 1998

Uganda 2000-01

Central African Rep. 1994-95

Chad 1996-97

Comoros 1996

Niger 1998

Eritrea 1995

Ethiopia 2000

Malawi 2000

Zambia 1996

Madagascar 1997

Percent 

0

10

20

30

40

50

60

70

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Uzbekistan 1996

Kyrgyz Rep. 1997

Cambodia 2000

Bangladesh 2000

India 2000

Nepal 1996

Brazil 1996

Colombia 2000

Dominican Rep. 1996

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

<18.5 18.5-24.9 >=25.0

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Central

Asia

Sub-Saharan Africa 

52 Findings
Wasting and underweight rates are also highest among children of mothers who are undernourished 

and lowest among children of mothers who are overweight (Figures 3.33 and 3.34). The exception is Uzbekistan, where the proportion underweight is highest among children of mothers with a normal BMI 

and lowest among children of undernourished mothers. 

Figure 3.33 

Percentage of children age 0-35 months who are wasted, by mother’s nutritional status, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

35

Gabon 2000

Zambia 1996

Malawi 2000

Kenya 1998

Zimbabwe 1999

Uganda 2000-01

Central African Rep. 1994-95

Côte d'Ivoire 1994

Cameroon 1998

Mozambique 1997

Comoros 1996

Madagascar 1997

Guinea 1999

Ethiopia 2000

Ghana 1998

Benin 1996

Eritrea 1995

Togo 1998

Chad 1996-97

Niger 1998

Mali 1995-96

Burkina Faso 1998-99

Percent 

Sub-Saharan Africa Sub-Saharan Africa 

0

5

10

15

20

25

30

35

Turkey 1998

Egypt 2000

Jordan 1997

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Bangladesh 2000

Nepal 1996

India 2000

Cambodia 2000

Bolivia 1998

Dominican Rep 1996

Colombia 2000

Peru 2000

Brazil 1996

Haiti 2000

Guatemala 1998-99

Percent 

<18.5 18.5-24.9 >=25.0

Latin America/ 

Caribbean 

Central

Asia 

South/ 

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

Central

Asia

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Findings 53
Figure 3.34 

Percentage of children age 0-35 months who are underweight, by mother’s nutritional status, 

Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

70

Gabon 2000

Zimbabwe 1999

Comoros 1996

Kenya 1998

Mozambique 1997

Ghana 1998

Zambia 1996

Central African Rep. 1994-95

Togo 1998

Uganda 2000-01

Malawi 2001

Guinea 1999

Benin 1996

Côte d'Ivoire 1994

Cameroon 1998

Burkina Faso 1998-99

Madagascar 1997

Eritrea 1995

Mali 1995-96

Ethiopia 2000

Chad 1996-97

Niger 1998

Percent 

Sub-Saharan Africa

0

10

20

30

40

50

60

70

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Uzbekistan 1996

Kyrgyz Rep. 1997

Cambodia 2000

Nepal 1996

India 2000

Bangladesh 2000

Brazil 1996

Bolivia 1998

Dominican Rep 1996

Colombia 2000

Peru 2000

Haiti 2000

Guatemala 1998-99

Percent 

<18.5 18.5-24.9 >=25.0

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

54 Findings
Antenatal Care 

Regular antenatal care is needed to help detect and manage pregnancy-related complications and improve 

delivery outcomes. Since most pregnancy-related complications cannot be anticipated, women need access 

to appropriate care if complications arise. WHO defines antenatal care as having one or more visits with a 

skilled medical attendant during pregnancy (WHO and UNICEF, 2003). Adequate, timely, and regular 

use of antenatal care contributes to improved birth outcomes and higher birth weight. 

The analysis of undernutrition by number of antenatal care visits looked at children of mothers who 

had one or more antenatal visits and children of mothers who had no visits (Table A.3.17). In most cases, 

children whose mothers had one or more antenatal care visits were less likely to be stunted and underweight than children whose mothers had no antenatal visits (Figures 3.35 and 3.37, respectively). Wasting 

rates were not as clearly related to antenatal care visits (Figure 3.36). In most countries, the rate of wasting was about the same for children of mothers who had one or more antenatal visits and those whose 

mothers had no visits. (This is not surprising since wasting measures acute undernutrition, which may be 

more influenced by a recent illness.) Use of antenatal care may be indicative of improved availability 

and/or access to health services as well as a willingness or ability to practice effective health behaviors. A 

multivariate analysis would better determine the impact of these factors on the nutritional status of children. 

Mother’s Age at Delivery 

Mother’s age at delivery is related to maternal nutritional status. There are higher rates of undernutrition 

among younger mothers, and undernourished mothers have higher rates of low birth weight babies. 

Younger women usually have lower BMIs than older women, and younger mothers and older mothers 

tend to have higher risk of low birth weight infants (Karim and Mascie-Taylor, 1997). In the DHS surveys, mother’s age at delivery is calculated from the mother’s date of birth and the child’s date of birth. In 

this analysis, three categories were used: under 20 years, 20 to 34 years, and 35 years or older. 

Some interesting region-specific patterns of undernutrition emerge by mother’s age at the time of the 

child’s birth (Table A.3.18). In sub-Saharan Africa, 17 of the 23 countries have the highest rates of stunting among children of mothers under age 20 (Figure 3.38). However wasting has a different pattern. In 

half of the 23 countries, wasting is most common among children of older mothers (35 years or older). In 

three countries (Comoros, Kenya, and Central African Republic), wasting is most common among children of younger mothers (under 20 years). 

Although the differences are small for Brazil, Colombia, and Haiti, in Latin America and the Caribbean, stunting is most common among children of older mothers (35 years or older). Wasting rates are 

quite low in this region, yet there are some noticeable differences by mother’s age at delivery. Wasting is 

highest among children of younger mothers (under 20 years) in the Dominican Republic. It is highest 

among children of older mothers (35 years or older) in Guatemala (Figure 3.39). 

Findings 55
Figure 3.35 

Percentage of children age 0-35 months who are stunted, by antenatal care visits, Demographic 

and Health Surveys, 1994-2001 

Sub-Saharan Africa 

0

10

20

30

40

50

60

Gabon 2000

Ghana 1998

Togo 1998

Guinea 1999

Côte d’Ivoire 1994

Benin 1996

Zimbabwe 1999

Mali 1995-96

Cameroon 1998

Chad 1996-97

Burkina Faso 1998-99

Kenya 1998

Central African Rep. 1994-95

Comoros 1996

Eritrea 1995

Mozambique 1997

Uganda 2000-01

Niger 1998

Tanzania 1999

Zambia 1996

Ethiopia 2000

Malawi 2000

Madagascar 1997

Percent 

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

Latin America/

Caribbean 

Central

Asia

North Africa/ 

West Asia/ 

Euro

South/

Southeast 

pe Asia 

One or more visits None/missing

56 Findings
Figure 3.36 

Percentage of children age 0-35 months who are wasted, by antenatal care visits, Demographic 

and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

Gabon 2000

Cameroon 1998

Uganda 2000-01

Zambia 1996

Tanzania 1999

Kenya 1998

Central African Rep. 1994-95

Zimbabwe 1999

Madagascar 1997

Malawi 2000

Côte d’Ivoire 1994

Comoros 1996

Mozambique 1997

Guinea 1999

Togo 1998

Ethiopia 2000

Ghana 1998

Benin 1996

Chad 1996-97

Eritrea 1995

Burkina Faso 1998-99

Niger 1998

Mali 1995-96

Percent 

Sub-Saharan Africa 

0

5

10

15

20

25

30

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

Cambodia 2000

India 1998-99

Peru 2000

Colombia 2000

Bolivia 1998

Dominican Rep. 1996

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

One or more visits None/missing

North Africa/ 

West Asia/ 

Europe 

Central 

Asia 

South/

Southeast 

Latin America/ 

Carribean 

Asia

Findings 57
Figure 3.37 

Percentage of children age 0-35 months who are underweight, by antenatal care visits, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Ghana 1998

Zimbabwe 1999

Cameroon 1998

Madagascar 1997

Eritrea 1995

Togo 1998

Côte d’Ivoire 1994

Guinea 1999

Kenya 1998

Zambia 1996

Uganda 2000-01

Central African Rep. 1994-95

Niger 1998

Mali 1995-96

Benin 1996

Chad 1996-97

Comoros 1996

Mozambique 1997

Burkina Faso 1998-99

Ethiopia 2000

Malawi 2000

Gabon 2000

Tanzania

1999

Percent

Sub-Saharan Africa

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Bangladesh 2000

Nepal 1996

Cambodia 2000

India 1998-99

Colombia 2000

Bolivia 1998

Haiti 2000

Dominican Rep. 1996

Peru 2000

Guatemala 1998-99

Brazil 1996

Percent 

One or more visits None/missing

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

58 Findings
Figure 3.38 

Levels of stunting among children age 0-35 months by mother’s age at delivery, Demographic and 

Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Ghana 1998

Gabon 2000

Guinea 1999

Zimbabwe 1999

Togo 1998

Mali 1995-96

Benin 1996

Côte d’Ivoire 1994

Cameroon 1998

Kenya 1998

Central African Rep. 1994-95

Burkina Faso 1998-99

Chad 1996-97

Comoros 1996

Eritrea 1995

Uganda 2000-01

Mozambique 1997

Tanzania 1999

Zambia 1996

Niger 1998

Ethiopia 2000

Malawi 2000

Madagascar 1997

Percent

0

10

20

30

40

50

60

Egypt 2000

Yemen 1997

Kazakhstan 1999

Uzbekistan 1996

Kyrgyz Rep. 1997

Cambodia 2000

Bangladesh 2000

Nepal 1996

India 1998-99

Brazil 1996

Colombia 2000

Dominican Rep. 1996

Haiti 2000

Bolivia 1998

Peru 2000

Guatemala 1998-99

Percent 

Sub-Saharan Africa

North Africa/

West Asia/ 

Europe 

Central South/

Southeast 

Asia 

Latin America/ 

Asia Carribean

< 20 20-34 35+

Findings 59
 

Figure 3.39 

Levels of wasting among children age 0-35 months by mother’s age at delivery, Demographic and 

Health Surveys, 1994-2001 

0

5

10

15

20

25

30

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Tanzania 1999

Zimbabwe 1999

Mozambique 1997

Malawi 2000

Madagascar 1997

Central African Rep. 1994-95

Guinea 1999

Kenya 1998

Côte d’Ivoire 1994

Ethiopia 2000

Comoros 1996

Ghana 1998

Togo 1998

Burkina Faso 1998-99

Benin 1996

Eritrea 1995

Chad 1996-97

Niger 1998

Mali 1995-96

Percent

0

5

10

15

20

25

Jordan 1997

Egypt 2000

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Bangladesh 2000

Nepal 1996

Cambodia 2000

India 1998-99

Colombia 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Brazil 1996

Dominican Rep. 1996

Haiti 2000

Percent 

< 20 20-34 35+

Sub-Saharan Africa

North Africa/ 

West Asia/ 

Europe 

Central South/

So st 

Latin America/ 

Asia uthea Carribean

Asia 

60 Findings
Figure 3.40 

Levels of underweight among children age 0-35 months by mother’s age at delivery, Demographic 

and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Zimbabwe 1999

Gabon 2000

Guinea 1999

Kenya 1998

Central African Rep. 1994-95

Uganda 2000-01

Cameroon 1998

Ghana 1998

Côte d’Ivoire 1994

Zambia 1996

Togo 1998

Malawi 2000

Mozambique 1997

Benin 1996

Comoros 1996

Tanzania 1999

Chad 1996-97

Burkina Faso 1998-99

Mali 1995-96

Eritrea 1995

Madagascar 1997

Ethiopia 2000

Niger 1998

Percent

0

10

20

30

40

50

60

70

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Nepal 1996

Bangladesh 2000

India 1998-99

Colombia 2000

Brazil 1996

Bolivia 1998

Peru 2000

Dominican Rep. 1996

Haiti 2000

Guatemala 1998-99

Percent 

< 20 20-34 35+

Sub-Saharan Africa

South/

Southeast 

Asia 

North Africa

a

/ 

West Asi / 

Europe

Central 

Asia

Latin America/

Carribean

Findings 61
In Central Asia, there is no discernible maternal age pattern in regard to stunting. However, wasting 

3.4.3.2 Child Characteristics 

Size at Birth 

The birth weight of an infant is a determinant of child health and nutrition. Low birth weight babies face 

higher risks of illness and death than do babies of normal birth weight. With only about 40 to 60 percent 

of women delivering in health facilities in most of the countries surveyed, actual birth weight is not available for most infants. As a proxy, a mother’s assessed size of her infant at birth is used. Mothers were 

asked, “When (NAME) was born, was he/she very large, larger than average, average, smaller than average, or very small.” The child’s nutritional status is assessed based on the mother’s report of the child’s size 

at birth (Table A.3.19). In this analysis, there are three categories of birth size: very small, smaller than 

average, and average or larger. 

In most countries in sub-Saharan Africa, the lowest rates of stunting, wasting, and underweight were 

recorded among children reported to be average or larger than average at birth (Figures 3.41 through 

3.43). On the other hand, children whom the mothers perceived as very small at birth had the highest 

rates of undernutrition. Ghana, Mozambique, and Tanzania had fewer than 50 cases of very small infants; 

hence their results in this category should be interpreted with caution. 

Countries in ica/West A urope, South Asia, and Latin Am the Caribbean have a pat birth size similar to that of sub-S n Africa, with low rates of undernutrition 

among children reported as average and above average at birth and the highest rates among children reported as very small at birth. The question of child size at birth was not asked in the Colombia and Peru 

surveys. 

The Central Asia region has very small numbers of children reported to be very small at birth. This 

category is therefore not included in the discussion. In most cases, the children who were reported to be 

average to above average at birth had lower rates of stunting, wasting, and underweight than those reported to be smaller than average. 

and underweight are higher among children of older mothers (35 years or older). In South/Southeast Asia

stunting, wasting, and underweight rates are higher among children of older mothers (35 years or older). 

Stunting is slightly higher among children of younger mothers in the North Africa/West Asia/Europe

region. However, wasting and underweight rates are almost the same in all maternal age groups in this 

region (Figures 3.39 and 3.40, respectively).

 North Afr sia/E /Southeast erica and

tern of ahara

62 Findings
Figure 3.41 

Levels of stunting among children age 0-35 months by mother’s perceived size of child at birth, 

Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa

70

40

0

10

20

30

9

50

60

e 1

Mozambiqu

Guin

Ghan

Tog

Burkina Faso 1

Gabo

Ken

Côte d’Ivoi

Cameroo

Chad 1

Zimbabw

Mali 1

Ben

Uganda 2

Eritre

Nig

Central African Rep. 1

Ethiop

Mala

Comor

Tanzan

Madagasc

Zamb

9

ea

7

199

a 1

9

99

o 1

8

99

99

8

8-99

n 2000

ya 1998

re 1994

n 1998

996-97

e 1999

995-96

in 1996

000-01

a 1995

er 1998

994-95

ia 2000

wi 2000

os 1996

ia 1999

ar 1997

ia 1996

t Percen

Very small Smaller than average Average or larger

0

10

50

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Uzbekistan 1996

Kyrgyz Rep. 1997

Kazakhstan 1999

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Haiti 2000

Dominican Rep. 1996

Brazil 1996

Bolivia 1998

Guatemala 1998-99

20

30

40

Percent

60

70

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Central 

Asia

Latin America/

Carribean

Findings 63
Figure 3.42 

Levels of wasting among children age 0-35 months by mother’s perceived size of child at birth, 

Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

35

40

45

Tanzania 1999

Kenya 1998

Gabon 2000

Zimbabwe 1999

Malawi 2000

Central African Rep. 1994-95

Uganda 2000-01

Cameroon 1998

Madagascar 1997

Zambia 1996

Ghana 1998

Côte d’Ivoire 1994

Comoros 1996

Ethiopia 2000

Togo 1998

Eritrea 1995

Guinea 1999

Benin 1996

Chad 1996-97

Niger 1998

Burkina Faso 1998-99

Mali 1995-96

Mozambique 1997

Percent

Very small Smaller than average Average or larger

0

5

10

15

20

25

30

Egypt 2000

Turkey 1998

Jordan 1997

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Dominican Rep. 1996

Guatemala 1998-99

Bolivia 1998

Haiti 2000

Brazil 1996

Percent

Sub-Saharan Africa

North Africa/ 

West Asia/ 

Europe 

Central South/ Latin America/

Asia S Carribean

Asia 

outheast 

64 Findings
Figure 3.43 

Levels of underweight among children age 0-35 months by mother’s perceived size of child at 

birth, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

70

80

Gabon 2000

Kenya 1998

Zimbabwe 1999

Comoros 1996

Uganda 2000-01

Guinea 1999

Central African Rep. 1994-95

Malawi 2000

Côte d’Ivoire 1994

Togo 1998

Cameroon 1998

Zambia 1996

Mozambique 1997

Ethiopia 2000

Chad 1996-97

Burkina Faso 1998-99

Ghana 1998

Madagascar 1997

Eritrea 1995

Benin 1996

Tanzania 1999

Niger 1998

Mali 1995-96

Percent 

Sub-Saharan Africa

0

10

20

30

40

50

60

70

80

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

India 1998-99

Nepal 1996

Bangladesh 2000

Bolivia 1998

Brazil 1996

Haiti 2000

Dominican Rep. 1996

Guatemala 1998-99

Percent 

North Africa/

West Asia/ 

Europe 

Central South/

Southeast 

Asia 

Latin America/

Asia Carribean

Very small Smaller than average Average or larger

Findings 65
Sex 

In most of the regions, there are gender differentials in stunting based on sex (Figure 3.44). Typi

ales have a slightly higher rate of stunting than fema

cally,

les (Table A.3.20). However, in South/Southeast 

there is a higher rate of stunting among females than males. Of the sub-Saharan countries included 

ere, Eritrea is the only one in which female er rate of stunting (41 percent) than 

tes are about equal between males and 

females.

Figure 3.44 

m

Asia,

h

m

s have a slightly high

ales (36 percent). In Tanzania and Mozambique, the stunting ra

Levels of stunting among children age 0-35 months by sex of a child, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa 

0

10

20

30

40

50

60

Gabon 2000

Ghana 19

Togo

Guin

98

98

9

19

ea 199

Benin 1996

Côte d’Ivoire 1994

Zimbabwe 1999

Cameroon 1998

Kenya 1

Burkina Faso 1998-99

Mali 1995-96

Comoros 1996

Central African Rep. 1994-95

Uganda 2000

Chad 1

998

-01

7

97

99

Mozambiqu 19

Tanzania 1999

Zambia 1996

Niger 1998

Eritrea 1995

Malawi 20

6-9

e

0

Ethiopia 20

Madagascar 19

Percent 

0

00

97

0

10

20

30

40

50

60

Jordan 1997Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

Latin America/ 

Caribbean 

Central

Asia

North Africa/ 

West Asia/ 

Euro

South/

Southeast 

pe Asia 

Male Female

66 Findings
In Latin America and the Caribbean, males have a higher rate of stunting, except in Peru, where the 

n sub-Saharan Africa, eight countries have about equal rates of wasting for males and females. 

nd in Togo and Malawi, the rates of wasting are higher among females. Jordan, in the North 

rate of stunting between males and females is about the same. Among all regions, the North Africa/West 

Asia/Europe region shows the smallest differences between males and females (Figure 3.44). 

Again, females seem to have a slight advantage when it comes to wasting, with slightly higher rates of 

wasting among males than among females across all regions (Figure 3.45). However, there are a few exceptions. I

A

Figure 3.45 

Levels of wasting among children age 0-35 months by sex of child, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Madagascar 1997

Central African Rep. 1994-95

Tanzania 1999

Côte d’Ivoire 1994

Kenya 1998

Zimbabwe 1999

Comoros 1996

Mozambique 1997

Malawi 2000

Ethiopia 2000

Ghana 1998

Guinea 1999

Benin 1996

Togo 1998

Chad 1996-97

Burkina Faso 1998-99

Eritrea 1995

Niger 1998

Mali 1995-96

Percent 

0

5

10

15

20

25

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Dominican Rep. 1996

Colombia 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Brazil 1996

Haiti 2000

Percent 

Male Female

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

Findings 67
Af

males. 

rica/West Asia/Europe region, shows no gender differences for wasting, and this is also the case in Colombia, Peru, and Brazil in Latin America and the Caribbean. In South/Southeast Asia, where rates of 

stunting are higher among females than males, rates of wasting are higher among males than fe

Underweight has a different distribution by sex, although females continue to have a small advantage 

over males (Figure 3.46). In sub-Saharan Africa, there are a few countries (namely, Burkina Faso, Ghana, 

Tanzania, Malawi, and Mali) where the prevalence of underweight is about the same for males and females. In Eritrea and Niger, females have a higher rate of underweight than males. 

Figure 3.46 

Levels of underweight among children age 0-35 months by sex of child, Demographic and Health

Surveys, 1994-2001 

0

10

20

30

40

50

60

Gabon 2000

Zimbabwe 1999

Kenya 1998

Cameroon 1998

Côte d’Ivoire 1994

Uganda 2000-01

Zambia 1996

Comoros 1996

Mozambique 1997

Togo 1998

Ghana 1998

Central African Rep. 1994-95

Benin 1996

Guinea 1999

Malawi 2000

Tanzania 1999

Burkina Faso 1998-99

Chad 1996-97

Madagascar 1997

Mali 1995-96

Ethiopia 2000

Eritrea 1995

Niger 1998

Percent 

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

Nepal 1996

India 1998-99

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Peru 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent 

Male Female

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

68 Findings
In North Africa/West Asia/Europe, underweight rates are higher for males than females, except in 

Jordan, where females are at a slight disadvantage to males. In Central Asia, males also have a higher rate 

of underweight than females. South/Southeast Asia has the opposite pattern, with higher rates of underweight among females, except in Cambodia where the rates are about the same for males and females. In 

Latin America and the Caribbean, four of the seven countries have almost the same rates of underweight 

for males and females (Figure 3.46). 

Birth Order 

A child’s birth order is taken from the birth history given by the mother at the time of the interview. 

Birth orders were recoded into four categories (first, second or third, fourth or fifth, and sixth or higher). 

Data on undernutrition and birth order are presented in Table A.3.21 and Figures 3.47 to 3.49. 

Figures 3.47 through 3.49 show the patterns of undernutrition by birth order for the five regions. With 

the exception of sub-Saharan Africa, all of the regions have a pattern of stunting that increases as birth 

order increases (Figure 3.47). This pattern may be partly a reflection of poverty because larger families are 

usually poorer than smaller families and therefore less likely to have adequate food resources available. 

Yemen, in North Africa/West Asia/Europe, has a pattern that is almost flat, with high levels of stunting 

among children of all birth orders. In Kazakhstan, in Central Asia, the highest levels of stunting are 

among children of fourth or fifth birth order: this is not surprising because Kazakhstan has a small number of births overall and therefore only a small number of higher order births in the sample. 

The sub-Saharan region shows four patterns of undernutrition by birth order, not all of which can be 

fully explained by poverty. The data suggest that the largest group (10 countries) has a pattern of stunting 

that increases with birth order, as seen in the other regions. Mothers of children of higher birth order 

tend to be older and less educated than younger mothers. 

A second group, made up of six countries (Cameroon, Central African Republic, Chad, Guinea, Niger, 

and Togo), has a flatter distribution of stunting, indicating that undernutrition as measured by stunting is 

not influenced by birth order (Figure 3.47). This may be due to the overall high levels of poverty in these 

countries. 

A third group, made up of five countries (Burkina Faso, Côte d’Ivoire, Tanzania, Zambia, and Madagascar), shows a U-shaped distribution of stunting, with levels of stunting being higher for the first and 

sixth or higher order births than the middle order births. This may be related to the mother’s increased 

experience with child feeding practices as well as the application of improved health behaviors with subsequent children. However, at higher birth orders, poverty may negate the improvements gained from 

knowledge and experience. 

In Benin, Burkina Faso, and Uganda, the prevalence of stunting is highest for first births and levels off 

for second and higher order births. Mozambique has a unique pattern of undernutrition that shows decreasing stunting with increasing birth order. 

Findings 69
Figure 3.47 

Levels of stunting among children age 0-35 months by birth order, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Ghana 1998

Gabon 2000

Togo 1998

Guinea 1999

Zimbabwe 1999

Benin 1996

Kenya 1998

Côte d’Ivoire 1994

Mali 1995-96

Comoros 1996

Cameroon 1998

Central African Rep. 1994-95

Chad 1996-97

Eritrea 1995

Burkina Faso 1998-99

Uganda 2000-01

Mozambique 1997

Tanzania 1999

Niger 1998

Zambia 1996

Ethiopia 2000

Malawi 2000

Madagascar 1997

Percent 

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

India 1998-99

Bangladesh 2000

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

1st birth Birth 2-3 Birth 4-5 Birth 6+

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

70 Findings
Wasting increases with increasing birth order in most countries. In 11 of 23 countries in sub-Saharan 

Africa, children that are of sixth or higher order have the highest rates of wasting. In three countries, 

wasting shows a generally flat pattern across all birth orders. Three countries have a U-shaped pattern, 

which may be a reflection of mothers’ experience and improved health and nutrition practices. Four countries in this region have wasting levels that are highest for fourth and fifth order children. Two countries 

(Kenya and the Central African Republic) show unique patterns of low rates of wasting for first births and 

birth order six or higher (Figure 3.48). 

Countries in Latin America and the Caribbean have very low rates of wasting to start with, and these 

rates are about equal across birth orders, with the exception of Colombia and Brazil, where wasting rates 

increase with increasing birth order. All countries in South/Southeast Asia have high rates of wasting 

(over 10 percent for all births of second or higher order), and their rates increase with increasing birth 

order in most cases. In Central Asia, the Kyrgyz Republic and Kazakhstan have low rates of wasting, but 

the rates in Uzbekistan are much higher. In Uzbekistan, wasting increases with increasing birth order; in 

Kazakhstan and the Kyrgyz Republic, first births have the highest prevalence of wasting. North Africa/West Asia/Europe has low rates of wasting in three of the four countries. Birth order has little effect 

on wasting rates in this region (Figure 3.48). 

Underweight patterns by birth order are similar to stunting patterns in most regions, the prevalence of 

underweight increases with increasing birth order (Figure 3.49). However, sub-Saharan Africa again offers a more challenging picture with four distinct patterns of underweight. Like the other regions, the first 

group, including Kenya, Uganda, Guinea, and others, has an increasing relationship of birth order to underweight. A second group, including Cameroon, Ghana, Mali, and others, shows a J-shaped pattern between birth order and underweight. A third group has a U-shaped pattern. In a fourth group of countries, 

including Comoros, Togo, Côte d’Ivoire, and others, the prevalence of underweight does not vary much 

by birth order. 

Findings 71
Figure 3.48 

Levels of wasting among children age 0-35 months by birth order, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

Gabon 2000

Uganda 2000-01

Cameroon 1998

Zambia 1996

Kenya 1998

Zimbabwe 1999

Central African Rep. 1994-95

Madagascar 1997

Mozambique 1997

Tanzania 1999

Malawi 2000

Ethiopia 2000

Côte d’Ivoire 1994

Comoros 1996

Guinea 1999

Togo 1998

Ghana 1998

Benin 1996

Burkina Faso 1998-99

Eritrea 1995

Chad 1996-97

Niger 1998

Mali 1995-96

Percent 

0

5

10

15

20

25

Turkey 1998

Jordan 1997

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Colombia 2000

Peru 2000

Dominican Rep. 1996

Bolivia 1998

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

1st birth Birth 2-3 Birth 4-5 Birth 6+

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

72 Findings
Figure 3.49 

Levels of underweight among children age 0-35 months by birth order, Demographic and Health 

Surveys, 1994-2001 

0

10

20

30

40

50

60

70

Zimbabwe 1999

Gabon 2000

Kenya 1998

Uganda 2000-01

Cameroon 1998

Guinea 1999

Central African Rep. 1994-95

Comoros 1996

Togo 1998

Ghana 1998

Côte d’Ivoire 1994

Mozambique 1997

Zambia 1996

Malawi 2000

Benin 1996

Tanzania 1999

Chad 1996-97

Madagascar 1997

Eritrea 1995

Ethiopia 2000

Burkina Faso 1998-99

Mali 1995-96

Niger 1998

Percent

0

10

20

30

40

50

60

70

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Nepal 1996

India 1998-99

Bangladesh 2000

Brazil 1996

Dominican Rep. 1996

Peru 2000

Colombia 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent

1st birth Birth 2-3 Birth 4-5 Birth 6+

Sub-Saharan Africa 

North Africa/ South/

Southeast 

Asia 

Central

West Asia/ Asia

Europe 

Caribbean 

Latin America/ 

Findings 73
Preceding Birth Interval 

The length of the birth interval provides not only a descriptive variable for undernutrition (Mozumder et 

al., 2000; Rafalimanana and Westoff, 2000; Sharmanov et al., 1997; Boerma and Bicego, 1992), but it 

also explains how other relationships operate. Short birth intervals have been found to be associated with 

low birth weight and with intrauterine growth retardation, both of which have major implications for 

child undernutrition. (Fikree and Berendes, 1994). In other studies, children of women who live in urban 

areas or have secondary or more education are less likely to be born after a short interval than children of 

women who live in rural areas or have lower levels of education (Rutstein, 2002). Both place of residence 

and level of education were reported earlier to be related to child undernutrition. 

The length of the interval preceding each child’s birth is derived from the birth history provided by the 

mother. Birth interval length is divided into four categories: first birth, less than 24 months, 24 to 47 

months, and 48 months or longer (Table A.3.22 and Figures 3.50 through 3.52). 

The pattern that emerges for all regions is that the highest rates of stunting are among children with 

birth intervals of less than 24 months, followed by intervals of 24 to 47 months. Four countries (Kenya, 

Uzbekistan, the Kyrgyz Republic, and Bolivia) are exceptions. In Kenya, the Kyrgyz Republic, and Bolivia 

the highest rate of stunting is among children with a birth interval of 24 to 47 months, and in Uzbekistan, 

the highest rate is among children with an interval of 48 months or longer. In Zambia, first births have 

the highest rate of stunting (Figure 3.50). 

In sub-Saharan Africa, the lowest rate of stunting is typically among children born after an interval of 

48 months or longer. Again, Kenya is the exception with a rate for the 48-month interval almost the same 

as that for first births; in Comoros and Zimbabwe, stunting is the lowest for first births. In the Latin 

America and Caribbean region, first births and children born after an interval of 48 months or longer 

have almost the same rate of stunting, except for Guatemala, where the rate of stunting is higher for first 

births. In the South/Southeast Asia region, Cambodia and Bangladesh have the lowest rates of stunting 

following an interval of 48 months. In Nepal and India, stunting rates are higher for children born after 

an interval of 49 months or longer than for first births. The North Africa/West Asia/Europe region has 

the lowest rates of stunting for children with intervals of 48 months or longer, except in Egypt, where the 

rate is almost the same in three of the four birth interval categories (Figure 3.50).

There are no discernible patterns in the level of wasting by the length of the preceding birth interval 

(Figure 3.51). The patterns for underweight by preceding birth interval are similar to those for stunting. 

In 17 of the 23 countries of sub-Saharan Africa, underweight is highest among children with the shortest 

birth interval (less than 24 months). Cameroon, Côte d’Ivoire, Guinea, Malawi, Tanzania, and Zambia 

are the exceptions (Figure 3.52). 

74 Findings
In most countries in the other four regions, the highest rates of underweight are among children with 

birth intervals of less than 24 months. There are a few exceptions. Bolivia and Guatemala in Latin America and the Caribbean, the Kyrgyz Republic in Central Asia, and Nepal in South/Southeast Asia all have 

rates of underweight that are higher among children with a birth interval of 24 to 47 months than among 

those with an interval of less than 24 months. The countries in South/Southeast Asia and Yemen in 

North Africa/West Asia/Europe all have high levels of underweight; the patterns of underweight by birth 

interval are similar to those of countries in sub-Saharan Africa that have high levels of underweight (Figure 3.52). 

Figure 3.50 

Levels of stunting among children age 0-35 months by length of preceding birth interval, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Ghana 1998

Gabon 2000

Togo 1998

Guinea 1999

Zimbabwe 1999

Benin 1996

Kenya 1998

Côte d’Ivoire 1994

Mali 1995-96

Cameroon 1998

Comoros 1996

Central African Rep. 1994-95

Chad 1996-97

Eritrea 1995

Burkina Faso 1998-99

Uganda 2000-01

Mozambique 1997

Tanzania 1999

Niger 1998

Zambia 1996

Ethiopia 2000

Malawi 2000

Madagascar 1997

Percent 

0

10

20

30

40

50

60

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

India 1998-99

Bangladesh 2000

Nepal 1996

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

First birth < 24 Months 24-47 Months 48 Months or more

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Findings 75
Figure 3.51 

Levels of wasting among children age 0-35 months by length of preceding birth interval, Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

Gabon 2000

Uganda 2000-01

Zambia 1996

Cameroon 1998

Kenya 1998

Zimbabwe 1999

Central African Rep. 1994-95

Mozambique 1997

Madagascar 1997

Tanzania 1999

Malawi 2000

Ethiopia 2000

Côte d’Ivoire 1994

Comoros 1996

Guinea 1999

Togo 1998

Ghana 1998

Benin 1996

Burkina Faso 1998-99

Eritrea 1995

Chad 1996-97

Niger 1998

Mali 1995-96

Percent 

0

5

10

15

20

25

Turkey 1998

Jordan 1997

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Colombia 2000

Peru 2000

Dominican Rep. 1996

Bolivia 1998

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

First birth < 24 Months 24-47 Months 48 Months or more

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/

Caribbean 

76 Findings
Figure 3.52 

Levels of underweight among children age 0-35 months by length of preceding birth interval, 

Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Zimbabwe 1999

Gabon 2000

Kenya 1998

Uganda 2000-01

Cameroon 1998

Guinea 1999

Central African Rep. 1994-95

Comoros 1996

Togo 1998

Ghana 1998

Côte d’Ivoire 1994

Mozambique 1997

Zambia 1996

Malawi 2000

Benin 1996

Tanzania 1999

Chad 1996-97

Madagascar 1997

Eritrea 1995

Burkina Faso 1998-99

Ethiopia 2000

Mali 1995-96

Niger 1998

Percent

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Cambodia 2000

India 1998-99

Bangladesh 2000

Brazil 1996

Dominican Rep. 1996

Colombia 2000

Peru 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent

First birth < 24 Months 24-47 Months 48 Months or more

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

Findings 77
Vaccination History 

Universal immunization of children less than one year of age against the six vaccine-preventable childhood diseases (tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, and measles) is one of the most 

cost-effective approaches to reducing child morbidity and mortality. To be fully immunized, a child 

should receive one dose of BCG (vaccination against tuberculosis) at birth, three doses each of DPT 

(diphtheria, pertussis, tetanus) and polio, and one dose of measles vaccine, although this vaccination 

schedule has been modified recently. Some countries recommend a second dose of measles vaccine after 

the first year. Nevertheless, for countries included in this study, a child who received one dose of measles 

vaccine is considered fully immunized for measles. Because it is recommended that children receive the 

complete schedule of vaccinations before 12 months of age, this report analyzes the vaccination status of 

children age 12-23 months. 

Measles 

Measles is a severe disease with high case fatality rates in developing countries. The primary reason for 

the difference in clinical severity and case fatality between developed and developing countries is the poor 

nutritional status of children in developing countries. Undernutrition reduces the body’s resistance to infections and adversely affects the immune system. Therefore, immunization against measles has proven to 

be very effective in reducing the incidence in many countries. 

In sub-Saharan Africa, the prevalence of measles vaccination (Table A.3.23) runs from a low of 23 percent (Chad) to 87 percent (Zambia). Latin America and the Caribbean region has a spread ranging from 

51 percent (Bolivia) to 89 percent (Brazil). Much higher rates are seen in Central Asia, with a high of 92 

percent (Uzbekistan). South/Southeast Asia has lower rates, ranging from 54 percent (India) to 70 percent (Bangladesh). Yemen in the North Africa/West Asia/Europe region has the lowest rate of measles 

vaccination (47 percent), while in the same region, Egypt has the highest (97 percent) (Figure 3.53). 

Figure 3.54 shows that in most countries, the rates of stunting are higher among children age 12-23 

months who did not receive a measles vaccination than among those who did. In a few countries (Benin, 

Burkina Faso, Ethiopia, Togo, Uganda, and Jordan), there is little difference in stunting rates between 

children who were vaccinated and those who were not. Contrary to expectation, in Madagascar and 

Egypt, children with measles vaccinations have higher rates of stunting. 

78 Findings
Figure 3.53 

Percentage of children age 12-23 months with a measles vaccination, Demographic and Health Surveys, 1994-2001 

0

20

40

60

80

100

Chad 1996-97

Ethiopia 2000

Niger 1998

Togo 1998

Madagascar 1997

Burkina Faso 1998-99

Central African Rep. 1994-95

Eritrea 1995

Mali 1995-96

Côte d’Ivoire 1994

Cameroon 1998

Gabon 2000

Guinea 1999

Uganda 2000-01

Comoros 1996

Mozambique 1997

Benin 1996

Ghana 1998

Tanzania 1999

Kenya 1998

Zimbabwe 1999

Malawi 2000

Zambia 1996

Percent 

0

20

40

60

80

100

Yemen 1997

Turkey 1998

Jordan 1997

Egypt 2000

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

India 1998-99

Cambodia 2000

Nepal 1996

Bangladesh 2000

Bolivia 1998

Haiti 2000

Colombia 2000

Peru 2000

Dominican Rep. 1996

Guatemala 1998-99

Brazil 1996

Percent 

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

Findings 79
Figure 3.54 

Levels of stunting among children age 0-35 months by measles vaccination status, Demographic 

and Health Surveys, 1994-2001 

0

20

40

60

80

100

Gabon 2000

Ghana 1998

Côte d’Ivoire 1994

Guinea 1999

Benin 1996

Togo 1998

Zimbabwe 1999

Kenya 1998

Central African Rep. 1994-95

Mali 1995-96

Mozambique 1997

Chad 1996-97

Cameroon 1998

Eritrea 1995

Burkina Faso 1998-99

Uganda 2000-01

Comoros 1996

Zambia 1996

Tanzania 1999

Niger 1998

Malawi 2000

Ethiopia 2000

Madagascar 1997

Percent 

0

20

40

60

80

100

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Dominican Rep. 1996

Brazil 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

Measles vaccination No measles vaccination

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

80 Findings
Figure 3.55 

Levels of wasting among children age 0-35 months by measles vaccination status, Demographic 

and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

35

Gabon 2000

Cameroon 1998

Uganda 2000-01

Tanzania 1999

Kenya 1998

Zambia 1996

Zimbabwe 1999

Central African Rep. 1994-95

Malawi 2000

Madagascar 1997

Comoros 1996

Mozambique 1997

Côte d’Ivoire 1994

Guinea 1999

Ghana 1998

Ethiopia 2000

Benin 1996

Togo 1998

Eritrea 1995

Burkina Faso 1998-99

Chad 1996-97

Niger 1998

Mali 1995-96

Percent 

0

5

10

15

20

25

30

35

Jordan 1997

Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Dominican Rep. 1996

Peru 2000

Bolivia 1998

Colombia 2000

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

Measles vaccination No measles vaccination

Sub-Saharan Africa 

Central

Asia

South/

Southeast 

Asia 

North Africa/ 

West Asia/ 

Europe 

Latin America/ 

Caribbean 

Findings 81
Similar to stunting, the rates of wasting are generally higher among children age 12-23 months who 

did not receive a measles vaccination than among those who did. However, particularly puzzling are the 

higher wasting rates among vaccinated children in Mozambique and Côte d’Ivoire in sub-Saharan Africa, 

Guatemala in Latin America and the Caribbean, Uzbekistan in Central Asia, and Cambodia in 

South/Southeast Asia (Figure 3.55). 

In most cases, underweight rates are higher among children age 12-23 months who have not been vaccinated against measles than among those who have (Figure 3.56). 

Figure 3.56 

Levels of underweight among children age 0-35 months by measles vaccination status, Demographic and Health Surveys, 1994-2001 

0

20

40

60

80

100

Gabon 2000

Zimbabwe 1999

Kenya 1998

Cameroon 1998

Côte d’Ivoire 1994

Comoros 1996

Uganda 2000-01

Central African Rep. 1994-95

Mozambique 1997

Guinea 1999

Zambia 1996

Malawi 2000

Ghana 1998

Togo 1998

Tanzania 1999

Benin 1996

Chad 1996-97

Burkina Faso 1998-99

Eritrea 1995

Mali 1995-96

Ethiopia 2000

Madagascar 1997

Niger 1998

Percent 

0

20

40

60

80

100

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

India 1998-99

Nepal 1996

Bangladesh 2000

Brazil 1996

Dominican Rep. 1996

Peru 2000

Colombia 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent 

Measles vaccination No measles vaccination

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Sub-Saharan Africa 

82 Findings
Other Vaccinations 

Exploring vaccination status further to see whether other vaccinations and no vaccinations make a difference in undernutrition rates, the analysis shows that the lowest rates of undernutrition are still among 

children who have had a measles vaccination (Table A.3.24). The highest rates are generally among those 

who have had no vaccinations. In the sub-Saharan region, rates of undernutrition among children with 

only other vaccinations tend to be lower than or equal to rates among children with no vaccinations (Figures 3.57 through 3.59). 

Sample size must be scrutinized closely when analyzing vaccination data. In sub-Saharan Africa, there 

are six countries with less than 50 cases with no vaccinations. In North Africa/West Asia/Europe, three 

of the four countries have less than 50 cases of no vaccinations; hence the results of only one country 

(Yemen) can be discussed. In Yemen, children with a measles vaccination still have the lowest rates of 

stunting and underweight, but those with no vaccinations have the lowest rates of wasting. In Central 

Asia, two of the three countries have no cases in which children received no vaccinations; the remaining 

country (Kazakhstan) has less than 10 cases. Therefore, most children in Central Asia have completed 

vaccinations (Table A.3.24). 

Five of the seven countries in the Latin America and Caribbean region have less than 50 cases with no 

vaccinations; therefore, only other vaccinations can be compared with measles vaccinations in these countries. In most cases, stunting and underweight rates are higher among children with only other vaccinations than among those with measles vaccinations (Figures 3.57 and 3.59, respectively). Wasting rates are 

generally low in this region; only Haiti has a high enough level to determine that there is no relationship 

between vaccination status and wasting rates in that country (Figure 3.58). In Guatemala, wasting rates 

are higher among children with a measles vaccination than among those with only other vaccinations. 

Uzbekistan in Central Asia and Cambodia in South/Southeast Asia stand out as having the highest rates 

of wasting among children with a measles vaccination (Figure 3.58). 

Findings 83
Figure 3.57 

Levels of stunting among children age 0-35 months by vaccination status, Demographic and Health 

Surveys, 1994-2001 

0

20

40

60

80

100

Gabon 2000

Ghana 1998

Côte d’Ivoire 1994

Guinea 1999

Benin 1996

Togo 1998

Zimbabwe 1999

Kenya 1998

Central African Rep. 1994-95

Mali 1995-96

Mozambique 1997

Chad 1996-97

Cameroon 1998

Eritrea 1995

Burkina Faso 1998-99

Uganda 2000-01

Comoros 1996

Zambia 1996

Tanzania 1999

Niger 1998

Malawi 2000

Ethiopia 2000

Madagascar 1997

Percent 

0

20

40

60

80

100

Jordan 1997Turkey 1998

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Dominican Rep. 1996

Brazil 1996

Colombia 2000

Haiti 2000

Peru 2000

Bolivia 1998

Guatemala 1998-99

Percent 

Measles Other vaccinations only No vaccinations/missing

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

Central

Asia

North Africa/ 

West Asia/ 

Europe 

Sub-Saharan Africa 

84 Findings
Figure 3.58 

Levels of wasting among children age 0-35 months by vaccination status, Demographic and Health 

Surveys, 1994-2001 

0

10

20

30

40

Gabon 2000

Cameroon 1998

Uganda 2000-01

Tanzania 1999

Kenya 1998

Zambia 1996

Zimbabwe 1999

Central African Rep .1994-95

Malawi 2000

Madagascar 1997

Comoros 1996

Mozambique 1997

Côte d’Ivoire 1994

Guinea 1999

Ghana 1998

Ethiopia 2000

Benin 1996

Togo 1998

Eritrea 1995

Burkina Faso 1998-99

Chad 1996-97

Niger 1998

Mali 1995-96

Percent 

0

10

20

30

40

Egypt 2000

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Nepal 1996

Bangladesh 2000

India 1998-99

Cambodia 2000

Dominican Rep. 1996

Peru 2000

Bolivia 1998

Colombia 2000

Brazil 1996

Guatemala 1998-99

Haiti 2000

Percent 

Measles Other vaccinations only No vaccinations/missing

Latin America/ 

Caribbean 

South/

Southeast 

Asia 

Central 

Asia 

North Africa/ 

West Asia/ 

Europe

Sub-Saharan Africa 

Findings 85
Figure 3.59 

Levels of underweight among children age 0-35 months by vaccination status, Demographic and 

Health Surveys, 1994-2001 

0

10

20

30

40

50

60

70

80

Zimbabwe 1999

Kenya 1998

Cameroon 1998

Côte d’Ivoire 1994

Comoros 1996

Uganda 2000-01

Central African Rep. 1994-95

Mozambique 1997

Guinea 1999

Zambia 1996

Malawi 2000

Ghana 1998

Togo 1998

Tanzania 1999

Benin 1996

Chad 1996-97

Burkina Faso 1998-99

Eritrea 1995

Mali 1995-96

Ethiopia 2000

Madagascar 1997

Niger 1998

Percent 

0

10

20

30

40

50

60

70

80

Egypt 2000

Jordan 1997

Turkey 1998

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Cambodia 2000

India 1998-99

Nepal 1996

Bangladesh 2000

Brazil 1996

Dominican Rep .1996

Peru 2000

Colombia 2000

Bolivia 1998

Haiti 2000

Guatemala 1998-99

Percent 

Measles Other vaccinations only No vaccinations/missing

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia

Latin America/ 

Caribbean 

86 Findings
Feeding Practices 

Infant feeding practices are important to the nutritional status of children. It is recommended that infants 

age 0-6 months are breastfed exclusively, followed by the timely introduction of complementary foods 

between the ages of 6 and 9 months.2

 The use of bottles for feeding infants is not recommended because 

poor hygienic practices can lead to the introduction of pathogens. Breastfeeding should continue into the 

second year of life (WHO, 2003). This report does not analyze child nutritional status by infant feeding 

practices. Data on infant feeding practices are based on the past 24 hours while nutritional status is based 

on a child’s experience over time. A comparison of the two would be better served by using longitudinal 

data. Nevertheless, an examination of infant feeding practices in the countries included in this report provides useful information for analysis of the nutritional status of children. There are substantial variations 

in infant feeding practices across countries and regions, and discussion of these variations is important. 

Exclusive breastfeeding in this report is measured based on the percentage of youngest children (under 

6 months of age) who have been fed only breast milk in the 24 hours preceding the survey. Breastfeeding 

status of children under six months of age is shown in Table A.3.25. Rates of exclusive breastfeeding in 

sub-Saharan Africa range from less than 1 percent in Niger to over 63 percent in Uganda (Figure 3.60). 

Countries in Latin America and the Caribbean have higher rates of exclusive breastfeeding, ranging 

from 18 percent in the Dominican Republic to 67 percent in Peru. In South/Southeast Asia, the proportion of exclusively breastfed children ranges from 11 percent in Cambodia to 75 percent in Nepal. Exclusive breastfeeding data are available for only one country in Central Asia, Kazakhstan, where the figure is 

36 percent. In North Africa/West Asia/Europe, Yemen has no data on exclusive breastfeeding, and Egypt 

has the highest rate for the region, 64 percent (Figure 3.60). 

Bottle-feeding of children less than six months of age varies across countries and regions. In subSaharan Africa, six countries have bottle-feeding rates of more than 10 percent, with a high of 37 percent 

in Gabon. In Latin America and the Caribbean, rates of bottle-feeding reach almost 60 percent for 

breastfed infants in the Dominican Republic and 87 percent among nonbreastfed infants in Brazil (Table 

A.3.25). 

Table A.3.26 shows current breastfeeding status for infants age 6-9 months. At this age, children are 

expected to begin eating solid (complementary) foods in addition to breast milk. In sub-Saharan Africa 

(Figure 3.61), timely complementary feeding of infants ranges from 28 percent in Guinea to more than 

90 percent in the Central African Republic, Malawi, Zambia, and Zimbabwe. (In many of these countries, rates of complementary feeding are already high among children under six months of age.) In Latin 

America and the Caribbean, timely complementary feeding ranges from 31 percent in Brazil to 76 percent in Peru. North Africa/West Asia/Europe has moderate rates of complementary feeding of children 

age 6-9 months, ranging from 55 to 64 percent. In South/Southeast Asia, India has a low rate of 34 percent, but in the three other countries, it ranges from 59 percent in Bangladesh to 72 percent in Cambodia. Table A.3.26 shows that there are significant proportions of children still being exclusively breastfed 

or receiving breast milk and plain water only at age 6-9 months, when complementary feeding is considered essential to provide adequate nutrition. 

 

2

 Since the initial preparation of this report, recommendations for complementary feeding have been greatly 

expanded (PAHO, 2003, WHO, 2005). Comparative DHS data on the new complementary feeding indicators can be 

found in the Infant and Young Child Feeding Update (Mukuria et al., 2006). 

Findings 87
Figure 3.60 

Exclusive Breastfeeding status of children under 6 months, Demographic and Health Surveys, 1994-

2001 

0

10

20

30

40

50

60

70

80

Niger 1998

Chad 1996-97

Central African Rep. 1994-95

Côte d’Ivoire 1994

Comoros 1996

Gabon 2000

Burkina Faso 1998-99

Mali 1995-96

Benin 1996

Togo 1998

Guinea 1999

Cameroon 1998

Kenya 1998

Zambia 1996

Mozambique 1997

Ghana 1998

Zimbabwe 1999

Tanzania

1999

Malawi 2000

Madagascar 1997

Ethiopia 2000

Eritrea 1995

Uganda 2000-01

Percent

0

10

20

30

40

50

60

70

80

Turkey 1998

Jordan 1997

Egypt 2000

Kazakhstan 1999

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Dominican Rep. 1996

Haiti 2000

Brazil 1996

Guatemala 1998-99

Bolivia 1998

Colombia 2000

Peru 2000

Percent

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

88 Findings
Figure 3.61 

Complementary feeding status of children age 6-9 months, Demographic and Health Surveys, 1994-

2001 

0

20

40

60

80

100

Turkey 1998Jordan 1997

Egypt 2000

Kazakhstan 1999

India 1998-99

Bangladesh 2000

Nepal 1996

Cambodia 2000

Brazil 1996

Colombia 2000

Dominican Rep. 1996

Guatemala 1998-99

Bolivia 1998

Haiti 2000

Peru 2000

Percent 

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

0

20

40

60

80

100

Guinea 1999

Mali 1995-96

Ethiopia 2000

Eritrea 1995

Burkina Faso 1998-99

Tanzania 1999

Gabon 2000

Ghana 1998

Côte d’Ivoire 1994

Chad 1996-97

Niger 1998

Cameroon 1998

Uganda 2000-01

Mozambique 1997

Benin 1996

Comoros 1996

Madagascar 1997

Togo 1998

Kenya 1998

Zimbabwe 1999

Central African Rep. 1994-95

Malawi 2000

Zambia 1996

Percent 

Findings 89
WHO recommends that breastfeeding should continue through the second year of life. Table A.3.27 

shows the median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding 

among children born in the three years preceding the survey. DHS calculates the median duration of 

breastfeeding from current breastfeeding status data. For each month of age, the percentage of children 

who are breastfeeding is derived by dividing the number of children breastfeeding by the total number of 

children born the same number of months ago. The median is derived (usually through interpolation) by 

identifying the age at which 50 percent of the sample children are no longer breastfeeding. This method 

is preferred over mothers’ reports of breastfeeding duration among fully weaned children because of biases 

in recall (Haggerty and Rutstein, 1999). 

In sub-Saharan Africa, the median duration of any breastfeeding ranges from 12 months in Gabon to 

26 months in Burkina Faso and Ethiopia. In North Africa/West Asia/Europe, it ranges from 12 months 

in Jordan and Turkey to 18 months in Yemen and Egypt. Among all the countries surveyed, Brazil (7 

months) and the Dominican Republic (8 months) in Latin America and the Caribbean have the shortest 

median duration of any breastfeeding. Central Asia has a median duration of about 16 months. In 

South/Southeast Asia, the median duration of breastfeeding ranges from 21 months in Cambodia to 31 

months in Bangladesh and Nepal (Figure 3.62 and Table A.3.27). 

The median duration of predominant breastfeeding (breast milk and other nonmilk liquids) is longer 

than that of exclusive breastfeeding in most countries. In three countries (Yemen, the Kyrgyz Republic, 

and Uzbekistan), the median durations of predominant and exclusive breastfeeding are the same (0.4 

month). The longest median duration of exclusive breastfeeding is found in Nepal (4.7 months). Short 

median durations of exclusive breastfeeding (less than 1 month) are reported for 16 of 23 countries in 

sub-Saharan Africa, 3 of 4 countries in North Africa/West Asia/Europe, 2 of 3 countries in Central Asia, 

1 of 4 countries in South/Southeast Asia, and 3 of 7 countries in Latin America and the Caribbean (Figure 3.62 and Table A.3.27). 

90 Findings
Figure 3.62 

Median duration of exclusive breastfeeding, predominant breastfeeding, and any breastfeeding, 

Demographic and Health Surveys, 1994-2001 

0

5

10

15

20

25

30

35

Gabon 2000

Comoros 1996

Central African Rep. 1994-95

Benin 1996

Côte d’Ivoire 1994

Chad 1996-97

Niger 1998

Burkina Faso 1998-99

Guinea 1999

Kenya 1998

Togo 1998

Zambia 1996

Cameroon 1998

Mali 1995-96

Ghana 1998

Mozambique 1997

Tanzania 1999

Zimbabwe 1999

Malawi 2000

Madagascar 1997

Ethiopia 2000

Eritrea 1995

Uganda 2000-01

Months

0

5

10

15

20

25

30

35

Jordan 1997

Egypt 2000

Kyrgyz Rep. 1997

Uzbekistan 1996

Kazakhstan 1999

Cambodia 2000

Bangladesh 2000

India 1998-99

Nepal 1996

Dominican Rep. 1996

Haiti 2000

Guatemala 1998-99

Brazil 1996

Bolivia 1998

Colombia 2000

Peru 2000

Months

Exclusive Predominant Any breastfeeding

Caribbean 

Latin America/ 

Sub-Saharan Africa 

North Africa/ South/

Southeast 

Asia 

Central

West Asia/ Asia 

Europe 

Findings 91
3.4.3.3 Immediate Influences 

Recent Illnesses 

The interaction of undernutrition and infection is the leading cause of morbidity and mortality in most 

developing countries. In a vicious cycle, infections make undernutrition worse and poor nutrition increases the susceptibility to and severity of infectious diseases. Acute respiratory infection (ARI) and diarrhea are the most prevalent infections in the developing world. 

Acute Respiratory Infection 

ARI is one of the leading causes of childhood morbidity and mortality in the developing world. Acute 

lower respiratory infections (primarily pneumonia) are the cause of a significant proportion (19 percent) of 

infant and childhood deaths (WHO, 2005). Programs for the early identification and antibiotic treatment 

of pneumonia are being implemented in many countries. To estimate the proportion of children who 

show symptoms consistent with ARI, DHS surveys asked mothers the following questions: 

“Has (NAME) had an illness with a cough at any time in the last two weeks?” 

“When (NAME) had an illness with a cough, did he/she breathe faster than usual with short, rapid 

breaths?” 

Table A.3.28 shows the prevalence of ARI in the two weeks preceding the survey among children age 4-

23 months by nutritional status. 

In sub-Saharan Africa, the prevalence of ARI ranges from 6 percent in Niger to 21 percent in the Central African Republic. In North Africa/West Asia/Europe, the range is relatively small—from 7 percent 

in Jordan to 12 percent in Yemen. Countries in Central Asia have a very low prevalence of ARI, from 1 

percent in Uzbekistan to 4 percent in the Kyrgyz Republic. In South/Southeast Asia, the prevalence 

ranges from 13 percent (Cambodia) to 20 percent (Nepal). In Latin America and the Caribbean, the lowest rate of ARI reported is in Peru (15 percent), and the highest rate is in Haiti (25 percent). 

Figures 3.63 through 3.65 show the prevalence of ARI by nutritional status. There is not as much elevation in ARI rates due to undernutrition as might be expected. In most countries, ARI rates for children 

that are stunted and those that are not are about the same or slightly higher or lower. There are no clear 

regional differences. The illness actually consists of lower respiratory infection, which includes pneumonia 

and poses a serious public health risk, and upper respiratory infection, which is common and poses less of 

a risk to children (Mishra et al., 2005). It has been suggested that the way ARI is assessed in DHS surveys may not be sensitive enough to distinguish between upper and lower respiratory infections, and this 

may account for the lack of a clear relationship between nutritional status and ARI. 

92 Findings
Figure 3.63 

Prevalence of ARI among children age 4-23 months by stunting, Demographic and Health Surveys, 

1994-2001 

Sub-Saharan Africa

0

5

10

15

20

25

30

Niger 1998

Mozambique 1997

Chad 1996-97

Zambia 1996

Mali 1995-96

Côte d’Ivoire 1994

Burkina Faso 1998-99

Togo 1998

Zimbabwe 1999

Gabon 2000

Comoros 1996

Tanzania 1999

Ghana 1998

Benin 1996

Madagascar 1997

Kenya 1998

Cameroon 1998

Ethiopia 2000

Eritrea 1995

Malawi 2001

Guinea 1999

Uganda 2000-01

Central African Rep 1994-95

Percent

Stunted Not stunted

0

5

10

15

20

25

30

Jordan 1997

Egypt 2000

Yemen 1997

Uzbekistan 1996

Kyrgyz Rep 1997

Kazakhstan 1999

Cambodia 2000

India 2001

Nepal 1996

Bangladesh 2000

Guatemala 1999

Peru 2000

Bolivia 1998

Dominican Rep 1996

Brazil 1996

Haiti 2001

Percent

North Africa/

West Asia/

Europe

South/

Southeast 

Asia

Latin America/

Caribbean

Central Asia

Findings 93
Figure 3.64 

Prevalence of ARI among children age 4-23 months by wasting, Demographic and Health Surveys, 

1994-2001 

0

5

10

15

20

25

Mozambique 1997

Niger 1998

Zambia 1996

Benin 1996

Chad 1996-97

Mali 1995-96

Guinea 1999

Togo 1998

Kenya 1998

Gabon 2000

Ethiopia 2000

Burkina Faso 1998-99

Côte d’Ivoire 1994

Cameroon 1998

Ghana 1998

Madagascar 1997

Eritrea 1995

Uganda 2000-01

Malawi 2000

Comoros 1996

Tanzania 1999

Central African Rep. 1994-95

Zimbabwe 1999

Percent 

0

5

10

15

20

25

Egypt 2000

Jordan 1997

Yemen 1997

Kazakhstan 1999

Kyrgyz Rep. 1997

Uzbekistan 1996

Bangladesh 2000

Cambodia 2000

India 1998-99

Nepal 1996

Bolivia 1998

Brazil 1996

Dominican Rep. 1996

Guatemala 1998-99

Haiti 2000

Peru 2000

Percent 

Wasted Not wasted

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/

Caribbean

94 Findings
Figure 3.65 

Prevalence of ARI among children age 4-23 months by underweight, Demographic and Health Surveys, 1994-2001 

Sub-Saharan Africa

0

5

10

15

20

25

30

Niger 1998

Gabon 2000

Chad 1996-97

Zambia 1996

Mozambique 1997

Mali 1995-96

Benin 1996

Côte d’Ivoire 1994

Guinea 1999

Togo 1998

Burkina Faso 1998-99

Tanzania 1999

Ghana 1998

Ethiopia 2000

Kenya 1998

Cameroon 1998

Madagascar 1997

Comoros 1996

Eritrea 1995

Zimbabwe 1999

Malawi 2001

Uganda 2000-01

Central African Rep 1994-95

Percent

Underweight Not underweight

North Africa/

West Asia/

Europe

0

5

10

15

20

25

30

Egypt 2000

Yemen 1997

Jordan 1997

Uzbekistan 1996

Kyrgyz Rep 1997

Kazakhstan 1999

Cambodia 2000

India 2001

Nepal 1996

Bangladesh 2000

Peru 2000

Guatemala 1999

Brazil 1996

Bolivia 1998

Haiti 2001

Dominican Rep 1996

Percent

Central 

Asia

South/

Southeasst 

Asia

Latin America/

Caribbean

Findings 95
Diarrhea 

Diarrhea is an important contributor to child morbidity and mortality. Mothers were asked to report the 

occurrence of diarrhea in their children. The following question was asked in DHS surveys: 

“Has (name) had diarrhea in the last two weeks?” 

Table A.3.29 shows the overall prevalence of diarrhea in the two weeks preceding the survey among 

children age 4-23 months and the prevalence of diarrhea by nutritional status of children. Overall, diarrhea rates in sub-Saharan Africa range from 23 percent in Kenya and Tanzania to 44 percent in Niger. In 

North Africa/West Asia/Europe, the range is broader, from 12 percent in Egypt to 44 percent in Turkey. 

In Central Asia, Uzbekistan has the lowest prevalence (7 percent) and the Kyrgyz Republic has the highest prevalence (24 percent). In South/Southeast Asia, the prevalence ranges from 11 percent in Bangladesh to 34 percent in Nepal. In Latin America and the Caribbean, the lowest rate reported is in Brazil (20 

percent), and the highest is in Haiti (43 percent). 

Figures 3.66 through 3.68 show the prevalence of diarrhea by nutritional status. Unlike ARI rates, diarrhea rates in most countries are higher among children who are stunted, wasted, or underweight. There 

are a few exceptions, particularly among stunted children in sub-Saharan Africa, where the rates of diarrhea are not affected by nutritional status. Wasting and underweight are better covariates of increased levels of diarrhea than stunting. As a measure of acute and generalized undernutrition, wasting could be the 

result of diarrhea or another recent childhood illness, whereas stunting is a long-term adaptation, less affected by acute illness in the past two weeks. 

96 Findings
Figure 3.66 

Prevalence of diarrhea among children age 4-23 months by stunting, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

70

Kenya 1998

Mozambique 1997

Zimbabwe 1999

Central African Rep. 1994-95

Benin 1996

Comoros 1996

Eritrea 1995

Cameroon 1998

Burkina Faso 1998-99

Ghana 1998

Gabon 2000

Guinea 1999

Malawi 2000

Uganda 2000-01

Madagascar 1997

Mali 1995-96

Zambia 1996

Ethiopia 2000

Togo 1998

Niger 1998

Percent 

0

10

20

30

40

50

60

70

Egypt 2000

Jordan 1997

Yemen 1997

Turkey 1998

Kazakhstan 1999

Uzbekistan 1996

Kyrgyz Rep. 1997

Bangladesh 2000

India 1998-99

Cambodia 2000

Nepal 1996

Brazil 1996

Colombia 2000

Guatemala 1998-99

Dominican Rep. 1996

Peru 2000

Bolivia 1998

Haiti 2000

Percent 

Stunted Not stunted

Caribbean 

Latin America/ 

Sub-Saharan Africa 

North Africa/ South/

Southeast 

Asia 

Central

West Asia/ Asia 

Europe 

Findings 97
Figure 3.67 

Prevalence of diarrhea among children age 4-23 months by wasting, Demographic and Health Surveys, 1994-2001 

0

10

20

30

40

50

60

Tanzania 1999

Zimbabwe 1999

Kenya 1998

Ghana 1998

Eritrea 1995

Comoros 1996

Côte d’Ivoire 1994

Uganda 2000-01

Central African Rep. 1994-95

Chad 1996-97

Benin 1996

Burkina Faso 1998-99

Madagascar 1997

Malawi 2000

Mali 1995-96

Cameroon 1998

Togo 1998

Zambia 1996

Guinea 1999

Gabon 2000

Mozambique 1997

Ethiopia 2000

Niger 1998

Percent 

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Yemen 1997

Turkey 1998

Uzbekistan 1996

Kyrgyz Rep. 1997

Kazakhstan 1999

Bangladesh 2000

India 1998-99

Cambodia 2000

Nepal 1996

Peru 2000

Brazil 1996

Bolivia 1998

Guatemala 1998-99

Dominican Rep. 1996

Haiti 2000

Colombia 2000

Percent 

Wasted Not wasted

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

98 Findings
Figure 3.68 

Prevalence of diarrhea among children age 4-23 months by underweight, Demographic and Health 

Surveys, 1994-2001 

0

10

20

30

40

50

60

Tanzania

1999

Côte d’Ivoire 1994

Comoros 1996

Chad 1996-97

Kenya 1998

Benin 1996

Ghana 1998

Eritrea 1995

Cameroon 1998

Mozambique 1997

Central African Rep. 1994-95

Zimbabwe 1999

Burkina Faso 1998-99

Gabon 2000

Mali 1995-96

Madagascar 1997

Uganda 2000-01

Malawi 2000

Guinea 1999

Togo 1998

Ethiopia 2000

Zambia 1996

Niger 1998

Percent 

0

10

20

30

40

50

60

Egypt 2000

Jordan 1997

Yemen 1997

Turkey 1998

Uzbekistan 1996

Kyrgyz Rep. 1997

Kazakhstan 1999

Bangladesh 2000

India 1998-99

Cambodia 2000

Nepal 1996

Brazil 1996

Guatemala 1998-99

Peru 2000

Dominican Rep. 1996

Colombia 2000

Bolivia 1998

Haiti 2000

Percent 

Underweight Not underweight

Sub-Saharan Africa 

North Africa/ 

West Asia/ 

Europe 

Central

Asia 

South/

Southeast 

Asia 

Latin America/ 

Caribbean 

Findings 99

4

Summary and Conclusions 

ndernutrition remains high in most developing countries. Underweight rates for children are 25 percent or more in most of sub-Saharan Africa and over 40 percent in South/Southeast Asia and in 

Yemen in North Africa/West Asia/Europe. Underweight rates are less than 10 percent in most countries 

in Latin America and the Caribbean (except Guatemala and Haiti), in most of North Africa/West 

Asia/Europe, and in Kazakhstan in Central Asia. Overweight rates, although generally low in most countries, should be monitored in Latin America and the Caribbean and in Central Asia, where rates are 

higher. Monitoring the nutritional status of children worldwide should continue to identify populations 

and subpopulations where malnutrition is increasing. Undernutrition is age dependent and related to 

place of residence; the highest rates are found among children age 6-23 months and among children who 

live in rural areas. Underlying influences that measure social and economic pressures on families and 

communities are more closely associated with stunting and underweight than with wasting. 

U

Biological and behavioral influences related to maternal and child demographic characteristics and 

utilization of health services produce differentials in child undernutrition; however, all indicators of undernutrition in children are higher for children whose mothers are undernourished. Mother’s age at delivery is an important variable that operates differently in different regions. Higher rates of undernutrition 

are observed for children of younger mothers (under 20 years) and/or older mothers (35 years or more). 

Use of antenatal services is negatively related to undernutrition in children. 

Certain characteristics of children, such as size at birth, sex, birth order, and preceding birth interval, 

are related to stunting and underweight but less so to wasting. All indicators of undernutrition are higher 

for children who were perceived to be very small at birth. Males have slightly higher rates of undernutrition than females in all regions except South/Southeast Asia. However, even in South/Southeast Asia, 

wasting is higher among males than females. In general, the higher the birth order and the smaller the 

birth interval, the higher the rates of stunting and underweight. 

Infant feeding practices vary by region and country along with levels of undernutrition. While breastfeeding duration is longest in South/Southeast Asia and sub-Saharan Africa, these regions also have the 

highest rates of undernutrition. On the other hand, these rates would probably be even higher if the children were not able to benefit from the protective effects and additional nutrients provided by breastfeeding and the nonuse of bottles. 

Immediate influences, such as recent episodes of diarrhea, are better predictors of wasting than any of 

the other factors and are less likely to be associated with stunting and underweight. ARI was not clearly 

related to undernutrition. 

Therefore, this report concludes that improved health services, water sources, and sanitation facilities, 

as well as immunizations, are important for the prevention and treatment of childhood illness and the 

improvement of the nutritional status of children. Although developing regions of the world share similar 

problems related to poverty and illiteracy, there are significant regional differences in the prevalence of 

Summary and Conclusions 101
undernutrition and the factors that influence child nutritional status. Of course, to gain a better understanding of how these factors interact and operate to cause undernutrition, multivariate analyses of the 

individual country data sets and/or smaller groups of countries in selected regions should be carried out. 

This report provides comparative data that can be used for policymaking, program planning, and monitoring the nutritional status of children. 

102 Summary and Conclusions
References

Begin, F., E.A. Frongillo, Jr., and H. Delisle. 1999. Caregiver behaviors and resources influence child 

height-for-age in rural Chad. Journal of Nutrition 129(3): 680-686. 

Black, R. 1999. Reducing perinatal and neonatal mortality. Report of a meeting, Baltimore, Maryland, May 

10-12, 1999. Child Health Research Project Special Report, Vol. 3, No. 1. Baltimore, Maryland: Johns 

Hopkins University. Available at http://www.reproline.jhu.edu/english/2mnh/perinatal.pdf. 

Boerma, J.T., and G.T. Bicego. 1992. Preceding birth intervals and child survival: searching for pathways 

of influence. Studies in Family Planning 23(4): 243-256. 

Brown, K., K. Dewey, and L. Allen. 1998. Complementary feeding of young children in developing 

countries: a review of current scientific knowledge. Geneva: World Health Organization. 

Fikree, F.F., and H.W. Berendes. 1994. Risk factors for term intrauterine growth retardation: a community-based study in Karachi. Bulletin of the World Health Organization 72(4): 581-587. 

Haggerty, P.A., and S.O. Rutstein. 1999. Breastfeeding and complementary infant feeding, and the postpartum effects of breastfeeding. DHS Comparative Studies, No. 3. Calverton, Maryland: Macro International 

Inc. p. 39. 

Karim, E., and C.G. Mascie-Taylor. 1997. The association between birthweight, sociodemographic variables and maternal anthropometry in an urban sample from Dhaka, Bangladesh. Annals of Human Biology 

24(5): 387-401. 

Lamontagne, J.F., P.L. Engle, and M.F. Zeitlin. 1998. Maternal employment, child care, and nutritional 

status of 12-18-month-old children in Managua, Nicaragua. Social Science and Medicine 46(3): 403-414. 

Mahy, M. 2003. Child mortality in the developing world: a review of evidence from the Demographic and 

Health Surveys. DHS Comparative Reports, No. 4. Calverton, Maryland: Macro International Inc. p. 4. 

Mishra, V., K.R. Smith, and R.D. Retherford. 2005. Effects of cooking smoke and environmental tobacco smoke on acute respiratory infections in young Indian children. Population and Environment 26(5).

Mozumder, A.B., Barkat-E-Khuda, T.T. Kane, A. Levin, and S. Ahmed. 2000. The effect of birth interval on malnutrition in Bangladeshi infants and young children. Journal of Biological Science 32(3): 289-300. 

Mukuria, A., M. Kothari, and N. Abderrahim. 2006. Infant and young child feeding update. Calverton, 

Maryland, USA: ORC Macro. 

Mukuria, A., C. Aboulafia, and A. Themme. 2005. The context of women’s health: Results from the Demographic and Health Surveys 1994-2001. DHS Comparative Studies, No. 11. Calverton, Maryland: ORC 

Macro. 

References 103
Pan American Health Organization (PAHO). 2003. Guiding principles for complementary feeding of the 

breastfed child. Washington, D.C.: PAHO/World Health Organization, Division of Health Promotions 

and Protection, Food and Nutrition Program. 

Pelletier, D.L., E.A. Frongillo, and J.P. Habicht. 1993. Epidemiological evidence for a potentiating effect 

of malnutrition on child mortality. American Journal of Public Health 83: 1130-1133. 

Pelletier, D.L., E.A. Frongillo, Jr., D.G. Shroeder, and J.P. Habicht. 1994. A methodology for estimating the contribution of malnutrition to child mortality in developing countries. Journal of Nutrition 124(10 

Suppl.): 2106S-2122S. 

Rafalimanana, H., and C.F. Westoff. 2000. Potential effects on fertility and child health and survival of 

birth-spacing preferences in sub-Saharan Africa. Studies in Family Planning 31(2): 99-110. 

Ramakrishnan, U., R. Martorell, D. Schroeder, and R. Flores. 1999. Role of intergenerational effects on 

linear growth. Journal of Nutrition 129(2S Suppl.): 544S-549S. 

Rice, A.L., L. Sacco, A. Hyder, and R.E. Black. 2000. Malnutrition as an underlying cause of childhood 

deaths associated with infectious diseases in developing countries. Bulletin of the World Health Organization 78(10): 1207-1221. 

Rutstein, S.O. 2000. Factors associated with trends in infant and child mortality in developing countries 

during the 1990s. Bulletin of the World Health Organization 78(10): 1256-1270. 

Rutstein, S.O. 2002. Fertility levels, trends, and differentials 1995-1999. DHS Comparative Reports, No. 

3. Calverton, Maryland: Macro International Inc. 

Rutstein, S.O., and K. Johnson. 2004. The DHS Wealth Index. DHS Comparative Reports, No. 6. Calverton, Maryland: Macro International Inc. 

Scrimshaw, N.S., C.E. Taylor, and J.E. Gordon. 1968. Interaction of nutrition and infection. World Health 

Organization Monograph Series, No. 57. Geneva: World Health Organization. 

Sharmanov, T.S., N.M. Karsybekova, T.T. Bekbocynov, A.P. Sarsembaeva, and Z.K. Kudalbergeno. 

1997. Nutritional status of early age children in Kazakhstan [in Russian] Voprosy Pitaniia (4)23-25. 

Smith, L.C., M.T. Ruel, and A. Ndiaye. 2004. Why is child malnutrition lower in urban than rural areas? 

Evidence from 36 developing countries. Discussion Paper No. 176. Washington, DC: International Food 

Policy Research Institute. 

Stephensen, C.B. 1999. Burden of infection on growth failure, Symposium: Causes and Etiology of 

Stunting, April, 1998, San Francisco, California. Journal of Nutrition 129 (2S Suppl.) 534S-538S. 

Tomkins, A. and F. Watson. 1993. Malnutrition and infection: a review. United Nations Administrative 

Committee on Coordination/Subcommittee on Nutrition State-of-the-Art Series, Nutrition Policy Discussion Paper, No. 5. Geneva: ACC/SCN. 

104 References
Toyama, N., S. Wakai, Y. Nakamura, and A. Arifin. 2001. Mother’s working status and nutritional status 

of children under the age of 5 in urban low-income community, Surabaya, Indonesia. Journal of Tropical 

Pediatrics 47: 179-181. 

United Nations Children’s Fund (UNICEF). 1998. The state of the world’s children 1998. New York: Oxford University Press. 

World Health Organization (WHO). 2003. Global strategy for infant young child feeding. Geneva: WHO. 

World Health Organization (WHO). 2005. Guiding principles for feeding non-brestfed children 6-24 months 

of age. Geneva: WHO. 

World Health Organization (WHO). 2005. Proportional mortality among under fives worldwide, 2001. 

Available at http://www.who.int/child-adolescent-health/OVERVIEW/CHILD_HEALTH/map_01_ 

world.jpg. 

World Health Organization (WHO) and United Nations Children’s Fund (UNICEF). 2000. Global water supply and sanitation assessment 2000 report. Geneva: WHO and UNICEF. 

World Health Organization (WHO) and United Nations Children’s Fund (UNICEF). 2003. Antenatal 

care in developing countries: promises, achievements and missed opportunities: an analysis of trends, levels and differentials, 1990-2001. Geneva: WHO. 

References 105

Appendix A 107

Appendix A 

Table A.3.1 

Infant and under-five mortality rates, Demographic and Health 

Surveys, 1994-2001 

Country 

Infant 

mortality rate 

Under-five 

mortality rate 

Sub-Saharan Africa 

Benin 1996 94 167 

Burkina Faso 1998-99 105 219 

Cameroon 1998 77 151 

Central African Republic 1994-95 97 157 

Chad 1996-97 103 194 

Comoros 1996 77 104 

Côte d’Ivoire 1994 89 150 

Eritrea 1995 97 166 

Ethiopia 2000 66 136 

Gabon 2000 57 89 

Ghana 1998 57 108 

Guinea 1999 98 177 

Kenya 1998 74 112 

Madagascar 1997 96 159 

Malawi 2000 104 189 

Mali 1995-96 123 238 

Mozambique 1997 135 201 

Niger 1998 123 274 

Tanzania 1999 99 147 

Togo 1998 80 146 

Uganda 2000-01 88 146 

Zambia 1996 109 197 

Zimbabwe 1999 65 102 

North Africa/West Asia/Europe 

Egypt 2000 54 44 

Jordan 1997 29 34 

Turkey 1998 43 52 

Yemen 1997 75 105 

Central Asia 

Kazakhstan 1999 62 71 

Kyrgyz Republic 1997 61 72 

Uzbekistan 1996 49 59 

South/Southeast Asia 

Bangladesh 2000 66 94 

Cambodia 2000 95 124 

India 1998-99 68 95 

Nepal 1996 79 118 

Latin America/Caribbean 

Bolivia 1998 67 92 

Brazil 1996 39 49 

Colombia 2000 21 25 

Dominican Republic 1996 47 57 

Guatemala 1998-99 45 59 

Haiti 2000 80 119 

Peru 2000 33 47 
108 Appendix A

Table A.3.2 

Contribution of undernutrition to under-five mortality 

Percentage of deaths among children age 0–59 months due to moderate or severe undernutrition, 

Demographic and Health Surveys, 1994-2001 

Percentage of deaths due to moderate 

or severe undernutrition 

Country 

Percentage of 

deaths due to total 

undernutrition 

Moderate 

undernutrition 

Severe 

undernutrition 

Sub-Saharan Africa 

Benin 1996 46a38 8 

Burkina Faso 1998-99 37 28 9 

Cameroon 1998 30a25 5 

Central African Republic 1994-95 38a26 12 

Chad 1996-97 52 38 14 

Comoros 1996 42 29 13 

Côte d’Ivoire 1994 40a34 6 

Eritrea 1995 61a46 15 

Ethiopia 2000 57 43 14 

Gabon 2000 25 21 4 

Ghana 1998 39 33 6 

Guinea 1999 37 30 7 

Kenya 1998 32a27 5 

Madagascar 1997 54a42 12 

Malawi 2000 37 31 6 

Mali 1995-96 57a42 15 

Mozambique 1997 44a33 11 

Niger 1998 57 41 16 

Tanzania 1999 40 34 6 

Togo 1998 38a32 6 

Uganda 2000-01 34 29 5 

Zambia 1996 38 35 3 

Zimbabwe 1999 28 27 <1 

North Africa/West Asia/Europe 

Egypt 2000 9 8 1 

Jordan 1997 11 10 <1 

Turkey 1998 17 15 2 

Yemen 1997 56 43 13 

Central Asia 

Kazakhstan 1999 10 9 1 

Kyrgyz Republic 1997 18 17 1 

Uzbekistan 1996 32 23 9 

South/Southeast Asia 

Bangladesh 2000 55 47 8 

Cambodia 2000 56 43 13 

India 1998-99 72 51 21 

Nepal 1996 57 44 13 

Latin America/Caribbean 

Bolivia 1998 16 14 2 

Brazil 1996 11 10 1 

Colombia 2000 12 11 1 

Dominican Republic 1996 16 14 2 

Guatemala 1998-99 37 32 5 

Haiti 2000 30 26 4 

Peru 2000 15 14 1 

Note: calculations are based on a formula developed by Pelletier et al. to quantify the contribution of 

moderate and severe undernutrition to under-five mortality (Pelletier et al.,1994). 

a

Data where collected only on children age 0-35 months. 
Appendix A 109

Table A.3.3 

Undernutrition among young children 

Percentage of children age 0-35 months who are stunted, wasted or underweight, 

Demographic and Health Surveys, 1994-2001 

Country Stunted Wasted Underweight

Number of 

children 

Sub-Saharan Africa 

Benin 1996 25.0 14.3 29.2 2,273 

Burkina Faso 1998-99 30.9 17.7 36.3 2,530 

Cameroon 1998 29.3 5.9 22.2 1,923 

Central African Republic 1994-95 33.6 7.1 27.3 2,310 

Chad 1996-97 34.9 17.9 39.1 3,541 

Comoros 1996 33.8 8.3 25.8 921 

Côte d’Ivoire 1994 24.4 8.3 23.8 3,341 

Eritrea 1995 38.4 16.4 43.7 2,269 

Ethiopia 2000 44.9 12.9 45.3 5,905 

Gabon 2000 20.5 3.1 12.9 2,013 

Ghana 1998 20.0 12.9 24.9 1,638 

Guinea 1999 23.2 11.7 25.4 2,067 

Kenya 1998 30.9 6.9 21.5 2,821 

Madagascar 1997 48.3 7.4 40.0 3,080 

Malawi 2000 44.0 7.5 27.8 6,073 

Mali 1995-96 30.1 23.3 40.0 4,678 

Mozambique 1997 35.9 7.9 26.1 2,837 

Niger 1998 41.1 20.7 49.6 4,022 

Tanzania 1999 37.9 6.5 30.3 1,674 

Togo 1998 21.7 12.3 25.1 3,260 

Uganda 2000-01 35.5 5.3 24.7 3,584 

Zambia 1996 38.9 5.4 25.3 3,588 

Zimbabwe 1999 26.4 7.2 13.7 1,587 

North Africa/West Asia/Europe 

Egypt 2000 19.3 3.2 4.5 6,235 

Jordan 1997 7.2 2.1 4.9 3,266 

Turkey 1998 12.0 2.5 7.6 1,610 

Yemen 1997 45.7 15.0 43.7 4,966 

Central Asia 

Kazakhstan 1999 9.5 1.9 4.6 354 

Kyrgyz Republic 1997 24.8 3.4 11.0 1,015 

Uzbekistan 1996 31.3 11.6 18.8 989 

South/Southeast Asia 

Bangladesh 2000 40.2 11.4 45.7 3,306 

Cambodia 2000 37.3 16.3 40.1 1,842 

India 1998-99 44.9 15.7 46.7 24,143 

Nepal 1996 48.4 11.2 46.9 3,705 

Latin America/Caribbean 

Bolivia 1998 24.2 1.9 9.0 3,451 

Brazil 1996 10.3 2.9 5.5 2,306 

Colombia 2000 12.8 1.0 7.2 2,498 

Dominican Republic 1996 11.0 1.6 6.3 2,131 

Guatemala 1998-99 41.9 3.2 23.9 2,149 

Haiti 2000 18.9 5.7 16.3 3,389 

Peru 2000 21.7 1.1 7.7 6,070 
110 Appendix A

Table A.3.4 

Height-for-age Z-scores among young children 

Percent distribution of height-for-age Z-scores among children age 0–35 months based on the standard deviation (SD) 

categories of the International Reference Population, Demographic and Health Surveys, 1994-2001 

Height for age Z scores 

Country 

Below 

-3.00 SD 

-3.00 to

-2.01 SD

-2.00 to

-1.01 SD

-1.00 to 

-0.01 SD

0.00 to 

1.00 SD

1.01 to 

2.00 SD

Above 

2.00 SD Total Number

Sub-Saharan Africa 

Benin 1996 7.8 17.2 27.2 25.7 14.6 5.7 1.9 100.0 2,273 

Burkina Faso 1998-99 13.9 17.0 25.2 23.5 12.3 5.2 2.9 100.0 2,530 

Cameroon 1998 10.7 18.6 25.8 22.8 14.1 5.2 2.9 100.0 1,923 

Central African Republic 

1994-95 14.3 19.4 26.4 22.3 12.2 4.0 1.4 100.0 2,310 

Chad 1996-97 16.7 18.2 21.2 20.9 12.8 6.5 3.7 100.0 3,541 

Comoros 1996 13.4 20.4 24.5 26.1 11.6 2.6 1.4 100.0 921 

Côte d’Ivoire 1994 8.4 16.1 27.8 27.5 13.0 5.7 1.6 100.0 3,341 

Eritrea 1995 18.3 20.1 27.5 18.8 11.0 2.9 1.4 100.0 2,269 

Ethiopia 2000 22.0 22.9 27.5 16.1 7.7 2.5 1.4 100.0 5,905 

Gabon 2000 6.5 14.0 24.9 29.0 15.8 6.1 3.8 100.0 2,013 

Ghana 1998 5.9 14.1 28.5 25.9 16.7 7.1 1.8 100.0 1,638 

Guinea 1999 8.9 14.3 24.6 25.0 16.5 6.4 4.2 100.0 2,067 

Kenya 1998 11.4 19.5 26.1 21.9 12.7 4.5 3.7 100.0 2,821 

Madagascar 1997 21.6 26.7 24.8 17.5 6.9 1.6 0.9 100.0 3,080 

Malawi 2000 21.8 22.2 23.7 17.1 9.4 3.3 2.5 100.0 6,073 

Mali 1995-96 14.5 15.6 23.8 22.3 14.9 6.3 2.6 100.0 4,678 

Mozambique 1997 15.7 20.2 25.5 20.5 12.7 3.3 2.2 100.0 2,837 

Niger 1998 19.5 21.6 25.6 19.2 9.8 2.9 1.4 100.0 4,022 

Tanzania 1999 13.9 24.0 31.3 21.0 7.6 1.7 0.5 100.0 1,674 

Togo 1998 7.0 14.8 27.6 29.0 14.3 5.1 2.2 100.0 3,260 

Uganda 2000-01 13.6 22.0 29.4 22.7 8.8 2.3 1.3 100.0 3,584 

Zambia 1996 15.8 23.1 28.1 20.3 8.7 2.6 1.3 100.0 3,588 

Zimbabwe 1999 10.0 16.4 25.2 23.1 13.1 6.9 5.2 100.0 1,587 

North Africa/West Asia/Europe 

Egypt 2000 6.9 12.4 26.8 30.8 14.0 5.2 3.8 100.0 6,235 

Jordan 1997 1.8 5.5 22.7 36.7 24.1 7.1 2.2 100.0 3,266 

Turkey 1998 4.0 8.0 22.3 30.8 23.0 9.2 2.6 100.0 1,610 

Yemen 1997 23.2 22.5 23.7 17.0 8.8 2.8 2.0 100.0 4,966 

Central Asia 

Kazakhstan 1999 2.7 6.7 25.4 33.4 21.4 7.5 2.8 100.0 354 

Kyrgyz Republic 1997 6.0 18.8 31.5 24.7 14.2 3.6 1.2 100.0 1,015 

Uzbekistan 1996 14.0 17.3 22.1 21.7 10.4 7.2 7.4 100.0 989 

South/Southeast Asia 

Bangladesh 2000 15.1 25.1 30.5 19.3 7.6 1.7 0.7 100.0 3,306 

Cambodia 2000 15.2 22.1 25.1 19.8 10.6 4.4 2.8 100.0 1,842 

India 1998-99 22.6 22.4 25.1 17.5 8.2 2.7 1.6 100.0 24,143 

Nepal 1996 20.2 28.2 29.7 15.6 4.9 1.1 0.3 100.0 3,705 

Latin America/Caribbean 

Bolivia 1998 8.3 15.9 27.0 26.2 15.4 4.7 2.4 100.0 3,451 

Brazil 1996 2.5 7.8 19.7 32.3 24.3 8.9 4.6 100.0 2,306 

Colombia 2000 2.7 10.1 27.1 36.7 19.1 3.7 0.5 100.0 2,498 

Dominican Republic 1996 2.6 8.4 21.7 32.8 23.9 8.2 2.4 100.0 2,131 

Guatemala 1998-99 17.2 24.7 29.4 19.1 7.4 1.8 0.5 100.0 2,149 

Haiti 2000 6.5 12.3 25.8 31.6 16.1 5.4 2.1 100.0 3,389 

Peru 2000 6.3 15.4 29.1 28.9 14.7 3.9 1.7 100.0 6,070 
Appendix A 111

Table A.3.5 

Weight-for-height Z-scores among young children 

Percent distribution of weight-for-height Z-scores among children age 0-35 months based on the standard deviation (SD) 

categories of the international Reference Population, Demographic and Health Surveys, 1994-2001 

Weight-for-height Z scores 

Country 

Below 

-3.00 SD 

-3.00 to

 -2.01 SD

-2.00 to

 -1.01 SD

-1.00 to 

-0.01 SD

0.00 to 

1.00 SD

1.01 to 

2.00 SD

Above 

2.00 SD Total Number 

Sub-Saharan Africa 

Benin 1996 2.7 11.6 28.8 32.7 18.3 4.6 1.3 100.0 2,273 

Burkina Faso 1998-99 3.5 14.2 31.9 29.1 16.9 3.3 1.1 100.0 2,530 

Cameroon 1998 0.8 5.2 20.9 28.7 27.3 12.2 5.0 100.0 1,923 

Central African Republic 

1994-95 1.1 6.1 23.0 35.3 25.1 7.1 2.3 100.0 2,310 

Chad 1996-97 3.3 14.6 29.7 29.7 17.4 3.7 1.6 100.0 3,541 

Comoros 1996 2.0 6.3 22.7 28.7 27.7 8.9 3.8 100.0 921 

Côte d’Ivoire 1994 1.2 7.1 26.3 34.6 23.1 6.2 1.5 100.0 3,341 

Eritrea 1995 3.1 13.3 33.3 30.8 14.8 3.8 0.9 100.0 2,269 

Ethiopia 2000 1.8 11.1 30.5 34.0 16.7 4.0 1.9 100.0 5,905 

Gabon 2000 0.4 2.7 16.0 33.3 31.3 12.1 4.3 100.0 2,013 

Ghana 1998 1.8 11.1 29.6 32.5 18.4 4.4 2.1 100.0 1,638 

Guinea 1999 2.7 9.0 24.2 30.5 21.8 8.7 3.0 100.0 2,067 

Kenya 1998 1.5 5.5 21.0 31.5 25.4 10.1 5.1 100.0 2,821 

Madagascar 1997 0.9 6.5 26.4 35.7 21.8 6.7 2.0 100.0 3,080 

Malawi 2000 1.5 5.9 17.0 28.4 29.8 12.6 4.7 100.0 6,073 

Mali 1995-96 6.2 17.1 32.1 26.1 13.6 3.6 1.3 100.0 4,678 

Mozambique 1997 2.1 5.8 21.7 31.1 26.6 9.3 3.4 100.0 2,837 

Niger 1998 3.7 17.0 33.8 29.2 12.9 2.6 0.8 100.0 4,022 

Tanzania 1999 0.6 5.9 22.8 34.1 25.5 9.0 2.1 100.0 1,674 

Togo 1998 2.1 10.1 28.1 33.9 19.1 5.1 1.5 100.0 3,260 

Uganda 2000-01 0.7 4.6 19.5 33.7 29.1 9.0 3.4 100.0 3,584 

Zambia 1996 0.8 4.6 18.9 34.9 27.9 9.3 3.7 100.0 3,588 

Zimbabwe 1999 1.9 5.3 17.0 26.1 29.0 12.3 8.5 100.0 1,587 

North Africa/West 

Asia/Europe 

Egypt 2000 0.6 2.6 6.6 22.4 33.3 21.3 13.2 100.0 6,235 

Jordan 1997 0.1 1.9 13.4 35.7 34.6 10.6 3.6 100.0 3,266 

Turkey 1998 0.5 2.0 14.3 34.2 35.8 10.5 2.8 100.0 1,610 

Yemen 1997 3.2 11.8 28.3 31.9 17.6 4.8 2.3 100.0 4,966 

Central Asia 

Kazakhstan 1999 0.3 1.5 11.6 33.7 36.5 13.4 3.0 100.0 354 

Kyrgyz Republic 1997 0.7 2.8 11.4 23.8 38.6 16.4 6.3 100.0 1,015 

Uzbekistan 1996 2.8 8.8 13.7 24.7 23.1 12.5 14.4 100.0 989 

South/Southeast Asia 

Bangladesh 2000 1.2 10.2 37.1 33.7 14.5 2.8 0.5 100.0 3,306 

Cambodia 2000 3.7 12.7 32.4 28.9 15.2 4.6 2.6 100.0 1,842 

India 1998-99 2.8 12.9 32.8 30.6 14.8 3.9 2.2 100.0 24,143 

Nepal 1996 1.7 9.6 33.2 35.2 16.9 3.0 0.5 100.0 3,705 

Latin America/Caribbean 

Bolivia 1998 0.5 1.5 7.6 26.6 39.0 17.3 7.5 100.0 3,451 

Brazil 1996 0.6 2.2 10.5 31.0 35.4 14.8 5.4 100.0 2,306 

Colombia 2000 0.1 1.0 9.5 31.6 38.7 14.9 4.3 100.0 2,498 

Dominican Republic 1996 0.1 1.5 12.4 32.3 34.9 14.0 4.7 100.0 2,131 

Guatemala 1998-99 1.4 1.7 11.5 33.4 33.1 13.6 5.3 100.0 2,149 

Haiti 2000 0.6 5.1 20.4 33.5 29.6 8.5 2.3 100.0 3,389 

Peru 2000 0.3 0.9 6.1 23.7 40.6 20.3 8.1 100.0 6,070 
112 Appendix A

Table A.3.6 

Weight-for-age Z-scores among young children 

Percent distribution of weight-for-age Z-scores among children age 0-35 months based on the standard deviation (SD) 

categories of the International Reference Population, Demographic and Health Surveys, 1994-2001 

Weight-for-age Z scores 

Country 

Below 

-3.00 SD 

-3.00 to 

-2.01 SD

-2.00 to

-1.01 SD

-1.00 to

-0.01 SD

0.00 to 

1.00 SD

1.01 to 

2.00 SD

Above 

2.00 SD Total Number 

Sub-Saharan Africa 

Benin 1996 7.4 21.8 31.6 23.9 11.2 3.4 0.7 100.0 2,273 

Burkina Faso 1998-99 13.6 22.8 29.5 19.7 9.9 3.4 1.1 100.0 2,530 

Cameroon 1998 4.8 17.4 26.1 24.0 16.0 8.4 3.3 100.0 1,923 

Central African Republic 

1994-95 7.5 19.8 29.7 24.9 13.3 3.4 1.4 100.0 2,310 

Chad 1996-97 15.4 23.7 25.2 18.9 10.9 4.1 1.8 100.0 3,541 

Comoros 1996 7.9 17.9 29.9 24.5 13.5 4.6 1.7 100.0 921 

Côte d’Ivoire 1994 6.3 17.5 30.4 27.4 13.1 3.9 1.3 100.0 3,341 

Eritrea 1995 17.0 26.8 28.3 16.9 7.5 2.7 0.9 100.0 2,269 

Ethiopia 2000 16.5 28.8 28.5 16.5 6.5 2.1 1.2 100.0 5,905 

Gabon 2000 2.4 10.5 25.3 29.6 21.1 7.2 3.8 100.0 2,013 

Ghana 1998 5.7 19.2 32.9 23.4 13.2 4.4 1.3 100.0 1,638 

Guinea 1999 6.2 19.3 26.1 24.2 15.1 5.0 4.1 100.0 2,067 

Kenya 1998 5.4 16.1 30.1 25.5 14.0 6.1 2.8 100.0 2,821 

Madagascar 1997 12.8 27.2 29.4 18.6 8.5 2.4 1.1 100.0 3,080 

Malawi 2000 7.2 20.6 29.6 24.1 12.6 4.1 1.8 100.0 6,073 

Mali 1995-96 16.5 23.5 26.9 19.8 9.4 2.6 1.2 100.0 4,678 

Mozambique 1997 9.1 17.1 30.2 26.0 12.3 4.2 1.2 100.0 2,837 

Niger 1998 20.2 29.4 25.8 15.4 6.8 1.6 0.8 100.0 4,022 

Tanzania 1999 7.3 23.1 32.9 21.3 10.9 3.6 0.9 100.0 1,674 

Togo 1998 6.7 18.4 31.1 26.1 13.0 3.4 1.2 100.0 3,260 

Uganda 2000-01 5.8 18.9 30.8 26.1 13.2 4.1 1.1 100.0 3,584 

Zambia 1996 6.4 18.9 32.9 23.2 13.6 3.8 1.2 100.0 3,588 

Zimbabwe 1999 2.0 11.7 29.5 26.4 18.4 8.0 4.0 100.0 1,587 

North Africa/West Asia/Europe 

Egypt 2000 0.7 3.8 17.8 35.3 25.8 11.5 5.1 100.0 6,235 

Jordan 1997 0.6 4.3 21.8 36.3 26.4 8.1 2.4 100.0 3,266 

Turkey 1998 1.6 6.0 21.6 32.3 25.6 9.6 3.3 100.0 1,610 

Yemen 1997 15.5 28.2 30.6 17.3 6.0 1.7 0.7 100.0 4,966 

Central Asia 

Kazakhstan 1999 0.7 3.9 21.4 36.4 25.7 8.5 3.5 100.0 354 

Kyrgyz Republic 1997 1.7 9.4 26.5 30.6 20.0 8.2 3.6 100.0 1,015 

Uzbekistan 1996 5.0 13.8 26.1 24.7 15.5 8.1 6.8 100.0 989 

South/Southeast Asia 

Bangladesh 2000 13.4 32.3 30.1 16.7 6.2 1.2 0.2 100.0 3,306 

Cambodia 2000 11.8 28.3 29.6 20.3 6.5 2.3 1.1 100.0 1,842 

India 1998-99 17.7 29.0 28.7 16.1 6.1 1.5 0.8 100.0 2,4143 

Nepal 1996 16.1 30.8 31.4 15.9 4.9 0.7 0.2 100.0 3,705 

Latin America/Caribbean 

Bolivia 1998 1.6 7.4 22.4 31.6 23.9 9.0 4.1 100.0 3,451 

Brazil 1996 0.8 4.6 17.6 32.9 28.5 10.9 4.7 100.0 2,306 

Colombia 2000 1.1 6.1 21.3 34.1 26.3 8.2 2.8 100.0 2,498 

Dominican Republic 1996 1.2 5.1 20.6 30.3 27.8 10.4 4.5 100.0 2,131 

Guatemala 1998-99 6.0 17.9 29.2 26.6 15.1 3.5 1.7 100.0 2,149 

Haiti 2000 3.6 12.7 28.3 29.2 17.9 5.9 2.4 100.0 3,389 

Peru 2000 1.1 6.6 21.0 30.4 25.5 11.3 4.1 100.0 6,070 
Appendix A 113

Table A.3.7 

Undernutrition by child's age group 

Percentage of children age 0 to 35 months who are stunted, wasted, or underweight by age group in months, Demographic and Health Surveys. 

1994-2000 

Percent stunted Percent wasted Percent underweight Number of children 

Country 0-5 6-9 10-12 13-24 25+ 0-5 6-9 10-12 13-24 25+ 0-5 6-9 10-12 13-24 25+ 0-5 6-9 10-12 13-24 25+ 

Sub-Saharan Africa 

Benin 1996 8.5 12.5 16.9 31.6 39.0 6.2 17.1 26.0 17.8 10.1 6.5 23.0 39.8 37.3 35.6 448 297 213 756 559

Burkina Faso 1998-99 5.0 13.5 19.8 48.7 45.7 6.9 20.2 31.1 24.2 12.4 4.1 29.3 48.6 51.2 45.0 544 339 255 766 626

Cameroon 1998 5.5 14.9 31.2 43.6 34.2 1.9 9.7 9.6 7.5 4.0 1.9 15.4 33.0 31.3 25.0 365 242 156 652 508

Central African Republic 

1994-95 5.6 16.9 30.1 45.3 46.3 2.8 8.8 10.3 10.4 4.4 3.6 18.0 34.8 35.9 33.7 415 274 222 742 658

Chad 1996-97 5.7 15.8 28.0 48.6 54.9 6.9 20.2 27.8 24.8 13.8 4.3 26.1 49.2 53.8 53.3 738 491 309 1,107 896

Comoros 1996 5.5 20.2 33.7 49.8 38.5 4.3 7.9 7.4 12.7 5.6 5.5 20.2 29.5 34.3 29.9 163 114 95 315 234

Côte d’Ivoire 1994 6.0 12.0 17.0 32.1 35.2 3.5 9.3 12.3 12.5 4.9 4.6 18.9 33.1 30.3 28.4 615 418 269 1,087 953

Ethiopia 2000 10.8 25.1 39.7 58.4 55.7 3.9 13.5 17.3 18.3 9.7 6.2 32.1 52.6 55.8 55.7 882 698 525 2,031 1,770

Eritrea 1995 4.4 17.3 26.2 51.0 57.3 6.5 12.5 22.3 24.2 14.4 6.2 26.4 55.1 55.4 57.7 403 284 191 687 704

Gabon 2000 3.8 14.1 16.3 31.2 22.0 2.5 5.7 4.0 2.9 2.3 1.9 11.8 19.6 19.0 11.3 360 243 158 686 567

Ghana 1998 2.9 7.7 18.7 26.6 28.0 3.3 13.8 24.1 19.6 6.6 0.5 14.5 37.4 36.6 25.7 259 233 109 592 445

Guinea 1999 7.0 10.8 23.3 34.6 32.0 6.8 13.2 20.5 17.5 5.9 5.9 18.8 41.8 37.0 29.1 487 298 143 636 503

Kenya 1998 7.1 14.1 30.3 42.1 37.3 5.2 6.2 10.1 9.3 4.4 2.3 11.3 24.3 27.1 28.1 427 350 243 990 810

Madagascar 1997 14.0 31.1 47.3 65.2 59.9 2.7 5.7 8.9 12.0 4.7 4.8 29.5 49.3 54.6 47.8 573 393 292 1,065 757

Malawi 2000 11.4 26.4 34.6 59.5 55.8 5.8 8.9 11.5 9.5 4.3 5.9 23.9 33.7 35.5 31.3 1,005 739 591 1,976 1,762

Mali 1995-96 5.3 11.3 19.6 43.8 46.8 12.3 25.2 35.8 31.7 17.9 9.7 28.1 47.7 54.1 51.0 964 624 434 1,348 1,308

Mozambique 1997 13.6 24.8 26.0 45.6 51.4 2.8 7.6 12.1 13.2 3.6 4.7 21.2 32.3 35.8 31.7 578 403 230 947 678

Niger 1998 6.8 22.3 39.5 58.0 56.0 6.7 18.8 33.6 30.5 14.7 6.7 38.5 66.2 66.4 60.6 792 512 393 1,310 1,016

Tanzania 1999 9.4 21.0 28.9 52.9 48.1 3.4 6.3 4.8 9.6 5.4 3.3 18.6 35.6 39.8 39.8 301 206 133 569 465

Togo 1998 3.6 7.9 17.1 33.9 28.8 6.0 11.1 20.5 18.4 7.5 3.3 16.6 33.2 36.3 29.0 610 446 303 999 903

Uganda 2000-01 7.9 22.9 33.4 47.3 41.1 2.5 5.2 8.9 7.6 2.3 2.8 22.0 34.8 32.7 23.6 538 436 331 1,331 948

Zambia 1996 10.4 20.5 29.9 50.6 51.6 2.3 6.3 7.3 8.8 2.2 3.7 17.6 31.0 34.7 27.4 597 379 364 1,236 1,012

Zimbabwe 1999 6.0 14.3 19.8 39.1 29.1 7.2 4.2 11.6 9.3 4.4 1.9 7.8 17.3 18.0 16.6 272 158 132 563 463

North Africa/West Asia/Europe 

Egypt 2000 10.7 17.6 22.9 23.4 19.2 5.3 3.4 5.0 3.0 1.7 1.4 6.2 7.1 5.6 3.7 1,007 747 487 2,044 1,951

Jordan 1997 3.3 5.8 6.7 10.5 5.9 1.0 1.8 1.7 2.8 1.9 0.8 3.4 7.7 6.3 4.8 420 396 303 1,133 1,014

Turkey 1998 2.0 2.7 10.1 17.9 16.5 2.1 1.3 7.1 2.7 1.5 1.7 3.8 12.8 10.6 7.8 285 207 146 534 437

Yemen 1997 16.4 32.4 35.8 63.2 58.3 10.9 18.2 22.5 17.6 10.0 12.9 39.3 48.2 54.8 54.0 944 733 504 1,521 1,265

Central Asia 

Kazakhstan 1999 5.5 2.8 8.9 15.7 7.0 1.7 3.5 0.0 2.3 1.4 4.0 4.5 4.3 5.9 3.4 48 39 32 119 116

Kyrgyz Republic 1997 5.4 12.4 30.8 33.5 29.3 1.9 3.8 6.1 5.7 1.1 0.3 4.7 17.6 19.4 8.7 174 111 84 330 315

Uzbekistan 1996 8.4 26.9 29.1 41.8 31.3 17.1 14.9 8.0 11.8 9.3 6.0 13.4 24.4 25.0 17.2 123 115 107 335 310

South/Southeast Asia 

Bangladesh 2000 13.9 21.4 36.6 53.3 49.5 3.1 5.7 17.9 18.3 8.6 8.1 32.1 60.5 58.6 55.2 627 320 286 1,137 937

Cambodia 2000 14.1 24.4 28.6 45.9 49.9 8.7 8.5 24.8 21.4 16.6 6.7 21.2 47.9 51.4 54.2 331 232 150 572 556

India 1998-99 15.2 27.7 39.1 57.8 55.8 9.6 11.6 18.3 22.2 12.9 11.9 32.4 50.7 58.6 57.9 4,104 2,875 1,850 8,037 7,276

Nepal 1996 14.9 24.8 38.3 61.8 64.3 3.8 5.7 10.2 21.3 6.0 8.8 31.2 48.5 61.4 56.9 594 431 367 1,270 1,043

Latin America/Caribbean 

Bolivia 1998 6.2 12.0 21.5 33.9 28.6 2.5 2.8 2.3 1.9 1.1 1.6 6.5 10.8 12.6 9.3 524 440 311 1,155 1,023

Brazil 1996 3.4 11.0 9.9 14.9 8.9 3.0 3.8 5.5 2.3 2.1 0.4 7.1 6.1 6.3 6.5 380 256 243 752 675

Colombia 2000 4.1 7.9 8.2 20.3 12.7 0.8 0.5 0.0 1.9 0.8 1.1 2.9 3.2 11.1 9.2 400 319 220 817 742

Dominican Republic 1996 5.0 3.3 13.7 15.5 10.8 1.4 2.4 1.0 2.2 1.1 1.2 1.6 9.3 8.1 7.6 310 236 211 725 649

Guatemala 1998-99 15.3 23.6 31.4 54.0 50.2 1.5 4.6 2.1 5.1 1.5 3.3 17.7 23.1 34.3 24.3 314 248 168 754 665

Haiti 2000 4.4 7.5 20.7 25.4 23.2 1.5 6.0 6.3 9.3 3.2 4.1 7.7 17.8 21.6 19.6 499 451 284 1,141 1,015

Peru 2000 3.9 10.1 14.4 29.2 27.1 1.0 1.2 1.6 1.5 0.7 1.0 3.5 9.6 10.1 8.9 854 626 545 2,113 1,932
114 Appendix A

Table A.3.8 

Nutritional status of young children 

Mean Z-scores and standard deviations for height-for-age, weight-for-height, and weight-for-age among children age 

0–35 months, Demographic and Health Surveys, 1994-2001 

Height-for-age Z-score Weight-for-height Z-score Weight-for-age Z-score 

Country Mean 

Standard 

deviation Mean 

Standard 

deviation Mean 

Standard 

deviation 

Number 

of 

 children

Sub-Saharan Africa 

Benin 1996 -1.1 1.4 -0.8 1.2 -1.4 1.2 2,088 

Burkina 1998-99 -1.4 1.6 -1.1 1.2 -1.7 1.3 2,315 

Cameroon 1998 -1.3 1.6 -0.2 1.3 -1.0 1.4 1,759 

Central African Republic 

1994-95 -1.5 1.5 -0.5 1.1 -1.3 1.3 2,122 

Chad 1996-97 -1.4 1.8 -1.0 1.2 -1.6 1.5 3,227 

Comoros 1996 -1.5 1.5 -0.4 1.3 -1.3 1.3 844 

Côte d’Ivoire 1994 -1.2 1.4 -0.6 1.1 -1.2 1.3 3,069 

Eritrea 1995 -1.7 1.5 -1.0 1.1 -1.9 1.3 2,080 

Ethiopia 2000 -2.0 1.5 -0.9 1.1 -1.9 1.2 5,532 

Gabon 2000 -0.9 1.5 -0.1 1.1 -0.6 1.3 1,861 

Ghana 1998 -1.0 1.4 -0.8 1.2 -1.2 1.3 1,530 

Guinea 1999 -1.0 1.6 -0.7 1.3 -1.1 1.4 1,847 

Kenya 1998 -1.3 1.6 -0.3 1.3 -1.0 1.4 2,649 

Madagascar 1997 -2.0 1.4 -0.6 1.1 -1.7 1.2 2,839 

Malawi 2000 -1.8 1.7 -0.2 1.3 -1.3 1.3 5,665 

Mali 1995-96 -1.3 1.7 -1.2 1.3 -1.7 1.4 4,258 

Mozambique 1997 -1.5 1.6 -0.5 1.3 -1.3 1.3 2,577 

Niger 1998 -1.8 1.5 -1.2 1.1 -2.1 1.2 3,679 

Tanzania 1999 -1.8 1.3 -0.4 1.1 -1.4 1.2 1,536 

Togo 1998 -1.1 1.4 -0.8 1.1 -1.3 1.2 3,012 

Uganda 2000-01 -1.6 1.4 -0.3 1.1 -1.2 1.2 3,380 

Zambia 1996 -1.7 1.4 -0.3 1.2 -1.3 1.3 3,331 

Zimbabwe 1999 -1.1 1.7 0.0 1.4 -0.7 1.3 1,460 

North Africa/West Asia/Europe 

Egypt 2000 -0.9 1.5 0.6 1.3 -0.2 1.2 5,759 

Jordan 1997 -0.5 1.2 0.0 1.0 -0.4 1.1 3,095 

Turkey 1998 -0.6 1.3 -0.1 1.0 -0.4 1.2 1,488 

Yemen 1997 -1.9 1.6 -0.8 1.3 -1.9 1.2 4,571 

Central Asia 

Kazakhstan 1999 -0.6 1.2 0.0 1.0 -0.4 1.1 331 

Kyrgyz Republic 1997 -1.2 1.3 0.2 1.2 -0.6 1.2 938 

Uzbekistan 1996 -1.1 2.0 0.1 1.8 -0.7 1.7 937 

South/Southeast Asia 

Bangladesh 2000 -1.8 1.3 -1.0 1.0 -1.9 1.1 3,027 

Cambodia 2000 -1.6 1.6 -0.9 1.3 -1.7 1.2 1,695 

India 1998-99 -1.9 1.6 -0.9 1.2 -1.9 1.3 22,723 

Nepal 1996 -2.0 1.3 -0.9 1.0 -2.0 1.1 3,472 

Latin America/Caribbean 

Bolivia 1998 -1.1 1.5 0.3 1.1 -0.5 1.3 3,244 

Brazil 1996 -0.4 1.4 0.1 1.2 -0.2 1.2 2,146 

Colombia 2000 -0.8 1.1 0.2 1.0 -0.4 1.2 2,333 

Dominican Republic 1996 -0.5 1.3 0.1 1.1 -0.3 1.3 1,992 

Guatemala 1998-99 -1.8 1.4 0.0 1.2 -1.1 1.3 2,033 

Haiti 2000 -0.9 1.4 -0.3 1.1 -0.9 1.3 3,189 

Peru 2000 -1.1 1.3 0.5 1.1 -0.3 1.3 5,716 
Appendix A 115

Table A.3.9 

Overweight children 

Percentage of overweight (weight-for-height) children age 0–35 

months, Demographic and Health Surveys, 1994-2001 

Country 

Overweight 

(above 2 SD) 

Number of 

children 

Sub-Sahara Africa 

Benin 1996 1.3 2,273 

Burkina 1998-99 1.1 2,530 

Cameroon 1998 5.1 1,923 

Central African Republic 

1994-95 2.4 2,310 

Chad 1996-97 1.6 3,541 

Comoros 1996 3.9 921 

Côte d’Ivoire 1994 1.5 3,341 

Eritrea 1995 0.9 2,269 

Ethiopia 2000 1.9 5,905 

Gabon 2000 4.3 2,013 

Ghana 1998 2.1 1,638 

Guinea 1999 3.1 2,067 

Kenya 1998 5.3 2,821 

Madagascar 1997 2.0 3,080 

Malawi 2000 4.8 6,073 

Mali 1995-96 1.3 4,678 

Mozambique 1997 3.6 2,837 

Niger 1998 0.8 4,022 

Tanzania 1999 2.1 1,674 

Togo 1998 1.5 3,260 

Uganda 2000-01 3.5 3,584 

Zambia 1996 3.7 3,588 

Zimbabwe 1999 8.5 1,587 

North Africa/West Asia/Europe 

Egypt 2000 13.4 6,235 

Jordan 1997 3.6 3,266 

Turkey 1998 2.9 1,610 

Yemen 1997 2.4 4,966 

Central Asia 

Kazakhstan 1999 3.0 354 

Kyrgyz Republic 1997 6.3 1,015 

Uzbekistan 1996 14.4 989 

South/Southeast Asia 

Bangladesh 2000 0.5 3,306 

Cambodia 2000 2.6 1,842 

India 1998-99 2.2 24,143 

Nepal 1996 0.5 3,705 

Latin America/Caribbean 

Bolivia 1998 7.7 3,451 

Brazil 1996 5.5 2,306 

Colombia 2000 4.3 2,498 

Dominican Republic 1996 4.7 2,131 

Guatemala 1998-99 5.4 2,149 

Haiti 2000 2.3 3,389 

Peru 2000 8.3 6,070 
116 Appendix A

Table A.3.10 

Undernutrition by urban-rural residence 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by urban-rural residence, Demographic and Health

Surveys, 1994-2001 

Percent stunted Percent wasted Percent underweight Number of children 

Country Urban Rural Urban Rural Urban Rural Urban Rural 

Sub-Saharan Africa 

Benin 1996 21.4 26.6 12.1 15.3 24.4 31.3 709 1,564 

Burkina 1998-99 20.4 32.4 13.0 18.4 24.6 38.0 306 2,224 

Cameroon 1998 22.3 31.8 4.9 6.3 14.3 25.0 508 1,415 

Central African Republic 

1994-95 28.6 37.2 5.8 8.1 22.2 30.8 949 1,361 

Chad 1996-97 27.6 36.8 15.8 18.5 32.9 40.8 747 2,794 

Comoros 1996 29.9 35.0 10.3 7.6 25.0 26.1 224 697 

Côte d’Ivoire 1994 15.3 29.2 7.9 8.4 16.2 27.7 1,134 2,206 

Ethiopia 2000 32.8 46.2 8.0 13.5 31.8 46.8 585 5,320 

Eritrea 1995 28.7 40.9 12.8 17.4 31.0 47.1 473 1,796 

Gabon 2000 18.1 26.4 3.1 3.1 10.9 18.1 1,431 582 

Ghana 1998 11.4 22.9 8.9 14.3 16.9 27.6 418 1,220 

Guinea 1999 17.3 25.7 11.3 11.9 21.7 27.0 613 1,454 

Kenya 1998 22.7 32.7 5.0 7.4 11.5 23.6 500 2,321 

Madagascar 1997 44.6 49.2 5.3 7.9 35.6 41.0 600 2,481 

Malawi 2000 29.2 46.3 6.2 7.7 12.0 30.2 800 5,274 

Mali 1995-96 21.8 33.1 23.3 23.3 31.7 43.0 1,235 3,443 

Mozambique 1997 27.3 38.9 10.4 7.1 20.0 28.2 713 2,124 

Niger 1998 31.2 43.0 13.3 22.1 35.3 52.4 656 3,366 

Tanzania 1999 19.7 42.0 6.0 6.6 18.7 32.9 308 1,366 

Togo 1998 14.8 23.9 9.1 13.3 16.1 27.9 770 2,490 

Uganda 2000-01 26.9 36.5 3.7 5.4 13.7 25.9 354 3,230 

Zambia 1996 30.1 44.5 4.4 6.1 17.9 29.9 1,382 2,206 

Zimbabwe 1999 22.1 28.5 3.8 8.8 7.8 16.5 505 1,082 

North Africa/West Africa/Europe 

Egypt 2000 14.6 22.4 2.9 3.4 3.2 5.4 2,454 3,782 

Jordan 1997 5.9 12.9 2.0 2.4 4.3 7.8 2,659 607 

Turkey 1998 9.2 16.8 2.2 2.9 5.8 10.6 1,010 600 

Yemen 1997 34.3 49.6 11.5 16.2 32.7 47.4 1,260 3,706 

Central Asia 

Kazakhstan 1999 6.8 11.1 1.9 1.8 6.0 3.7 136 219 

Kyrgyz Republic 1997 14.8 27.7 4.3 3.2 5.9 12.5 228 787 

Uzbekistan 1996 32.6 30.7 10.2 12.2 16.6 19.7 285 704 

South/Southeast Asia 

Bangladesh 2000 33.2 41.6 10.7 11.5 38.6 47.0 540 2,767 

Cambodia 2000 35.1 37.6 12.3 17.0 32.3 41.4 260 1,582 

India 1998-99 35.2 48.0 13.3 16.5 38.2 49.3 5,689 18,454 

Nepal 1996 35.4 49.3 5.8 11.6 29.8 48.1 237 3,468 

Latin America/Caribbean 

Bolivia 1998 17.4 33.6 1.5 2.4 5.9 13.3 2,004 1,448 

Brazil 1996 7.4 19.2 2.8 3.0 4.1 9.7 1,750 556 

Colombia 2000 10.2 18.5 0.9 1.3 6.3 9.1 1,703 795 

Dominican Republic 1996 7.5 15.6 1.7 1.5 4.1 9.3 1,204 927 

Guatemala 1998-99 31.2 48.2 2.2 3.7 14.5 29.4 797 1,352 

Haiti 2000 11.2 22.5 6.8 5.2 13.1 17.7 1,074 2,315 

Peru 2000 11.1 34.5 0.9 1.4 3.4 12.8 3,319 2,751 
Appendix A 117

Table A.3.11 

Undernutrition by mother's education 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by mother's education, Demographic and Health Surveys, 1994-2001 

Percent stunted Percent wasted Percent underweight Number of children 

Country 

No 

education1

Primary 

Secondary 

No 

education1

Primary 

Secondary 

No 

education1

Primary 

Secondary 

No 

education1

Primary 

Secondary 

Sub-Saharan Africa 

Benin 1996 26.1 23.6 13.3 14.5 13.2 15.3 30.6 25.5 20.3 1,762 391 120 

Burkina Faso 1998-99 31.4 33.9 12.4 18.2 15.7 8.6 37.3 34.6 14.0 2,269 178 83 

Cameroon 1998 38.2 27.0 21.6 8.0 5.8 3.5 35.1 18.2 12.0 644 773 507 

Central Afr. Rep. 

1994-95 37.2 32.4 24.1 7.7 7.0 5.2 30.9 25.4 19.1 1,138 867 305 

Chad 1996-97 37.1 28.5 19.7 19.3 13.4 12.2 42.2 29.6 23.4 2,727 702 112 

Comoros 1996 38.2 27.4 25.0 8.4 8.7 7.1 28.4 25.0 16.4 573 208 140 

Côte d’Ivoire 1994 26.7 22.3 13.0 9.2 6.9 4.9 25.9 22.6 11.6 2,228 825 288 

Eritrea 1995 41.8 29.2 22.9 17.3 14.6 11.7 47.2 36.3 24.3 1,735 364 170 

Ethiopia 2000 46.5 43.2 25.7 13.6 10.2 9.0 47.8 38.3 26.3 4,790 774 341 

Gabon 2000 21.8 24.9 16.4 4.5 3.3 2.7 17.4 16.5 9.2 139 875 999 

Ghana 1998 23.7 22.3 15.8 15.7 11.9 11.2 30.2 24.8 20.5 584 344 709 

Guinea 1999 24.8 17.3 13.0 12.1 12.3 7.3 26.8 20.7 16.4 1,720 192 155 

Kenya 1998 42.9 34.0 18.3 9.7 7.7 3.9 34.4 23.7 10.7 303 1,786 732 

Madagascar 1997 48.5 51.3 40.5 7.5 8.1 5.3 42.3 43.0 29.9 632 1,764 684 

Malawi 2001 49.5 43.5 26.3 9.2 6.7 7.0 31.6 27.9 11.2 1,859 3,761 454 

Mali 1995-96 31.7 24.3 14.7 24.0 19.3 20.5 41.9 32.0 24.5 3,944 516 218 

Mozambique 1997 40.8 34.8 9.1 7.5 7.7 14.6 30.4 24.1 17.3 1,040 1,678 119 

Niger 1998 42.3 35.5 23.6 21.2 20.0 8.9 50.7 46.6 28.7 3,536 354 132 

Tanzania 1999 41.3 37.9 15.7 8.8 5.7 4.4 34.9 29.5 11.9 463 1,143 67 

Togo 1998 25.5 17.6 12.0 14.2 9.6 9.5 30.1 19.1 14.2 1,915 1,047 299 

Uganda 2000-01 39.6 35.4 27.4 7.3 4.8 3.6 30.7 23.8 17.3 854 2,321 410 

Zambia 1996 47.4 40.5 28.9 8.1 5.5 3.6 33.9 26.8 15.6 503 2,292 793 

Zimbabwe 1999 32.7 30.9 21.7 11.7 8.2 5.8 26.4 17.3 9.0 110 682 796 

North Africa/West 

Africa/Europe 

Egypt 2000 23.2 21.2 15.6 3.2 2.9 3.2 6.1 4.4 3.3 2,355 925 2,955 

Jordan 1997 22.7 11.3 5.6 4.1 1.8 1.9 13.2 7.8 4.0 178 375 2,713 

Turkey 1998 27.4 9.8 3.8 4.3 2.1 1.6 18.7 5.5 2.7 325 943 342 

South/Southeast Asia 

Bangladesh 2000 48.1 41.1 25.3 13.3 11.1 8.4 53.7 46.6 30.4 1,508 947 851 

Cambodia 2000 42 37 27.4 18.9 16.3 10.5 47 38.3 31.1 597 983 261 

India 1998-99 54.5 44.3 30.2 17.6 15.9 12.7 55.1 48.6 32.6 12,300 3,995 7,847 

Nepal 1996 52.4 40.1 24.7 12.2 8.4 6.9 51.1 36.2 25.0 2,924 441 340 

Latin America/Caribbean 

Bolivia 1998 41.4 30.3 13.1 2.7 2.2 1.4 18.9 10.8 4.5 353 1,653 1,445 

Brazil 1996 20.8 14.8 5.9 4.6 3.1 2.5 9.0 8.3 3.0 145 899 1,263 

Colombia 2000 26.0 17.8 8.6 3.2 0.8 1.1 14.2 9.4 5.3 80 1,002 1,417 

Dominican Rep 1996 22.3 13.2 5.1 1.5 1.7 1.6 15.3 7.1 3.0 192 1,159 780 

Guatemala 1999 58.9 40.4 11.3 3.6 3.3 1.6 35.0 22.4 5.5 696 1,122 331 

Haiti 2000 24.6 18.3 7.1 5.8 4.9 7.6 18.8 15.1 13.7 1,239 1,621 528 

Peru 2000 48.5 31.8 10.8 2.9 1.5 0.6 20.0 11.6 3.2 431 2,372 3,267 

1

 Includes missing cases 
118 Appendix A

Table A.3.12 

Undernutrition by mother's work status 

Percentage of children age 0 to 35 months who are stunted, wasted, or underweight by mother's work status, 

Demographic and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country 

Mother 

working 

Not 

working1

Mother 

working 

Not 

working1

Mother 

working 

Not 

working1

Mother 

working 

Not 

working1

Sub-Saharan Africa 

Benin 1996 25.7 18.8 14.4 13.8 29.6 25.2 2,045 228 

Burkina Faso 1998-99 31.2 30.5 18.8 15.3 38.3 32.1 1,718 811 

Cameroon 1998 30.7 24.9 6.1 5.4 23.4 18.6 1,451 472 

Central African Republic 

1994-95 35.2 27.2 7.4 5.9 29.0 20.3 1,852 457 

Chad 1996-97 33.7 35.8 17.3 18.3 38.8 39.4 1,513 2,028 

Comoros 1996 32.9 34.4 7.7 8.6 25.2 26.3 389 532 

Côte d’Ivoire 1994 25.8 20.3 8.2 8.4 24.4 22.1 2,497 844 

Eritrea 1995 38.6 38.3 15.4 16.8 41.5 44.5 579 1,690 

Ethiopia 2000 46.0 43.5 13.8 11.9 46.1 44.2 3,294 2,610 

Gabon 2000 20.7 20.4 3.0 3.2 11.7 13.7 717 1,296 

Ghana 1998 20.2 19.2 13.0 12.7 25.0 24.1 1,332 306 

Guinea 1999 24.1 19.4 11.8 11.5 25.7 24.2 1,680 387 

Kenya 1998 30.3 31.6 7.2 6.6 21.5 21.4 1,533 1,288 

Madagascar 1997 50.0 41.8 7.6 6.6 41.0 35.7 2,464 616 

Malawi 2000 44.7 43.1 7.2 7.9 29.5 25.5 3,513 2,561 

Mali 1995-96 30.0 30.3 22.6 24.2 39.7 40.4 2,489 2,189 

Mozambique 1997 38.9 31.7 6.6 9.7 29.1 21.8 1,666 1,171 

Niger 1998 42.7 39.3 22.1 19.1 52.1 46.8 2,100 1,922 

Tanzania 1999 40.6 29.1 5.5 10.0 31.6 25.9 1,283 391 

Togo 1998 21.6 22.5 12.0 13.6 25.1 25.4 2,730 530 

Uganda 2000-01 36.4 32.3 5.2 5.5 26.3 19.1 2,789 796 

Zambia 1996 40.9 37.1 4.8 6.0 27.2 23.6 1,726 1,863 

Zimbabwe 1999 24.6 28.1 8.1 6.3 13.1 14.3 763 825 

North Africa/West Asia/Europe 

Egypt 2000 18.9 19.4 3.5 3.1 3.8 4.6 817 5,419 

Jordan 1997 6.2 7.3 1.9 2.1 5.9 4.8 346 2,920 

Turkey 1998 11.2 12.3 1.6 2.8 6.8 7.8 397 1,213 

Yemen 1997 48.7 44.7 13.4 15.5 46.0 42.9 1,239 3,728 

Central Asia 

Kazakhstan 1999 4.7 10.4 2.1 1.8 2.4 5.0 58 296 

Kyrgyz Republic 1997 26.5 24.4 3.2 3.5 11.8 10.8 224 791 

Uzbekistan 1996 36.6 29.2 9.0 12.6 20.4 18.2 272 717 

South/Southeast Asia 

Bangladesh 2000 42.0 39.9 11.2 11.4 48.6 45.1 508 2,798 

Cambodia 2000 38.6 34.3 18.1 12.3 44.2 31.0 1,272 570 

India 1998-99 51.8 42.1 19.2 14.3 55.6 43.0 7,123 17,020 

Nepal 1996 51.5 39.0 12.0 8.8 50.1 37.3 2,786 919 

Latin America/Caribbean 

Bolivia 1998 25.1 23.5 2.1 1.7 8.5 9.4 1,614 1,838 

Brazil 1996 8.6 11.2 2.7 2.9 4.1 6.2 819 1,487 

Colombia 2000 12.8 12.8 1.3 0.9 7.1 7.3 922 1,576 

Dominican Republic 1996 6.1 13.1 0.8 2.0 3.5 7.5 626 1,505 

Guatemala 1998-99 38.5 42.9 2.4 3.4 21.1 24.7 488 1,661 

Haiti 2000 18.7 19.1 5.8 5.6 15.5 17.0 1,655 1,734 

Peru 2000 25.0 18.3 1.0 1.3 8.6 6.7 3,077 2,993 1

 Includes missing cases 
Appendix A 119

Table A.3.13 

Undernutrition by flooring status 

Percentage of children age 0 to 35 months who are stunted, wasted, or underweight by flooring in residence, Demographic and 

Health Surveys, 1994-2001 

Percent stunted Percent wasted Percent underweight Number of children 

Country 

Finished 

flooring 

Unfinished 

flooring1

Finished 

flooring 

Unfinished 

flooring1

Finished 

flooring 

Unfinished

flooring1

Finished 

flooring 

Unfinished

flooring1

Sub-Saharan Africa 

Benin 1996 22.6 27.2 11.8 16.6 23.9 34.0 1,090 1,184 

Burkina Faso 1998-99 25.5 32.8 14.2 18.9 28.2 39.1 636 1,894 

Cameroon 1998 22.3 33.5 4.0 7.1 14.6 26.8 727 1,196 

Central African Rep. 1994-95 27.0 35.1 4.9 7.6 20.4 28.8 406 1,904 

Chad 1996-97 26.0 35.3 11.4 18.2 30.3 39.5 158 3,384 

Comoros 1996 25.8 40.1 6.4 9.7 19.7 30.7 407 514 

Côte d’Ivoire 1994 21.7 32.1 7.6 10.1 21.5 30.2 2,460 881 

Eritrea 1995 25.0 40.5 9.4 17.5 25.2 46.7 315 1,955 

Ethiopia 2000 26.9 45.6 9.3 13.1 24.1 46.1 222 5,683 

Gabon 2000 16.9 28.2 3.1 3.1 10.8 17.6 1,371 642 

Ghana 1998 18.5 27.1 12.2 16.4 23.1 33.2 1,354 284 

Guinea 1999 20.2 25.8 11.5 11.9 22.1 28.3 950 1,117 

Kenya 1998 20.7 35.0 5.1 7.7 11.8 25.3 801 2,020 

Madagascar 1997 41.4 49.4 5.6 7.6 33.2 41.0 397 2,683 

Malawi 2000 29.4 46.9 6.4 7.7 12.7 30.7 998 5,075 

Mali 1995-96 19.6 32.9 21.6 23.8 27.8 43.2 964 3,715 

Mozambique 1997 20.7 40.8 8.6 7.7 15.9 29.3 682 2,155 

Niger 1998 30.0 42.8 12.7 21.9 33.8 52.1 555 3,467 

Tanzania 1999 18.9 41.1 6.8 6.5 21.0 31.8 238 1,436 

Togo 1998 19.8 26.2 12.0 13.0 23.6 28.5 2,257 1,003 

Uganda 2000-01 26.6 37.0 2.6 5.7 12.8 26.7 521 3,064 

Zambia 1996 29.1 45.8 4.4 6.1 17.1 31.0 1,471 2,117 

Zimbabwe 1999 22.7 32.3 6.6 8.1 10.8 18.4 972 615 

North Africa/West Asia/Europe 

Egypt 2000 17.1 25.3 3.1 3.5 3.6 7.1 4,565 1,670 

Jordan 1997 7.1 * 2.0 * 4.8 * 3,251 15 

Turkey 1998 11.9 12.6 2.8 1.4 7.1 9.0 1,202 408 

Yemen 1997 41.3 50.4 12.2 17.9 38.2 49.4 2,541 2,425 

Central Asia 

Kazakhstan 1999 3.3 10.7 3.5 1.5 5.9 4.3 59 295 

Kyrgyz Republic 1997 10.2 26.0 0.8 3.6 3.2 11.6 74 941 

Uzbekistan 1996 23.6 31.7 9.2 11.8 11.1 19.2 55 934 

South/Southeast Asia 

Bangladesh 2000 22.7 42.9 7.2 12.1 26.3 48.5 436 2,871 

Cambodia 2000 14.0 38.5 17.8 16.2 20.2 41.2 94 1,748 

Nepal 1996 23.6 49.5 4.4 11.6 23.8 48.0 165 3,540 

Latin America/Caribbean 

Bolivia 1998 16.4 31.9 1.5 2.3 5.4 12.5 1,712 1,740 

Brazil 1996 8.1 22.1 2.7 3.9 4.2 12.1 1,942 364 

Colombia 2000 10.7 22.5 0.9 1.4 6.0 12.7 2,042 456 

Dominican Rep. 1996 9.2 24.0 1.3 3.6 4.8 17.2 1,868 263 

Guatemala 1998-99 28.4 55.5 2.8 3.5 15.5 32.3 1,081 1,069 

Haiti 2001 13.5 23.6 6.1 5.3 12.0 20.0 1,583 1,806 

Peru 2000 8.4 30.1 0.5 1.5 2.3 11.1 2,359 3,712 

Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1

 Rudimentary and natural flooring 
120 Appendix A

Table A.3.14 

Undernutrition by type of sanitation facility 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by type of household sanitation facilities, 

Demographic and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country Improved1

Unimproved2Improved1Unimproved2Improved1Unimproved2Improved1Unimproved2

Sub-Saharan Africa 18.5 26.2 11.3 14.9 20.6 30.6 345 1,904 

Benin 1996 25.6 32.9 13.7 18.9 29.5 38.5 508 1,930 

Burkina Faso 1998-99 27.9 38.0 5.2 8.4 20.3 37.8 1,607 198 

Cameroon 1998 31.0 41.9 6.8 7.9 24.8 34.8 1,733 570 

Central African 

Republic 1994-95 29.5 36.9 15.9 18.7 32.9 41.6 1,001 2,528 

Chad 1996-97 34.0 * 8.4 * 26.0 * 909 4 

Comoros 1996 19.7 29.7 6.8 10.0 19.9 28.1 1,767 1,559 

Côte d’Ivoire 1994 25.3 40.3 11.9 17.1 26.3 46.3 291 1,973 

Ethiopia 2000 34.5 46.8 8.5 13.8 36.3 47.0 812 4,892 

Eritrea 1995 20.2 22.6 3.3 1.4 13.3 10.2 1,808 194 

Gabon 2000 19.3 21.3 13.3 12.2 23.4 28.1 1,135 501 

Ghana 1998 16.0 25.0 11.0 11.8 20.2 26.7 418 1,607 

Guinea 1999 28.3 42.9 6.7 8.1 18.2 35.7 2,276 522 

Kenya 1998 52.0 46.3 6.0 8.1 38.8 40.6 1,088 1,990 

Madagascar 1997 42.5 50.8 7.0 9.6 25.8 36.1 4,804 1,094 

Malawi 2000 28.8 33.7 22.6 24.7 37.7 46.5 3,399 1,249 

Mali 1995-96 32.0 39.7 8.0 7.9 21.1 30.6 1,332 1,469 

Mozambique 1997 31.6 43.1 13.7 22.3 36.3 52.6 735 3,272 

Niger 1998 37.5 40.2 6.7 5.5 30.9 27.9 1,303 270 

Tanzania 1999 14.4 24.2 10.2 12.8 17.4 27.9 797 2,375 

Togo 1998 34.9 38.6 4.8 5.9 23.6 28.3 2,812 584 

Uganda 2000-01 36.8 44.0 5.3 5.7 23.6 29.3 2,587 970 

Zambia 1996 24.7 31.4 6.1 10.2 11.6 19.1 1,042 472 

Zimbabwe 1999 18.5 26.2 11.3 14.9 20.6 30.6 345 1,904 

North Africa/West Asia/Europe 

Egypt 2000 19.0 30.1 3.2 3.3 4.4 11.1 5,819 167 

Jordan 1997 7.1 * 2.0 * 4.9 * 3,251 14 

Turkey 1998 10.3 21.4 2.2 3.9 6.1 15.1 1,321 271 

Yemen 1997 42.6 50.1 12.4 18.5 40.0 48.8 2,879 2,083 

Central Asia 

Kazakhstan 1999 10.1 * 1.7 * 4.5 * 331 23 

Kyrgyz Republic 1997 24.9 * 3.5 * 11.1 * 1,011 2 

Uzbekistan 1996 31.3 * 11.6 * 18.8 * 988 1 

South/Southeast Asia 

Bangladesh 2000 35.2 46.6 11.1 11.7 40.7 51.8 1,831 1,466 

Cambodia 2000 27.1 39.1 11.7 17.0 25.7 42.5 267 1,561 

India 1998-99 31.5 50.6 11.6 17.4 32.5 52.6 7,192 17,195 

Nepal 1996 34.4 50.6 8.3 11.7 36.0 48.7 507 3,191 

Latin America/Caribbean 

Bolivia 1998 16.9 30.6 1.9 1.9 6.5 11.2 1,587 1,854 

Brazil 1996 7.7 22.1 2.6 3.8 4.3 11.1 1,883 411 

Colombia 2000 11.3 23.9 0.9 2.0 6.3 13.6 2,190 307 

Dominican Rep 1996 7.5 18.6 1.7 1.5 4.5 10.2 1,437 679 

Guatemala 1998-99 39.5 53.7 2.7 5.4 21.5 35.4 1,768 374 

Haiti 2001 15.4 23.2 5.6 5.8 14.5 18.6 1,826 1,525 

Peru 2000 15.5 34.9 0.8 1.9 5.3 12.8 3,988 1,917 

Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 

1

Flush toilet, pit latrine, VIP latrine 

2

No facility, open pit, service or bucket latrine, public latrine 
Appendix A 121

Table A.3.15 

Undernutrition by source of drinking water 

Percentage of children age 0-35 months who are stunted, wasted, or underweight, by source of drinking water, Demographic and 

Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country Improved1

Unimproved2Improved1Unimproved2Improved1Unimproved2Improved1Unimproved2

Sub-Saharan Africa 

Benin 1996 22.0 29.4 13.8 15.3 26.9 32.4 1,363 900 

Burkina Faso 1998-99 30.2 32.3 17.8 17.8 34.0 38.9 1,177 1,271 

Cameroon 1998 26.9 30.3 5.4 5.7 19.4 24.1 754 1,050 

Central African Republic 

1994-95 27.4 37.1 6.2 7.7 22.1 30.5 837 1,454 

Chad 1996-97 34.7 35.0 19.3 17.4 38.6 39.4 1,007 2,522 

Comoros 1996 32.9 (36.7) 8.3 (4.1) 25.1 (28.6) 853 49 

Côte d’Ivoire 1994 19.3 27.9 8.2 8.3 20.0 26.3 1,363 1,965 

Eritrea 1995 31.6 40.0 12.8 17.3 34.4 45.9 433 1,832 

Ethiopia 2000 39.1 46.7 11.5 13.5 39.8 47.0 1,189 4,513 

Gabon 2000 17.9 26.7 3.1 3.0 11.6 16.0 1,432 574 

Ghana 1998 17.9 22.4 10.9 15.2 21.7 28.5 882 753 

Guinea 1999 20.5 23.9 11.0 12.1 25.3 25.5 487 1,559 

Kenya 1998 24.3 33.9 5.8 7.3 15.1 24.3 782 1,986 

Madagascar 1997 41.5 49.5 5.7 7.7 34.0 41.0 453 2,626 

Malawi 2000 40.7 49.9 7.1 8.1 24.4 33.4 3,745 2,158 

Mali 1995-96 28.2 30.9 23.0 23.4 36.8 41.4 1,402 3,255 

Mozambique 1997 27.1 39.3 9.0 7.6 17.2 29.5 763 2,046 

Niger 1998 38.0 42.9 18.6 21.9 45.4 52.1 1,353 2,620 

Tanzania 1999 33.3 45.5 6.7 6.2 28.9 32.7 973 600 

Togo 1998 20.1 23.4 10.7 14.0 22.7 27.5 1,575 1,656 

Uganda 2000-01 31.6 39.6 4.7 5.7 21.4 27.9 1,717 1,699 

Zambia 1996 30.7 45.7 5.0 5.6 19.0 30.4 1,598 1,954 

Zimbabwe 1999 25.2 32.6 7.1 8.1 13.4 15.7 1,196 318 

North Africa/West Asia/Europe 

Egypt 2000 19.5 14.0 3.2 3.4 4.7 3.1 5,782 204 

Jordan 1997 6.9 12.2 2.0 2.6 4.8 5.7 3,086 176 

Turkey 1998 10.1 17.7 2.5 2.4 7.2 8.5 1,153 436 

Yemen 1997 41.3 49.2 13.0 16.5 38.0 48.0 2,167 2,793 

Central Asia 

Kazakhstan 1999 6.3 12.1 1.7 2.0 5.4 3.9 172 176 

Kyrgyz Republic 1997 21.0 33.4 2.8 4.9 9.3 14.8 698 315 

Uzbekistan 1996 30.7 32.6 9.3 16.6 17.6 21.4 678 311 

South/Southeast Asia 

Bangladesh 2000 40.1 43.2 11.6 7.1 45.6 47.5 3,183 118 

Cambodia 2000 35.3 37.7 14.0 17.1 37.8 40.8 533 1,228 

India 1998-99 44.5 46.2 15.1 18.0 45.9 49.5 19,054 5,254 

Nepal 1996 45.6 52.9 11.0 11.6 45.5 49.1 2,352 1,285 

Latin America/Caribbean 

Bolivia 1998 20.0 33.7 1.8 2.2 6.9 13.7 2,364 1,023 

Brazil 1996 7.3 16.9 2.3 3.4 3.8 9.1 1,594 602 

Colombia 2000 11.7 19.2 1.1 0.9 6.6 10.2 2,111 375 

Dominican Republic 

1996 11.3 9.7 1.8 1.4 6.5 5.6 1,374 729 

Guatemala 1998-99 45.0 26.1 3.5 1.7 25.8 14.4 1,773 370 

Haiti 2001 17.4 21.2 5.5 6.1 14.5 19.0 1,968 1,385 

Peru 2000 16.9 31.9 0.7 2.0 5.3 12.7 3,853 1,931 

Note: Figures in parentheses are based on 25-49 unweighted cases. 

1

Piped water into residence, piped public tap, protected well water, rainwater 

2

Unprotected well or spring, surface water, vendor, bottled water, tanker truck 
122 Appendix A

Table A.3.16 

Undernutrition by mother’s nutritional status 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by mother's nutritional status (eligible women BMI 

<=60.0), Demographic and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

 Country <18.5 18.5-24.9 25.0 <18.5 18.5-24.9 25.0 <18.5 18.5-24.9 25.0 <18.5 18.5-24.9 25.0 

Sub-Saharan Africa 

Benin 1996 26.1 25.8 15.3 21.8 14.4 8.5 40.9 30.2 17.5 268 1,470 191 

Burkina 1998-99 32.1 30.2 31.2 31.3 17.1 13.4 49.5 35.8 28.1 260 1,831 111 

Cameroon 1998 37.5 31.4 20.8 14.1 5.5 4.1 44.0 24.2 10.2 121 1,130 326 

Central African 

Republic 1994-95 39.4 32.4 25.8 11.5 6.7 4.1 37.5 26.0 14.4 299 1,448 134 

Chad 1996-97 42.1 33.5 25.3 28.1 16.9 14.6 54.4 37.1 24.9 594 2,193 139 

Comoros 1996 42.7 34.3 24.8 14.7 8.1 8.1 30.7 27.5 18.8 75 530 149 

Côte d’Ivoire 1994 30.5 25.2 16.9 13.6 9.0 5.0 43.4 24.9 12.0 222 2,209 382 

Eritrea 1995 43.9 34.4 24.3 22.0 13.7 7.4 52.5 39.4 22.8 745 1,049 75 

Ethiopia 2000 46.4 44.8 38.5 18.0 12.0 9.2 53.9 44.3 21.8 1,217 3,691 86 

Gabon 2000 25.4 22.6 13.4 3.4 3.3 2.5 23.6 14.6 8.7 121 1,116 478 

Ghana 1998 21.6 21.5 13.0 20.3 13.3 6.3 34.5 26.5 15.3 173 1,026 232 

Guinea 1999 32.7 24.2 17.2 16.3 12.5 10.2 40.4 26.5 16.6 187 1,377 203 

Kenya 1998 37.8 31.8 17.2 10.0 7.1 4.1 34.0 20.8 10.8 298 1,822 310 

Madagascar 1997 53.6 48.1 29.5 14.9 6.0 3.6 51.6 38.5 15.3 496 1,949 91 

Malawi 2000 48.3 44.5 37.3 9.8 8.0 4.5 40.3 28.5 15.9 317 4,279 546 

Mali 1995-96 36.4 29.4 18.3 31.2 23.1 22.4 52.9 39.8 27.8 592 2,881 330 

Mozambique 1997 37.7 37.4 18.9 14.4 8.7 4.2 34.2 28.2 8.5 233 1,945 242 

Niger 1998 43.7 41.7 22.2 31.2 19.9 11.0 59.3 49.7 28.4 656 2,359 255 

Togo 1998 26.4 22.0 14.0 22.5 12.5 7.0 38.0 25.6 13.7 306 2,208 322 

Uganda 2000-01 39.0 34.8 25.3 10.9 5.4 3.2 40.3 25.2 12.7 263 2,265 308 

Zambia 1996 49.1 38.3 31.6 6.9 5.7 2.6 36.4 26.7 10.7 259 2,390 343 

Zimbabwe 1999 31.2 29.3 18.6 10.2 6.9 6.0 24.0 14.1 8.1 68 1,008 315 

North Africa/West Africa/Europe 

Egypt 2000 21.7 14.1 18.7 2.7 1.7 2.9 4.7 3.5 4.9 958 311 1,917 

Jordan 1997 8.7 8.9 6.4 3.1 3.0 1.2 7.1 6.5 3.9 68 1,018 1,506 

Turkey 1998 (14.1) 12.8 9.9 (1.4) 3.3 1.8 (11.1) 8.7 5.9 36 629 726 

Yemen 1997 48.8 45.0 35.4 24.0 13.9 8.9 53.4 41.9 31.8 947 2,347 577 

Central Asia 

Kazakhstan 1999 (0.0) 13.1 4.2 (4.9) 2.0 0.0 (4.9) 5.3 0.0 28 231 66 

Kyrgyz Republic 1997 32.4 24.6 20.1 12.6 3.6 0.9 29.2 11.4 6.0 63 658 161 

Uzbekistan 1996 31.0 30.3 35.7 13.1 11.6 6.2 13.6 20.3 16.4 116 631 125 

South/Southeast Asia 

Bangladesh 2000 45.6 38.3 19.6 14.9 9.0 5.7 57.4 37.8 18.9 1,376 1,443 101 

Cambodia 2000 43.7 35.6 31.9 21.4 14.5 7.0 51.6 36.6 28.2 324 1,122 77 

India 1998-99 50.2 42.3 23.9 19.8 12.9 8.5 57.3 40.5 21.4 8,821 11,037 949 

Nepal 1996 51.1 46.4 31.0 16.4 9.8 7.3 56.6 43.7 21.9 891 2,278 52 

Latin America/Caribbean 

Bolivia 1998 (34.0) 24.9 22.5 (0.0) 2.0 1.6 (11.2) 9.4 7.8 25 1,666 1,279 

Brazil 1996 15.2 9.8 7.8 5.1 3.3 1.8 10.4 5.3 3.1 132 1,209 636 

Colombia 2000 17.9 13.3 10.1 3.1 1.2 0.8 16.7 8.0 4.5 72 1,290 830 

Dominican Republic 

1996 18.6 11.7 6.5 1.9 1.8 0.5 15.6 5.7 3.4 130 1,052 606 

Guatemala 1998-99 (61.0) 45.2 32.4 (10.6) 3.6 2.6 (49.3) 28.8 16.3 41 1,031 755 

Haiti 2000 23.9 19.2 11.6 9.6 5.4 4.6 25.9 16.4 10.5 257 1,975 663 

Peru 2000 (28.0) 24.6 17.0 (4.6) 1.5 0.5 (22.8) 9.5 4.5 47 3,000 2,413 

Note: Figures in parentheses are based on 25-49 unweighted cases. 
Appendix A 123

Table A.3.17 

Undernutrition by antenatal care visits 

Percentage of children age 0-35 months who are stunted, wasted, or underweight by whether the mother had one or more 

antenatal visits, Demographic and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country 

One or more 

antenatal 

visits None1

One or more 

antenatal 

visits None1

One or more 

antenatal 

visits None1

One or more 

antenatal 

visits None1

Sub-Saharan Africa 

Benin 1996 24.4 27.8 13.5 18.3 27.9 35.9 1,904 370 

Burkina Faso 1998-99 29.6 33.6 17.2 18.7 34.8 39.2 1,665 865 

Cameroon 1998 26.7 38.4 5.4 7.7 18.8 34.3 1,498 425 

Central African Republic 

1994-95 31.3 40.9 6.9 7.8 25.0 34.6 1,751 559 

Chad 1996-97 29.2 38.3 14.3 20.1 32.2 43.4 1,339 2,202 

Comoros 1996 32.7 40.5 8.0 9.9 24.1 36.6 790 131 

Côte d’Ivoire 1994 23.2 31.5 7.9 10.4 22.4 31.9 2,837 504 

Eritrea 1995 33.3 43.6 15.7 17.2 40.2 47.3 1,142 1,127 

Ethiopia 2000 39.7 46.5 12.2 13.2 39.9 47.0 1,435 4,469 

Gabon 2000 19.5 25.1 2.7 5.0 12.2 16.4 1,666 347 

Ghana 1998 19.7 22.2 12.3 18.3 24.5 27.6 1,458 180 

Guinea 1999 22.9 24.6 11.4 13.0 24.5 29.3 1,670 397 

Kenya 1998 30.7 33.2 6.9 7.3 21.0 27.2 2,616 205 

Madagascar 1997 49.1 44.3 7.3 8.1 40.1 39.1 2,613 467 

Malawi 2000 42.2 55.2 7.7 6.2 26.7 34.2 5,210 863 

Mali 1995-96 25.2 34.6 21.8 24.7 34.2 45.2 2,211 2,467 

Mozambique 1997 33.8 41.3 8.3 6.8 25.5 27.6 2,021 816 

Niger 1998 35.5 45.0 17.6 22.8 44.1 53.4 1,661 2,361 

Tanzania 1999 35.9 51.3 6.3 8.1 29.1 38.1 1,458 216 

Togo 1998 20.7 26.3 11.9 13.9 23.9 30.9 2,688 572 

Uganda 2000-01 34.5 39.5 5.5 4.2 25.0 23.7 2,830 754 

Zambia 1996 38.6 44.6 5.5 5.0 24.9 31.6 3,388 200 

Zimbabwe 1999 25.0 31.0 7.1 7.4 12.9 16.4 1,218 369 

North Africa/West Asia/Europe 

Egypt 2000 17.7 21.1 3.3 3.1 4.0 5.1 3,316 2,920 

Jordan 1997 6.9 16.9 2.0 2.4 4.7 10.8 3,148 118 

Turkey 1998 7.7 22.7 2.1 3.5 4.9 14.0 1,141 469 

Yemen 1997 39.7 49.5 12.9 16.3 36.0 48.5 1,913 3,053 

Central Asia 

Kazakhstan 1999 9.3 10.0 1.6 3.2 4.6 4.5 294 60 

Kyrgyz Republic 1997 24.4 28.7 3.8 0.0 11.4 8.3 908 107 

Uzbekistan 1996 31.2 31.6 11.2 14.8 18.4 21.3 863 125 

South/Southeast Asia 

Bangladesh 2000 32.4 44.7 11.2 11.5 39.2 49.3 1,201 2,105 

Cambodia 2000 31.8 41.1 14.8 17.4 33.9 44.5 763 1,079 

India 1998-99 39.7 57.4 15.4 16.4 42.8 56.1 17,013 7,130 

Nepal 1996 43.4 52.1 10.9 11.5 43.8 49.2 1,580 2,125 

Latin America/Caribbean 

Bolivia 1998 19.7 35.5 1.5 3.0 6.6 14.8 2,455 997 

Brazil 1996 7.9 26.5 2.9 2.5 4.3 13.5 2,013 293 

Colombia 2000 10.9 21.1 1.1 0.9 5.9 12.6 2,022 476 

Dominican Republic 1996 10.8 23.1 1.6 3.4 6.1 18.1 2,091 40 

Guatemala 1998-99 41.2 47.2 3.1 3.5 23.7 24.9 1,913 236 

Haiti 2000 15.2 27.1 5.4 6.2 13.4 22.6 2,343 1,046 

Peru 2000 17.7 36.5 1.0 1.7 6.0 13.8 4,776 1,294 

1

 Includes missing cases 
124 Appendix A

Table A.3.18 

Undernutrition by mother's age at delivery 

Percentage of children 0-35 months who are stunted, wasted, or underweight by mother's age at delivery, Demographic and Health Surveys, 1994-2001 

Percent stunted Percent wasted 

Percent 

underweight 

Number of 

children 

Country < 20 20-34 35+ < 20 20-34 35+ < 20 20-34 35+ < 20 20-34 35+ 

Sub-Saharan Africa 

Benin 1996 30.9 24.2 23.8 14.7 14.0 15.2 33.5 28.3 29.4 297 1,584 392 

Burkina Faso 1998-99 36.7 30.6 27.7 13.9 17.6 20.9 38.2 35.5 37.8 355 1,712 462 

Cameroon 1998 32.9 28.5 27.2 6.4 5.7 6.7 26.9 20.2 25.0 406 1,279 238 

Central African Rep. 1994-95 33.4 34.0 31.8 9.0 6.5 7.6 25.1 27.3 30.7 456 1,593 261 

Chad 1996-97 36.8 34.4 34.1 17.4 17.4 22.1 36.6 39.5 42.2 771 2,387 384 

Comoros 1996 37.6 33.9 30.5 10.9 8.4 5.8 34.7 25.7 20.8 101 666 154 

Côte d’Ivoire 1994 31.2 22.6 24.3 9.4 7.8 9.0 28.5 22.3 24.9 646 2,287 408 

Eritrea 1995 40.6 35.4 45.3 15.8 16.9 15.3 40.9 43.0 48.0 370 1,413 486 

Ethiopia 2000 45.6 45.0 43.8 10.5 13.3 13.5 42.7 44.9 49.0 812 4,121 972 

Gabon 2000 22.4 19.8 20.5 2.6 2.9 5.2 15.5 12.1 12.1 504 1,302 207 

Ghana 1998 21.5 19.9 19.4 12.3 12.6 14.7 28.1 23.9 26.5 195 1,160 283 

Guinea 1999 24.6 22.8 23.0 9.0 12.7 11.3 23.4 26.4 24.1 423 1,365 279 

Kenya 1998 33.2 30.2 32.1 9.1 6.4 7.5 23.5 20.3 26.2 460 2,041 320 

Madagascar 1997 49.8 47.1 52.4 8.2 7.0 8.0 41.1 38.5 45.6 637 2,038 405 

Malawi 2000 46.0 42.8 47.5 8.1 7.0 9.2 30.3 26.4 31.4 1,153 4,128 793 

Mali 1995-96 28.5 30.6 29.8 21.2 23.6 24.5 39.9 39.7 41.4 760 3,166 752 

Mozambique 1997 42.6 35.1 29.5 8.1 7.1 11.7 32.1 25.0 22.0 600 1,871 366 

Niger 1998 43.5 40.0 41.9 19.8 20.1 24.4 50.8 48.4 53.1 870 2,560 592 

Tanzania 1999 43.6 36.3 40.4 7.2 5.6 10.5 35.2 28.8 32.7 260 1,202 212 

Togo 1998 27.5 21.0 21.0 13.9 11.6 14.0 29.0 24.5 25.3 354 2,370 537 

Uganda 2000-01 42.5 34.1 33.9 3.7 5.0 8.9 25.7 23.7 29.0 620 2,505 459 

Zambia 1996 43.5 37.3 40.5 6.0 5.1 6.5 29.0 23.9 27.2 703 2,451 434 

Zimbabwe 1999 26.1 25.8 30.3 7.7 6.8 8.4 12.6 13.8 15.0 318 1,074 196 

North Africa/West Asia/Europe 

Egypt 2000 22.5 18.6 21.7 3.0 3.2 3.1 5.3 4.3 5.3 661 4,935 640 

Jordan 1997 9.3 6.8 8.6 2.8 2.0 1.7 6.5 4.8 4.8 260 2,578 427 

Turkey 1998 15.2 11.3 14.0 3.8 2.3 1.6 9.4 7.4 5.9 229 1,255 126 

Yemen 1997 49.9 45.4 43.1 13.1 15.2 15.9 44.9 43.3 44.2 713 3,458 795 

Central Asia 

Kazakhstan 1999 (12.7) 8.2 (17.0) (1.0) 2.2 (0.0) (1.8) 4.8 (5.9) 39 284 31 

Kyrgyz Rep. 1997 27.9 24.0 28.7 2.0 3.1 9.1 10.3 10.2 20.1 123 810 82 

Uzbekistan 1996 27.8 31.0 43.2 10.1 11.3 20.8 10.8 19.3 28.4 114 824 51 

South/Southeast Asia 

Bangladesh 2000 46.2 36.3 52.2 10.0 11.9 13.6 49.1 43.0 57.6 1,021 2,102 183 

Cambodia 2000 38.6 36.2 40.3 15.4 15.6 19.1 40.1 39.1 43.4 167 1,279 396 

India 1998-99 50.0 43.2 47.6 16.2 15.5 16.5 50.7 45.2 52.4 5,532 17,710 901 

Nepal 1996 45.5 48.3 54.2 10.8 11.2 12.3 45.1 46.6 52.9 654 2,695 355 

Latin America/Caribbean 

Bolivia 1998 20.0 23.6 30.0 1.8 1.9 2.1 7.2 8.9 10.9 475 2,396 580 

Brazil 1996 10.9 10.1 10.5 3.1 2.6 3.8 5.8 5.3 5.9 450 1,627 229 

Colombia 2000 13.5 12.4 14.3 0.7 1.1 1.3 5.0 7.7 8.0 508 1,736 253 

Dominican Rep. 1996 13.8 9.9 15.3 3.2 1.2 1.0 10.4 4.7 12.6 441 1,578 112 

Guatemala 1998-99 43.5 40.1 49.1 2.4 2.8 5.9 21.1 22.3 34.8 344 1,510 295 

Haiti 2000 19.1 18.5 20.2 4.5 5.9 5.8 14.3 16.1 18.2 467 2,264 658 

Peru 2000 22.8 20.1 27.6 1.3 1.1 1.3 9.3 6.8 10.1 892 4,218 960 

Note: Figures in parentheses are based on 25-49 unweighted cases. 
Appendix A 125

Table A.3.19 

Undernutrition by mother's perceived size of child at birth 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by mother's perceived size of child at birth, 

Demographic and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country 

Very 

Small 

Smaller 

than 

average 

Average 

or larger

Very 

Small

Smaller 

than 

average

Average 

or larger

Very 

Small

Smaller 

than 

average

Average 

or larger 

Very 

Small 

Smaller 

than 

average

Average 

or larger

Sub-Saharan Africa 

Benin 1996 43.2 32.9 23.1 23.7 14.4 13.9 55.7 39.0 26.7 83 266 1,919 

Burkina Faso 1998-99 36.1 37.5 29.9 27.6 18.2 16.9 53.7 44.8 34.2 158 245 2,119 

Cameroon 1998 40.6 33.3 28.1 10.0 5.8 5.8 45.2 25.5 20.5 81 215 1,622 

Central African Republic 

1994-95 50.4 44.0 31.2 9.1 11.0 6.5 43.7 35.5 25.3 91 285 1,887 

Chad 1996-97 40.7 38.6 32.6 26.2 22.5 14.8 52.9 45.8 34.3 520 653 2,355 

Comoros 1996 54.3 38.5 30.5 14.9 8.5 7.3 39.4 32.3 23.1 94 130 685 

Côte d’Ivoire 1994 40.0 30.4 22.5 14.7 11.1 7.4 43.7 32.8 21.2 194 378 2,767 

Eritrea 1995 47.3 39.3 36.4 22.6 22.2 14.0 55.1 51.8 40.0 371 238 1,622 

Ethiopia 2000 51.2 50.6 41.5 17.6 12.5 12.7 52.7 51.4 41.6 371 1,804 3,721 

Gabon 2000 36.7 28.3 18.6 7.4 2.8 2.9 26.4 20.8 11.1 80 168 1,728 

Ghana 1998 (32.7) 31.0 18.3 (14.6) 18.8 12.1 (53.9) 39.6 22.3 27 189 1,418 

Guinea 1999 29.2 24.2 22.8 22.8 13.8 11.0 43.4 32.0 23.7 80 183 1,782 

Kenya 1998 38.0 39.0 29.4 5.8 7.1 7.0 33.2 27.9 19.9 130 306 2,375 

Madagascar 1997 59.8 53.3 45.5 10.7 10.3 6.4 54.2 48.9 36.0 372 394 2,297 

Malawi 2000 52.8 55.7 42.0 8.1 11.0 7.0 43.7 39.7 25.4 223 719 5,110 

Mali 1995-96 41.3 36.0 29.0 35.2 27.8 22.3 58.4 48.4 38.1 179 475 3,975 

Mozambique 1997 (14.6) 44.0 34.5 (42.1) 6.6 7.7 (51.6) 31.5 24.5 39 466 2,298 

Niger 1998 49.4 42.5 38.6 27.4 23.4 18.2 57.4 57.0 45.3 621 831 2,556 

Tanzania 1999 (55.0) 43.6 36.9 (5.6) 15.3 5.7 (55.9) 36.0 29.0 47 137 1,490 

Togo 1998 34.7 28.4 19.6 19.9 18.1 10.7 44.1 38.5 21.5 242 368 2,647 

Uganda 2000-01 44.9 43.9 33.5 9.8 7.2 4.5 40.2 33.8 21.9 250 452 2,837 

Zambia 1996 63.1 47.9 37.2 12.7 9.4 4.8 51.4 39.9 22.9 99 343 3,145 

Zimbabwe 1999 40.9 29.2 25.5 8.1 5.5 7.4 36.1 15.8 12.4 70 181 1,326 

North Africa/West Asia/Europe 

Egypt 2000 26.3 24.8 18.4 3.2 3.8 3.1 11.4 6.4 4.0 197 700 5,318 

Jordan 1997 19.5 13.4 5.7 5.8 1.6 1.9 16.3 10.0 3.6 174 329 2,762 

Turkey 1998 22.6 16.1 9.7 4.3 2.0 2.3 17.5 6.9 6.3 174 260 1,169 

Yemen 1997 53.1 49.9 43.5 18.5 17.7 13.7 54.1 49.4 40.5 487 1,032 3,441 

Central Asia 

Kazakhstan 1999 * 11.9 7.8 * 8.2 0.8 * 13.1 2.5 12 53 289 

Kyrgyz Republic 1997 * 45.7 22.5 * 3.4 3.4 * 20.4 9.8 20 100 887 

Uzbekistan 1996 * 37.4 30.7 * 17.6 10.4 * 29.2 17.1 5 108 865 

South/Southeast Asia 

Bangladesh 2000 56.9 48.2 37.7 16.3 14.5 10.5 68.2 55.3 42.4 175 491 2,638 

Cambodia 2000 51.0 43.6 35.9 16.2 24.0 15.3 47.2 52.7 38.2 76 191 1,559 

India 1998-99 57.1 50.0 42.9 21.0 20.5 14.2 61.9 54.5 43.8 1,101 4,642 18,360 

Nepal 1996 64.4 57.3 44.8 15.5 16.5 9.5 62.6 60.7 42.1 188 757 2,759 

Latin America/Caribbean 

Bolivia 1998 37.6 33.9 21.5 3.5 2.6 1.6 16.0 16.1 7.3 269 401 2,773 

Brazil 1996 31.0 18.0 7.1 6.8 4.5 2.2 20.3 8.2 3.9 93 460 1,744 

Dominican Republic 1996 29.8 19.0 8.3 2.0 1.3 1.7 27.1 12.1 3.9 96 355 1,675 

Guatemala 1998-99 52.5 49.7 38.0 2.6 3.4 2.9 30.0 30.1 20.8 204 426 1,501 

Haiti 2000 26.4 16.9 16.6 6.0 8.0 5.1 25.0 21.4 12.2 775 428 2,186 

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25

unweighted cases and has been suppressed. 
126 Appendix A

Table A.3.20 

Undernutrition by sex of child 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by sex of child, 

Demographic and Health Surveys, 1994-2001 

 Percent 

stunted 

Percent 

wasted 

Percent 

underweight 

Number of 

children 

 Country Male Female Male Female Male Female Male Female

Sub-Saharan Africa 

Benin 1996 27.2 22.7 16.0 12.6 32.1 26.2 1,145 1,128 

Burkina Faso 1998-99 32.8 29.1 19.3 16.1 35.9 36.8 1,272 1,258 

Cameroon 1998 31.5 27.0 7.0 4.9 24.0 20.4 962 961 

Central African Republic 

1994-95 35.5 31.8 7.6 6.6 29.1 25.4 1,171 1,139 

Chad 1996-97 35.7 34.1 19.8 16.0 40.6 37.7 1,760 1,781 

Comoros 1996 35.7 31.7 9.4 7.0 27.6 24.0 479 442 

Côte d’Ivoire 1994 25.2 23.6 9.7 6.7 26.4 21.1 1,705 1,636 

Eritrea 1995 36.4 40.5 16.2 16.7 42.3 45.2 1,162 1,107 

Ethiopia 2000 46.5 43.2 14.6 11.2 47.2 43.3 2,991 2,914 

Gabon 2000 22.7 18.2 3.2 3.0 14.0 11.9 1,010 1,003 

Ghana 1998 21.1 19.0 14.5 11.4 24.4 25.3 807 830 

Guinea 1999 24.9 21.4 12.0 11.4 24.6 26.3 1,075 992 

Kenya 1998 33.8 27.9 7.1 6.8 22.9 20.0 1,440 1,380 

Madagascar 1997 51.8 44.8 8.2 6.5 42.2 37.7 1,553 1,528 

Malawi 2000 46.1 41.9 6.9 8.1 27.9 27.6 3,032 3,042 

Mali 1995-96 31.0 29.2 24.5 22.2 39.7 40.3 2,288 2,390 

Mozambique 1997 36.1 35.8 8.0 7.7 28.2 24.0 1,450 1,387 

Niger 1998 42.5 39.5 20.6 20.7 48.9 50.3 2,108 1,914 

Tanzania 1999 38.4 37.4 6.4 6.6 29.8 30.8 863 811 

Togo 1998 23.4 20.1 11.4 13.1 25.8 24.5 1,603 1,657 

Uganda 2000-01 37.3 33.7 6.6 3.9 26.3 23.1 1,783 1,802 

Zambia 1996 40.4 37.5 6.5 4.4 27.1 23.6 1,767 1,822 

Zimbabwe 1999 27.4 25.3 7.5 6.9 14.6 12.8 821 767 

North Africa/West Asia/Europe 

Egypt 2000 20.5 18.0 3.7 2.6 5.2 3.8 3,209 3,027 

Jordan 1997 8.0 6.4 2.1 2.0 4.6 5.2 1,668 1,598 

Turkey 1998 12.6 11.4 2.8 2.0 8.3 6.7 866 744 

Yemen 1997 46.4 45.1 15.9 14.1 44.0 43.4 2,526 2,440 

Central Asia 

Kazakhstan 1999 7.8 10.9 3.3 0.6 5.2 4.0 166 188 

Kyrgyz Republic 1997 28.0 21.5 4.2 2.6 13.4 8.6 519 496 

Uzbekistan 1996 33.9 28.5 12.6 10.6 20.7 16.8 509 480 

South/Southeast Asia 

Bangladesh 2000 39.4 41.0 11.6 11.2 44.4 47.0 1,684 1,623 

Cambodia 2000 36.2 38.4 17.1 15.5 39.8 40.4 949 893 

India 1998-99 43.6 46.4 16.0 15.4 45.0 48.5 12,574 11,569 

Nepal 1996 46.6 50.2 12.3 10.2 45.8 48.0 1,887 1,817 

Latin America/Caribbean 

Bolivia 1998 25.5 22.9 2.2 1.6 9.4 8.6 1,742 1,709 

Brazil 1996 11.2 9.4 2.8 2.9 6.4 4.5 1,144 1,162 

Colombia 2000 13.6 12.1 0.8 1.2 7.0 7.4 1,285 1,214 

Dominican Republic 1996 12.5 9.4 2.1 1.1 7.0 5.6 1,099 1,031 

Guatemala 1998-99 45.1 38.6 3.6 2.8 27.6 20.0 1,093 1,057 

Haiti 2000 20.4 17.3 4.8 6.6 16.1 16.4 1,726 1,663 

Peru 2000 21.4 22.0 1.1 1.2 7.9 7.5 3,075 2,995 
Appendix A 127

Table A.3.21 

Undernutrition by birth order 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by birth order, Demographic and Health Surveys, 1994-2001 

Percent stunted Percent wasted Percent underweight Number of children 

Country 

1st 

Birth 

Birth 

2-3 

Birth 

4-5 

Birth 

6+ 

1st 

Birth

Birth 

2-3 

Birth 

4-5 

Birth 

6+ 

1st 

Birth

Birth 

2-3 

Birth 

4-5 

Birth 

6+ 

1st 

Birth

Birth

2-3

Birth 

4-5 

Birth 

6+ 

Sub-Saharan Africa 

Benin 1996 26.8 24.8 24.6 24.2 13.9 14.6 12.7 15.6 30.8 27.6 31.0 28.4 442 725 500 606 

Burkina Faso 1998-99 35.8 28.9 30.3 30.9 15.2 17.2 17.7 19.9 37.7 34.3 34.2 39.6 435 799 595 701 

Cameroon 1998 30.8 27.5 29.7 29.9 5.0 5.6 6.0 7.3 21.7 19.2 23.4 25.6 419 617 435 452 

Central African Republic 

1994-95 31.5 35.2 33.2 33.8 6.0 8.8 6.2 6.6 23.6 28.6 27.6 28.3 466 775 527 541 

Chad 1996-97 33.4 34.0 36.3 35.6 17.4 15.4 18.2 20.9 36.1 35.3 42.5 42.6 652 1,081 869 939 

Comoros 1996 29.8 33.9 33.2 36.5 8.9 6.3 8.9 9.4 23.8 25.9 25.3 27.4 168 286 190 277 

Côte d’Ivoire 1994 27.6 23.7 22.0 25.4 8.7 7.2 8.7 8.9 25.0 22.5 23.9 24.6 630 1,072 828 811 

Eritrea 1995 35.2 33.8 40.9 44.5 16.5 15.8 17.6 16.1 37.5 41.0 46.7 49.9 499 703 496 570 

Ethiopia 2000 42.1 43.8 45.6 47.3 8.2 13.2 14.8 14.1 37.5 43.1 49.1 49.5 1,056 1,847 1,286 1,716 

Gabon 2000 19.5 20.7 17.9 23.9 3.5 2.5 3.4 3.3 12.7 14.4 10.6 13.3 508 683 411 411 

Ghana 1998 18.4 19.8 17.9 24.5 13.4 11.9 13.1 14.1 24.7 22.9 24.4 29.2 390 592 332 324 

Guinea 1999 21.6 24.0 22.9 23.8 9.5 10.7 14.5 11.9 22.1 24.9 26.5 27.5 386 652 519 510 

Kenya 1998 27.2 29.5 34.3 34.4 5.5 7.6 7.8 6.8 16.8 20.6 23.6 26.3 685 998 545 593 

Madagascar 1997 49.1 44.3 46.8 54.2 6.3 7.1 8.6 7.7 36.6 37.6 41.0 45.2 678 996 650 756 

Malawi 2000 43.8 43.1 42.8 47.0 7.4 7.3 7.8 7.6 29.7 26.0 27.2 29.4 1,327 2,177 1,275 1,295 

Mali 1995-96 29.3 26.3 30.4 33.4 20.3 21.2 23.6 26.3 37.9 35.7 39.0 45.2 690 1,313 1,080 1,595 

Mozambique 1997 40.1 38.6 33.4 29.2 6.3 8.1 6.6 11.0 25.6 27.9 26.1 23.1 577 1,067 673 520 

Niger 1998 40.6 40.2 42.5 41.1 19.4 18.4 20.6 23.0 48.1 45.9 49.7 53.1 670 1,073 883 1,396 

Tanzania 1999 40.5 32.2 39.0 43.3 7.1 6.4 5.1 7.4 32.3 29.2 27.8 32.5 367 577 361 369 

Togo 1998 21.0 20.6 22.5 22.9 12.4 11.7 10.7 14.6 24.3 24.8 25.0 26.4 622 1,031 820 788 

Uganda 2000-01 37.0 35.5 36.6 33.8 4.2 4.2 5.5 6.9 21.4 22.7 26.6 27.3 555 1,171 860 999 

Zambia 1996 41.7 37.2 37.3 40.6 5.1 5.9 4.7 5.8 26.4 24.2 24.7 26.5 723 1,195 805 866 

Zimbabwe 1999 23.4 26.3 29.5 30.3 6.0 7.1 8.3 8.8 11.8 13.7 14.4 17.7 507 618 243 221 

North Africa/West Asia/Europe 

Egypt 2000 18.5 17.9 20.1 25.2 3.4 2.8 3.8 3.1 4.4 3.2 5.5 8.0 1,693 2,654 1,152 737 

Jordan 1997 5.9 6.3 7.4 9.7 2.8 2.3 2.0 1.1 4.9 3.5 5.8 6.3 608 1,181 766 711 

Turkey 1998 9.9 10.5 13.3 27.4 2.3 2.4 3.2 2.3 6.6 6.4 9.6 14.7 582 698 194 136 

Yemen 1997 44.9 42.6 47.1 47.5 14.7 14.9 15.2 15.0 40.6 40.7 45.2 46.4 843 1,317 974 1,832 

Central Asia 

Kazakhstan 1999 7.3 7.9 18.6 * 3.6 1.1 1.0 * 5.3 3.6 7.5 * 118 170 51 16 

Kyrgyz Republic 1997 21.7 23.9 25.9 40.2 4.4 2.5 3.8 4.8 9.8 10.2 9.9 23.4 287 468 184 76 

Uzbekistan 1996 27.4 30.7 37.4 40.7 9.0 11.6 13.0 22.8 11.8 20.0 23.4 35.1 313 465 154 56 

South/Southeast Asia 

Bangladesh 2000 40.6 36.6 44.8 46.4 9.4 10.7 15.9 12.5 45.8 41.8 50.6 53.0 936 1,439 574 358 

Cambodia 2000 35.3 35.3 37.5 41.8 16.8 13.2 16.4 20.6 39.5 35.4 42.3 45.8 336 649 445 411 

India 1998-99 39.2 43.8 52.1 55.9 14.6 15.2 17.2 18.8 40.7 45.9 52.9 58.3 7,092 10,769 4,127 2,154 

Nepal 1996 40.9 48.4 49.9 56.4 8.3 10.2 13.5 14.8 39.5 45.4 51.3 54.7 819 1,469 823 594 

Latin America/Caribbean 

Bolivia 1998 14.6 21.3 30.0 35.4 2.0 2.0 1.2 2.3 5.3 7.8 10.4 14.2 834 1,246 690 681 

Brazil 1996 6.9 8.5 14.8 27.6 2.5 2.6 3.8 4.4 3.9 3.4 11.0 14.6 819 1,007 289 192 

Colombia 2000 10.0 12.1 17.0 29.9 0.6 0.9 2.1 2.8 4.9 7.0 9.8 19.3 931 1,118 319 130 

Dominican Republic 1996 7.4 9.8 17.7 19.8 1.9 1.0 3.1 1.2 4.6 4.9 11.2 12.5 665 975 327 164 

Guatemala 1998-99 34.2 36.1 47.8 53.6 2.9 3.0 2.8 4.1 16.1 19.6 26.0 37.0 502 730 458 460 

Haiti 2000 13.7 15.6 20.2 27.2 3.9 6.2 6.5 6.0 13.0 13.4 16.0 23.5 798 1,109 655 827 

Peru 2000 14.2 18.3 28.3 41.0 0.8 1.2 1.4 1.5 4.8 6.1 10.2 16.2 1,866 2,426 961 816 

Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 
128 Appendix A

Table A.3.22 

Undernutrition by length of preceding birth interval 

Percentage of children age 0–35 months who are stunted, wasted, or underweight by length of preceding birth interval in months, Demographic 

and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country 

First 

birth1

< 24 24-47 48+ 

First 

birth1

< 24 24-47 48+ 

First 

birth1

< 24 24-47 48+ 

First 

birth1

< 24 24-47 48+ 

Sub-Saharan Africa 

Benin 1996 26.9 33.6 23.6 23.2 14.1 20.0 14.4 11.2 30.9 38.0 27.9 27.2 445 176 1,322 331 

Burkina Faso 1998-99 36.0 35.8 29.4 28.8 15.2 21.0 17.5 19.1 37.6 46.4 35.3 33.8 436 218 1,406 470 

Cameroon 1998 30.8 35.6 28.3 24.7 5.2 7.4 6.0 5.5 22.3 22.6 24.1 15.5 423 257 948 295 

Central African Republic 

1994-95 31.4 40.8 34.2 27.4 5.9 10.2 5.9 9.6 23.5 34.9 25.8 29.4 467 353 1,155 335 

Chad 1996-97 33.3 46.0 33.6 28.9 17.6 18.3 17.7 18.5 36.2 46.9 38.0 38.5 654 559 1,855 473 

Comoros 1996 30.8 38.8 32.7 33.3 8.7 8.5 8.9 4.9 24.4 34.3 22.6 25.2 172 201 425 123 

Côte d’Ivoire 1994 27.6 27.7 24.9 17.9 8.6 5.3 8.8 8.1 24.9 24.4 25.2 18.4 633 353 1,742 613 

Eritrea 1995 35.1 46.6 40.0 28.4 16.4 18.3 15.7 16.9 37.3 50.8 46.4 36.5 501 347 1,116 304 

Ethiopia 2000 42.3 52.7 45.8 37.7 8.2 12.2 14.5 13.7 37.8 51.1 46.3 45.2 1,064 831 3,078 931 

Gabon 2000 19.7 26.8 22.0 13.3 3.4 4.3 2.3 3.1 12.7 16.5 13.8 8.5 514 331 769 399 

Ghana 1998 18.3 26.3 22.5 15.3 13.4 15.1 12.0 13.4 24.6 32.7 26.3 20.1 392 135 706 405 

Guinea 1999 21.9 29.1 24.2 19.4 9.9 9.4 12.2 13.4 22.7 26.6 25.4 27.5 390 194 1,036 447 

Kenya 1998 27.0 31.0 35.1 27.2 5.7 10.4 7.2 5.1 16.7 28.1 22.8 19.2 691 458 1,118 554 

Madagascar 1997 49.2 49.9 49.0 42.7 6.3 8.8 7.6 6.6 36.8 43.4 41.0 37.1 681 524 1,442 433 

Malawi 2000 44.2 48.9 43.0 43.1 7.5 8.1 6.7 9.0 30.0 30.5 25.4 29.3 1,340 782 2,837 1,115 

Mali 1995-96 29.4 38.3 30.1 22.4 20.3 24.2 23.4 25.4 38.2 48.0 39.1 36.9 695 709 2,582 693 

Mozambique 1997 40.0 40.5 36.7 28.1 6.3 5.3 8.2 9.8 25.4 32.3 28.4 18.5 580 246 1,433 578 

Niger 1998 40.5 50.2 39.7 35.0 19.3 23.5 20.1 21.1 48.1 59.0 48.5 43.3 673 672 2,232 444 

Tanzania 1999 40.5 42.0 36.2 37.0 7.1 1.5 7.6 5.9 32.3 32.5 31.2 24.0 367 185 819 303 

Togo 1998 20.8 26.8 22.9 17.8 12.4 12.8 12.4 11.6 24.5 30.3 26.3 20.9 627 252 1,702 679 

Uganda 2000-01 36.9 39.9 34.8 28.6 4.1 5.3 5.4 6.1 21.2 26.9 25.7 20.7 558 775 1,835 417 

Zambia 1996 41.6 39.9 38.5 35.6 5.1 4.7 5.5 6.5 26.3 24.9 25.0 25.4 725 539 1,845 478 

Zimbabwe 1999 23.5 29.2 27.3 28.1 5.9 4.7 7.8 8.6 12.0 16.7 15.1 13.2 511 112 576 389 

North Africa/West Asia/Europe 

Egypt 2000 18.6 23.3 18.7 18.2 3.4 4.1 3.1 2.2 4.4 6.8 4.3 3.3 1,713 1,011 2,231 1,280 

Jordan 1997 6.1 8.6 8.1 2.8 2.7 2.6 1.5 1.0 4.8 6.0 5.0 2.0 617 1,143 1,087 419 

Turkey 1998 9.8 19.8 14.0 8.8 2.5 4.1 2.1 1.8 6.8 12.7 8.4 4.9 590 233 395 393 

Yemen 1997 45.0 50.9 45.2 38.1 14.7 14.3 15.6 15.0 40.7 47.7 44.3 37.7 845 1,374 2,047 700 

Central Asia 

Kazakhstan 1999 7.3 12.0 13.2 7.6 3.6 0.0 2.6 0.5 5.3 9.1 4.9 0.0 118 72 68 96 

Kyrgyz Republic 1997 21.7 28.4 29.2 18.7 4.4 2.4 3.0 3.8 9.7 12.8 13.4 7.4 288 192 333 202 

Uzbekistan 1996 27.4 33.6 31.5 36.7 9.0 13.9 13.8 8.7 11.8 28.0 20.9 16.4 314 196 348 131 

South/Southeast Asia 

Bangladesh 2000 40.9 48.9 42.8 32.2 9.7 11.0 12.3 12.4 46.1 53.1 46.8 40.4 942 379 1,129 856 

Cambodia 2000 35.3 50.2 38.2 29.8 16.8 11.0 17.5 16.8 39.5 47.9 41.1 34.5 336 255 792 458 

India 1998-99 39.3 50.3 48.3 41.7 14.6 16.1 15.9 16.7 40.9 52.0 49.7 44.8 7,124 3,805 9,513 3,701 

Nepal 1996 40.9 51.2 50.8 48.9 8.3 13.2 11.2 13.5 39.4 49.0 49.2 48.8 823 604 1,737 541 

Latin America/Caribbean 

Bolivia 1998 14.6 29.8 30.7 18.3 2.0 1.0 2.1 2.4 5.3 9.8 12.2 6.8 838 704 1,249 660 

Brazil 1996 6.9 19.6 12.4 6.6 2.5 3.1 4.5 1.6 3.9 10.7 8.1 1.5 820 405 514 567 

Colombia 2000 10.0 20.1 16.4 9.3 0.6 1.8 1.1 1.1 4.8 12.7 10.5 4.3 937 407 542 613 

Dominican Republic 

1996 7.4 18.1 12.5 5.4 1.9 1.5 1.3 1.9 4.5 9.5 6.6 4.9 668 475 647 340 

Guatemala 1998-99 34.2 50.1 46.6 26.8 2.9 3.2 3.8 1.9 16.1 27.4 29.2 15.1 502 500 862 286 

Haiti 2000 13.8 26.4 20.6 12.9 4.2 5.2 6.0 7.6 13.3 20.6 17.4 12.5 802 651 1,398 539 

Peru 2000 14.4 34.1 29.8 15.8 0.8 1.0 1.4 1.3 4.9 13.5 10.5 5.3 1,873 717 1,807 1,673 

1

 Includes all children from multiple first births 
Appendix A 129

Table A.3.23 

Undernutrition by measles vaccination status 

Percentage of children age 12-23 months who are stunted, wasted, or underweight by measles vaccination status, Demographic and 

Health Surveys, 1994-2001 

Percent stunted Percent wasted Percent underweight Number of children 

Country 

Percentage 

of children 

age 12-23 

months 

with a 

measles 

vaccination 

Measles 

vaccination 

No measles 

vaccination

Measles 

vaccination

No measles 

vaccination

Measles 

vaccination

No measles 

vaccination 

Measles 

vaccination

No measles 

vaccination

Sub-Saharan Africa 

Benin 1996 67.5 30.2 31.6 19.1 19.0 37.8 40.2 515 248 

Burkina Faso 1998-99 50.6 44.1 46.0 23.3 27.5 45.7 58.2 407 397 

Cameroon 1998 54.4 40.5 48.8 4.6 11.9 24.0 42.3 355 297 

Central African Republic 

1994-95 51.6 38.1 51.9 9.5 11.6 29.9 42.5 384 360 

Chad 1996-97 22.7 40.4 47.6 23.5 26.9 42.6 56.6 254 866 

Comoros 1996 65.1 46.4 51.4 9.7 18.0 28.5 43.2 207 111 

Côte d’Ivoire 1994 53.5 28.7 33.4 13.8 12.5 28.2 34.4 577 502 

Ethiopia 2000 27.1 57.5 57.6 17.9 20.2 53.6 57.5 551 1,479 

Eritrea 1995 51.6 40.7 59.8 22.4 28.4 48.1 64.0 357 335 

Gabon 2000 55.5 25.2 34.2 1.9 3.3 15.9 22.1 381 306 

Ghana 1998 74.4 25.6 31.1 17.8 27.0 35.8 44.5 439 151 

Guinea 1999 56.3 29.9 37.1 16.2 20.5 32.7 41.7 360 279 

Kenya 1998 78.2 37.3 58.3 8.2 12.7 22.5 42.7 766 213 

Madagascar 1997 46.8 66.8 62.6 9.7 14.4 55.0 55.9 505 574 

Malawi 2000 83.5 56.8 62.8 9.7 10.7 34.7 46.1 1,688 334 

Mali 1995-96 51.7 38.3 42.8 31.7 34.5 51.7 55.7 719 672 

Mozambique 1997 66.4 40.3 46.4 13.0 12.0 32.5 36.3 636 322 

Niger 1998 35.5 48.9 59.4 27.1 33.3 57.3 70.6 472 859 

Tanzania 1999 78.0 47.4 63.8 6.9 19.4 37.3 56.5 435 122 

Togo 1998 44.1 32.0 33.4 19.5 19.7 37.3 36.6 442 559 

Uganda 2000-01 57.9 46.0 46.7 6.3 8.5 29.5 35.6 769 558 

Zambia 1996 86.5 47.3 50.2 8.7 9.6 33.4 43.2 1,087 170 

Zimbabwe 1999 81.4 33.7 50.9 9.4 11.3 16.5 25.4 458 105 

North Africa/West Asia/Europe 

Egypt 2000 97.1 23.6 20.2 3.1 2.5 5.6 8.2 1,992 60 

Jordan 1997 89.7 10.5 11.3 2.8 2.1 6.4 7.8 1,016 116 

Turkey 1998 78.7 14.4 24.8 2.9 2.9 7.9 19.7 430 116 

Yemen 1997 46.8 55.5 65.4 17.9 20.3 49.1 59.8 726 827 

Central Asia 

Kazakhstan 1999 79.4 15.9 * 3.0 * 4.2 * 94 24 

Kyrgyz Rep 1997 85.1 32.5 45.0 5.9 6.8 19.1 20.6 292 51 

Uzbekistan 1996 92.4 42.2 (60.0) 13.8 (5.4) 25.3 (18.8) 309 25 

South/Southeast Asia 

Bangladesh 2000 70.2 48.1 62.3 19.4 22.2 54.7 72.0 804 341 

Cambodia 2000 56.0 40.2 48.8 26.2 19.3 49.4 51.0 310 244 

India 1998-99 54.2 48.3 66.7 20.2 24.3 50.7 66.7 4,403 3,726 

Nepal 1996 57.0 53.3 67.4 17.4 24.6 52.4 68.5 736 554 

Latin America/Caribbean 

Bolivia 1998 50.9 31.0 34.0 1.8 2.1 10.8 14.0 588 567 

Brazil 1996 88.6 13.6 27.0 2.6 5.0 5.4 13.9 681 88 

Colombia 2000 71.0 17.5 25.6 1.8 1.2 8.5 13.5 584 239 

Dominican Republic 

1996 78.5 13.6 19.2 1.4 4.8 8.1 10.8 576 157 

Guatemala 1998-99 82.0 50.4 65.2 6.1 3.4 30.7 42.5 598 132 

Haiti 2000 54.6 20.9 32.7 8.8 8.9 17.2 26.8 624 519 

Peru 2000 72.3 27.4 30.5 1.6 1.3 10.0 12.4 1,556 595 

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25

unweighted cases and has been suppressed. 
130 Appendix A

Table A.3.24 

Undernutrition by vaccination status 

Among all children age 12–23 months, the percentage who are stunted, wasted, or underweight by vaccination status (according to

vaccination card or mother's report), Demographic and Health Surveys, 1994-2001 

 Percent stunted Percent wasted Percent underweight Number of children 

Country Measles 

Other 

vaccinations 

only 

No vaccinations1

Measles

Other 

vaccinations 

only 

No vaccinations1

Measles

Other 

vaccinations 

only 

No vaccinations1

Measles

Other 

vaccinations 

only 

No vaccinations1

Sub-Saharan Africa 

Benin 1996 30.2 33.1 28.2 19.1 14.0 29.6 37.8 36.4 48.3 515 168 79 

Burkina Faso 1998-99 44.1 47.0 41.9 23.3 26.9 29.8 45.7 58.4 57.6 407 319 78 

Cameroon 1998 40.5 48.0 51.0 4.6 11.8 12.2 24.0 42.6 41.5 355 217 80 

Central African Republic 

 1994-95 38.1 51.5 52.5 9.5 8.7 16.3 29.9 39.5 47.5 384 225 135 

Chad 1996-97 40.4 48.1 47.2 23.5 22.4 30.1 42.6 52.2 59.7 254 365 501 

Comoros 1996 46.4 49.5 * 9.7 15.1 * 28.5 39.8 * 207 93 18 

Côte d’Ivoire 1994 28.7 32.7 34.7 13.8 11.3 14.7 28.2 31.7 39.1 577 319 183 

Ethiopia 2000 57.5 58.6 54.2 17.9 20.5 19.4 53.6 57.4 57.9 551 1,142 337 

Eritrea 1995 40.7 64.3 58.4 22.4 27.8 28.6 48.1 64.2 64.0 357 78 257 

Gabon 2000 25.2 33.0 (45.7) 1.9 3.6 (0.0) 15.9 21.5 (28.1) 381 278 28 

Ghana 1998 25.6 29.0 (37.7) 17.8 24.9 (33.6) 35.8 41.9 (52.5) 439 114 37 

Guinea 1999 29.9 37.4 36.5 16.2 21.1 19.4 32.7 42.5 40.2 360 185 95 

Kenya 1998 37.3 59.7 (48.3) 8.2 14.1 (2.6) 22.5 43.1 (40.0) 766 186 27 

Madagascar 1997 66.8 61.9 64.0 9.7 14.8 13.4 55.0 54.4 58.8 505 375 198 

Malawi 2000 56.8 59.1 82.7 9.7 11.4 7.4 34.7 45.0 52.1 1,688 282 52 

Mali 1995-96 38.3 42.5 43.1 31.7 36.1 32.6 51.7 56.7 54.5 719 359 313 

Mozambique 1997 40.3 46.0 47.1 13.0 9.5 15.9 32.5 36.8 35.6 636 196 127 

Niger 1998 48.9 57.6 60.5 27.1 29.6 35.8 57.3 65.4 73.9 472 334 524 

Tanzania 1999 47.4 64.4 (61.7) 6.9 16.5 (28.6) 37.3 65.2 (28.9) 435 93 29 

Togo 1998 32.0 31.8 37.7 19.5 19.9 19.4 37.3 34.0 44.0 442 412 148 

Uganda 2000-01 46.0 46.7 46.7 6.3 8.0 9.7 29.5 33.1 41.8 769 398 161 

Zambia 1996 47.3 48.6 * 8.7 10.3 * 33.4 42.2 * 1,087 147 23 

Zimbabwe 1999 33.7 (41.5) 58.9 9.4 (10.6) 11.9 16.5 (26.7) 24.3 458 48 57 

North Africa/West Asia/Europe 

Egypt 2000 23.6 19.2 * 3.1 2.7 * 5.6 8.7 * 1,992 56 4 

Jordan 1997 10.5 11.3 * 2.8 2.1 * 6.4 7.8 * 1,016 116 0 

Turkey 1998 14.4 20.7 * 2.9 2.8 * 7.9 17.6 * 430 99 18 

Yemen 1997 55.5 65.8 63.3 17.9 21.3 15.4 49.1 59.8 59.4 726 683 144 

Central Asia 

Kazakhstan 1999 15.9 * * 3.0 * * 4.2 * * 94 18 6 

Kyrgyz Republic 1997 32.5 44.7 * 5.9 6.9 * 19.1 20.2 * 292 51 0 

Uzbekistan 1996 42.2 (60.0) * 13.8 (5.4) * 25.3 (18.8) * 309 25 0 

South/Southeast Asia 

Bangladesh 2000 48.1 60.4 67.2 19.4 21.5 24.1 54.7 69.6 78.5 804 249 92 

Cambodia 2000 40.2 49.2 48.3 26.2 22.2 16.4 49.4 50.0 52.2 310 124 120 

India 1998-99 48.3 64.3 73.5 20.2 24.0 25.3 50.7 64.6 72.8 4,403 2,774 952 

Nepal 1996 53.3 69.0 65.6 17.4 23.8 25.6 52.4 70.8 65.9 736 298 257 

Latin America/Caribbean 

Bolivia 1998 31.0 31.3 48.3 1.8 2.2 1.7 10.8 11.6 27.0 588 477 90 

Brazil 1996 13.6 20.7 * 2.6 6.0 * 5.4 13.9 * 681 74 14 

Colombia 2000 19.0 19.8 * 2.0 1.5 * 10.7 9.6 * 210 604 10 

Dominican Republic 1996 13.6 19.9 * 1.4 4.7 * 8.1 10.5 * 576 146 11 

Guatemala 1998-99 50.4 65.4 * 6.1 1.4 * 30.7 39.7 * 598 108 24 

Haiti 2001 20.9 30.1 37.3 8.8 8.3 9.8 17.2 27.8 25.1 624 330 189 

Peru 2000 27.4 29.3 (53.0) 1.6 1.4 (0.0) 10.0 12.0 (19.1) 1,556 565 30 

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted 

cases and has been suppressed. 

1

Includes missing cases
Appendix A 131

Table A.3.25 

Breastfeeding status of children under 6 months 

Percent distribution of youngest children under 6 months living with the mother by breastfeeding status and percentage of children under 6 

months using a bottle with a nipple according to age in months, Demographic and Health Surveys, 1994-2001 

Country 

Exclusive 

breastfeeding1

Breastmilk and 

plain 

water 

Fully 

breastfed2

Predominantly 

breastfed3

Predominantly or 

fully 

breastfed4

Received 

milk5

Received 

complementary 

foods6

Breastfed 

and used 

bottle 

Not 

breastfed

Not 

breastfed 

and used 

bottle 

 Number 

of 

children 

Sub-Saharan Africa 

Benin 1996 10.1 14.8 25.0 35.7 60.7 2.0 37.0 5.8 0.3 u 505 

Burkina Faso 1998-99 5.5 29.2 34.6 53.5 88.2 2.3 9.4 1.0 0.1 u 639 

Cameroon 1998 12.2 32.4 44.6 16.2 60.8 7.9 30.1 19.3 1.3 4.0 422 

Central African Republic 

1994-95 3.0 40.8 43.8 6.6 50.4 0.5 49.0 2.0 0.2 u 456 

Chad 1996-97 1.9 51.7 53.6 23.1 76.8 8.3 14.2 3.6 0.7 1.1 808 

Comoros 1996 3.2 21.5 24.7 14.0 38.7 23.1 37.1 22.6 1.1 1.0 186 

Côte d’Ivoire 1994 3.0 60.4 63.4 11.8 75.2 2.2 21.7 4.6 0.9 4.3 663 

Ethiopia 2000 54.3 15.2 69.5 8.0 77.5 16.9 4.7 14.6 0.9 4.7 1,070 

Eritrea 1995 58.9 17.0 76.0 13.7 89.7 6.8 3.2 3.1 0.3 1.5 448 

Gabon 2000 5.4 22.5 27.9 1.5 29.4 41.7 15.1 37.0 13.8 34.8 401 

Ghana 1998 31.5 33.9 65.4 11.4 76.8 6.8 16.3 23.1 u u 291 

Guinea 1999 11.2 53.7 64.9 16.8 81.7 7.2 10.0 7.8 1.1 0.0 662 

Kenya 1998 12.6 9.5 22.1 15.1 37.2 20.0 42.2 24.7 0.6 0.9 517 

Madagascar 1997 47.9 9.4 57.3 14.1 71.4 2.9 25.1 2.8 0.7 1.3 663 

Malawi 2000 44.0 12.0 56.1 0.6 56.7 1.0 42.3 2.3 u 0.3 1,257 

Mali 1995-96 8.4 66.9 75.3 13.0 88.3 6.5 4.9 3.2 0.4 1.3 1,039 

Mozambique 1997 30.3 34.1 64.5 3.1 67.6 2.3 26.7 u 3.4 u 757 

Niger 1998 0.8 51.1 51.9 28.5 80.3 6.9 12.1 3.9 0.6 u 856 

Tanzania 1999 34.2 21.4 55.6 14.7 70.3 21.4 5.9 9.1 2.5 u 326 

Togo 1998 10.5 27.8 38.4 14.1 52.4 2.0 44.6 6.9 0.9 u 657 

Uganda 2000-01 63.2 3.8 67.0 3.9 70.9 17.1 11.3 4.7 0.6 1.1 705 

Zambia 1996 18.8 34.2 53.0 3.1 56.1 3.0 40.3 3.2 0.7 1.7 655 

Zimbabwe 1999 31.9 22.3 54.2 0.4 54.6 2.0 43.3 4.6 u u 342 

North Africa/West Asia/Europe 

Egypt 2000 64.0 0.3 64.3 14.2 78.5 3.8 14.1 16.4 3.7 36.8 1,191 

Jordan 1997 11.0 10.2 21.2 21.3 42.5 19.6 30.2 35.1 7.7 35.0 490 

Turkey 1998 7.1 24.8 31.9 14.9 46.8 20.0 23.6 35.8 9.6 29.9 357 

Central Asia 

Kazakhstan 1999 35.8 18.9 54.7 11.0 65.7 11.1 17.6 26.0 5.6 6.4 113 

South/Southeast Asia 

Bangladesh 2000 46.5 9.9 56.4 9.8 66.2 13.9 19.5 19.8 0.4 0.9 765 

Cambodia 2000 11.4 64.6 76.0 3.2 79.2 3.6 16.1 11.1 1.0 4.4 800 

India 1998-99 46.8 24.5 71.3 2.6 73.9 18.2 5.9 11.6 1.9 80.1 5,495 

Nepal 1996 74.8 3.4 78.1 0.5 78.7 10.7 10.3 2.7 0.3 1.5 678 

Latin America and the Caribbean 

Bolivia 1998 50.6 3.2 53.8 9.7 63.5 20.1 13.7 29.4 2.7 15.8 600 

Brazil 1996 29.4 4.4 33.8 9.3 43.1 15.6 17.2 37.2 24.1 87.0 433 

Colombia 2000 51.7 7.5 59.2 3.0 62.2 20.0 8.6 52.7 9.3 0.0 427 

Dominican Republic 1996 18.0 4.4 22.5 9.9 32.4 32.4 17.4 58.6 17.8 68.6 384 

Guatemala 1998-99 39.2 4.6 43.8 21.3 65.1 16.2 15.4 36.0 3.2 13.7 462 

Haiti 2001 23.7 16.0 39.7 9.2 48.8 15.6 34.5 33.3 1.1 6.0 531 

Peru 2000 67.2 3.9 71.0 5.8 76.8 13.4 7.4 21.3 2.4 24.0 1,025 

u = Unknown (not available) 

1

 Breast milk only 

2

 Exclusive breastfeeding or breast milk and plain water 

3

 Breast milk predominantly, with other non-milk liquids 

4

 Combines full and predominant breastfeeding 

5

 Receive breast milk plus other milks or formula 

6

 Breast milk plus solid or semisolid foods 
132 Appendix A

Table A.3.26 

Breastfeeding status of children age 6–9 months 

Percent distribution of youngest children age 6–9 months living with the mother by breastfeeding status and percentage of children age 6 to 9 

months using a bottle with a nipple, according to age in months, Demographic and Health Surveys, 1994-2001 

Country 

Exclusive 

breastfeeding1

Breastmilk and 

plain 

water 

Fully 

breastfed2

Predominantly 

breastfed3

Predominantly or 

fully 

breastfed4

Received 

milk5

Received 

complementary 

foods6

Breastfed 

and used 

bottle 

Not breastfed 

Not 

breastfed

and used 

bottle 

 Number 

of children 

Sub-Saharan Africa 

Benin 1996 0.0 2.7 2.7 10.0 12.8 1.8 84.8 3.1 0.7 0.0 325 

Burkina Faso 1998-99 1.7 20.5 22.2 26.6 48.8 1.3 49.8 0.6 0.2 0.0 366 

Cameroon 1998 1.2 11.3 12.5 7.5 20.0 5.0 73.0 17.8 2.0 1.8 263 

Central African Rep. 

1994-95 0.0 5.1 5.1 0.8 5.9 0.3 93.4 0.0 0.3 0.0 289 

Chad 1996-97 0.4 16.9 17.3 6.4 23.7 3.9 71.2 2.1 1.1 1.2 506 

Comoros 1996 0.0 1.6 1.6 0.8 2.5 5.7 86.9 18.9 4.9 2.0 122 

Côte d’Ivoire 1994 0.6 25.7 26.4 5.6 32.0 1.3 66.2 0.8 0.6 2.0 425 

Ethiopia 2000 12.8 14.7 27.5 8.1 35.6 21.0 42.4 13.5 1.0 4.9 724 

Eritrea 1995 15.6 17.9 33.5 13.0 46.5 7.9 44.9 4.4 0.6 1.3 290 

Gabon 2000 0.3 3.3 3.6 0.7 4.3 13.5 63.9 25.8 18.3 28.4 259 

Ghana 1998 4.8 12.0 16.8 10.4 27.2 7.3 64.5 22.6 1.0 0.0 232 

Guinea 1999 7.5 36.4 43.9 21.4 65.3 5.3 27.9 7.9 1.5 0.9 328 

Kenya 1998 0.9 1.2 2.1 1.4 3.5 3.3 89.6 23.0 3.6 7.6 378 

Madagascar 1997 2.8 3.1 5.9 4.3 10.3 0.5 88.4 3.0 0.8 3.4 412 

Malawi 2000 2.6 3.1 5.6 0.6 6.2 0.2 93.4 2.3 0.1 0.7 799 

Mali 1995-96 3.1 46.4 49.5 9.1 58.5 8.1 33.0 2.4 0.4 0.2 659 

Mozambique 1997 2.2 9.3 11.5 1.3 12.8 0.8 84.5 0.0 1.9 0.0 458 

Niger 1998 0.2 9.2 9.4 15.5 24.9 3.4 71.5 3.8 0.2 0.0 536 

Tanzania 1999 2.2 5.8 8.0 11.3 19.3 14.0 63.8 10.0 2.8 0.1 205 

Togo 1998 0.3 5.3 5.6 4.0 9.6 1.2 88.6 4.2 0.6 1.2 468 

Uganda 2000-01 6.8 2.1 8.9 6.5 15.4 8.7 74.6 5.4 1.2 1.3 488 

Zambia 1996 0.7 2.8 3.5 1.0 4.5 0.8 93.6 3.6 1.2 2.8 392 

Zimbabwe 1999 0.5 4.0 4.5 2.6 7.1 0.0 90.6 13.1 2.4 2.9 209 

North Africa/West Asia/Europe 

Egypt 2000 16.4 0.4 16.8 4.6 21.3 4.4 64.4 14.5 9.8 57.1 800 

Jordan 1997 0.3 3.3 3.5 3.0 6.5 2.6 63.7 15.5 27.2 103.8 439 

Turkey 1998 0.0 5.0 5.0 3.7 8.7 2.8 54.5 30.3 34.0 76.1 245 

Central Asia 

Kazakhstan 1999 2.3 2.1 4.4 3.1 7.5 3.1 72.7 37.0 16.7 12.3 88 

South/Southeast Asia 

Bangladesh 2000 7.6 11.2 18.8 7.2 25.9 11.9 59.4 20.4 2.8 8.9 352 

Cambodia 2000 1.8 19.4 21.2 0.7 21.9 0.1 71.9 13.4 6.2 24.7 527 

India 1998-99 12.7 23.5 36.2 4.1 40.3 21.8 33.6 15.2 4.3 116.9 3,484 

Nepal 1996 21.4 7.1 28.5 0.6 29.1 7.5 62.5 5.2 0.8 1.5 437 

Latin America and the Caribbean 

Bolivia 1998 9.7 0.7 10.4 3.7 14.1 6.0 70.3 32.8 9.7 43.3 469 

Brazil 1996 8.6 2.1 10.8 4.1 14.9 5.2 31.0 29.0 48.9 120.7 290 

Colombia 2000 31.5 1.2 32.7 0.7 33.5 2.8 33.3 48.6 30.4 0.0 334 

Dominican Rep. 1996 1.8 1.6 3.3 1.7 5.1 7.3 38.5 43.9 49.1 124.9 255 

Guatemala 1998-99 10.6 2.2 12.9 11.7 24.6 3.4 61.2 34.5 10.8 31.4 292 

Haiti 2001 3.2 7.4 10.7 2.5 13.2 7.2 74.1 25.1 5.5 21.4 458 

Peru 2000 9.4 1.1 10.5 3.4 13.9 3.1 75.6 27.8 7.4 47.8 681 

1

 Breast milk only 4 Combines full and predominant breastfeeding 2

 Exclusive breastfeeding or breast milk and plain water 5 Resceive breast milk plus other milks or formula 3

 Breast milk predominantly, with other non-milk liquids 6 Breast milk plus solid or semisolid foods 
Appendix A 133

Table A.3.27 

Median duration and frequency of breastfeeding 

Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding 

among children born in the three years preceding the survey, Demographic and Health Surveys, 

1994-2001 

Country 

Any breastfeeding 

Exclusive 

breastfeeding1

Predominant 

breastdfeeding2

Number of 

children 

Sub-Saharan Africa 

Benin 1996 22.8 0.4 3.2 2,939 

Burkina Faso 1998-99 25.8 0.4 7.0 3,622 

Cameroon 1998 18.1 0.5 3.3 2,469 

Central African Republic 1994-95 20.6 0.4 2.4 2,836 

Chad 1996-97 21.4 0.4 5.0 4,450 

Comoros 1996 20.1 0.4 1.7 1,145 

Côte d’Ivoire 1994 20.3 0.4 4.9 3,989 

Ethiopia 2000 25.5 2.5 5.3 7,165 

Eritrea 1995 22.0 3.3 7.1 2,580 

Gabon 2000 12.1 0.4 0.6 2,482 

Ghana 1998 21.5 0.7 4.8 1,927 

Guinea 1999 22.4 0.4 8.7 3,427 

Kenya 1998 20.9 0.5 1.9 3,464 

Madagascar 1997 20.7 2.2 4.1 3,893 

Malawi 2000 23.3 2.0 2.7 7,758 

Mali 1995-96 21.6 0.5 7.8 6,019 

Mozambique 1997 22.0 0.8 3.9 4,207 

Niger 1998 20.6 0.4 5.3 5,007 

Tanzania 1999 20.9 1.3 4.1 2,029 

Togo 1998 24.4 0.5 2.5 3,978 

Uganda 2000-01 19.9 3.4 4.2 4,681 

Zambia 1996 20.0 0.5 2.6 4,449 

Zimbabwe 1999 19.6 1.3 2.6 2,191 

North Africa/West Asia/Europe 

Egypt 2000 18.4 3.7 4.8 7,026 

Jordan 1997 11.9 0.5 1.9 3,817 

Turkey 1998 12.0 0.4 2.2 2,108 

Yemen 1997 17.8 0.4 0.4 7,706 

Central Asia 

Kazakhstan 1999 14.7 1.7 3.7 827 

Kyrgyz Rep 1997 16.9 0.4 0.4 1,172 

Uzbekistan 1996 17.3 0.4 0.4 1,392 

South/Southeast Asia 

Bangladesh 2000 30.5 1.8 4.4 4,214 

Cambodia 2000 21.2 0.4 4.9 4,657 

India 1998-99 25.4 1.9 5.8 32,393 

Nepal 1996 31.0 4.7 5.4 4,375 

Latin America/Caribbean 

Bolivia 1998 17.5 2.3 3.7 4,106 

Brazil 1996 7.0 1.1 2.0 2,865 

Colombia 2000 12.8 2.6 4.4 2,775 

Dominican Republic 1996 7.6 0.6 0.9 2,654 

Guatemala 1998-99 19.9 0.9 4.8 2,751 

Haiti 2001 17.3 0.7 2.2 3,985 

Peru 2000 20.6 4.0 4.8 7,013 

1

 Breast milk only 

2

 Breast milk predominantly, with other non-milk liquids 
134 Appendix A

Table A.3.28 

Undernutrition by ARI status 

Prevalence of ARI (cough with rapid breathing) with no diarrhea in malnourished children age 4–23 months, Demographic and 

Health Surveys, 1994-2001 

Percentage with ARI Total number of children 

Country

Percentage 

of children 

age 4-23 

months 

with ARI Stunted 

Not 

stunted Wasted

Not 

wasted

Underweight

Not 

underweight Stunted

Not 

stunted Wasted 

Not 

wasted 

Underweight

Not 

underweight

 

 All children 

Sub-Saharan Africa 

Benin 1996 10.7 12.5 10.2 6.5 11.6 9.9 11.1 313 1,061 244 1,130 434 940 1,374 

Burkina Faso 1998-99 9.7 10.3 9.4 12.5 8.8 12.1 8.0 449 1,058 344 1,163 598 909 1,507 

Cameroon 1998 16.1 14.0 17.0 14.1 16.2 14.4 16.6 358 763 86 1,035 282 838 1,121 

Central African Republic 

1994-95 21.0 22.7 20.1 21.7 20.9 21.3 20.9 431 882 124 1,189 380 933 1,312 

Chad 1996-97 8.1 7.8 8.2 7.9 8.1 8.2 7.9 654 1,411 467 1,598 830 1,235 2,065 

Comoros 1996 13.9 11.3 15.4 18.6 13.4 14.7 13.6 203 350 59 494 156 397 553 

Côte d’Ivoire 1994 10.2 10.1 10.3 13.6 9.8 11.5 9.8 433 1,484 210 1,707 484 1,433 1,917 

Ethiopia 2000 14.1 14.8 13.6 12.3 14.5 13.7 14.5 1,528 1,895 563 2,860 1,573 1,850 3,423 

Eritrea 1995 14.4 15.5 13.7 15.9 14.0 14.7 14.1 433 804 249 988 544 694 1,238 

Gabon 2000 11.9 11.2 12.1 (12.3) 11.8 8.0 12.6 257 918 39 1,136 181 994 1,175 

Ghana 1998 12.3 12.0 12.4 14.2 11.9 13.5 11.8 186 793 170 809 281 698 979 

Guinea 1999 13.3 16.2 12.4 9.6 13.9 11.7 13.9 281 924 186 1,019 341 864 1,205 

Kenya 1998 15.1 13.9 15.6 10.6 15.5 14.0 15.4 509 1,132 137 1,503 342 1,298 1,641 

Madagascar 1997 14.6 13.5 15.7 14.4 14.7 14.6 14.7 937 934 179 1,692 811 1,060 1,871 

Malawi 2000 18.7 15.9 20.8 17.3 18.8 17.2 19.3 1,550 2,004 328 3,227 1,060 2,494 3,555 

Mali 1995-96 9.8 8.5 10.3 8.2 10.5 9.0 10.4 712 1,944 765 1,891 1,098 1,559 2,656 

Mozambique 1997 8.4 7.7 8.7 4.2 8.9 8.6 8.3 576 1,156 173 1,559 477 1,255 1,732 

Niger 1998 5.7 5.3 5.9 4.7 6.0 4.7 6.7 976 1,377 619 1,734 1,260 1,093 2,353 

Tanzania 1999 12.0 11.5 12.4 19.7 11.4 12.8 11.7 376 585 72 889 300 660 960 

Togo 1998 12.8 10.7 13.3 10.5 13.2 12.0 13.1 405 1,481 299 1,587 515 1,371 1,886 

Uganda 2000-01 17.0 18.0 16.4 16.7 17.0 18.8 16.3 815 1,411 152 2,074 625 1,601 2,226 

Zambia 1996 7.9 8.1 7.8 5.9 8.0 8.2 7.7 783 1,312 160 1,934 592 1,502 2,094 

Zimbabwe 1999 13.9 11.0 15.1 22.2 13.1 15.8 13.6 260 626 76 811 127 760 886 

North Africa/West 

 Asia/Europe 

Egypt 2000 8.2 10.0 7.7 9.1 8.2 11.7 8.0 733 2,730 114 3,349 195 3,268 3,463 

Jordan 1997 7.4 8.0 7.4 (16.4) 7.2 12.9 7.1 156 1,746 44 1,858 104 1,797 1,902 

Yemen 1997 12.3 12.2 12.4 11.0 12.6 12.5 12.2 1,348 1,598 546 2,401 1,354 1,593 2,946 

Central Asia 

Kazakhstan 1999 1.3 * 0.7 * 1.3 * 1.4 24 175 4 195 12 187 199 

Kyrgyz Republic 1997 3.5 3.6 3.5 3.8 3.5 1.3 3.9 150 417 30 537 83 484 567 

Uzbekistan 1996 1.2 0.7 1.5 4.6 0.8 0.4 1.5 205 372 71 506 122 454 576 

South/Southeast Asia 

Bangladesh 2000 19.0 21.2 17.5 17.7 19.2 20.3 17.7 758 1,079 272 1,565 899 938 1,837 

Cambodia 2000 12.8 10.2 14.1 8.0 13.8 10.5 14.2 344 680 179 844 381 643 1,024 

India 1998-99 14.0 13.8 14.1 14.4 13.9 14.4 13.7 6,176 7,637 2,512 11,300 6,507 7,306 13,812 

Nepal 1996 20.2 17.3 22.6 19.2 20.4 18.7 21.6 997 1,198 320 1,875 1,040 1,155 2,195 

Latin America/Caribbean 

Bolivia 1998 17.3 17.5 17.3 (23.2) 17.2 21.8 16.9 493 1,547 43 1,997 199 1,841 2,040 

Brazil 1996 19.2 20.1 19.0 (13.8) 19.3 17.8 19.2 160 1,175 45 1,290 75 1,260 1,335 

Dominican Republic 

1996 18.2 19.6 18.0 (20.1) 18.2 25.7 17.7 141 1,074 26 1,189 84 1,131 1,215 

Guatemala 1998-99 15.3 12.2 17.6 20.7 15.1 14.6 15.6 510 714 55 1,170 320 904 1,224 

Haiti 2001 25.1 22.9 25.7 22.6 25.3 25.4 25.1 376 1,597 140 1,833 319 1,654 1,973 

Peru 2000 15.2 13.7 15.7 (15.2) 15.2 14.4 15.3 725 2,717 48 3,394 276 3,166 3,442 

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases 

and has been suppressed. 
Appendix A 135

Table A.3.29 

Undernutrition by diarrhea status

Prevalence of diarrhea in malnourished children age 4-23 months, Demographic and Health Survey 1994-2001

Percentage with diarrhea Total number of children

Country

Percentage 

of children 

age 4-23 

months 

with 

diarrhea Stunted

Not 

stunted Wasted

Not

wasted

Underweight 

Not 

underweight StuntedNot 

stunted Wasted 

Not 

wasted

Underweight

Not 

underweight

All 

Children

Sub-Saharan Africa 

Benin 1996 30.6 27.0 31.7 34.9 29.7 31.7 30.1 313 1,061 244 1,130 434 940 1,374 

Burkina Faso 1998-99 29.4 31.5 28.6 35.1 27.8 33.9 26.5 449 1,058 344 1,163 598 909 1,507 

Cameroon 1998 24.9 31.2 21.9 37.6 23.8 33.1 22.1 358 763 86 1,035 282 838 1,121 

Central African Rep 

 1994-95 27.8 27.0 28.2 33.9 27.2 33.5 25.4 431 882 124 1,189 380 933 1,312 

Chad 1996-97 28.4 26.1 29.5 34.2 26.7 30.4 27.1 654 1,411 467 1,598 830 1,235 2,065 

Comoros 1996 27.7 27.6 27.7 28.8 27.5 28.8 27.2 203 350 59 494 156 397 553 

Côte d’Ivoire 1994 25.2 26.1 25.0 32.5 24.4 28.1 24.3 433 1,484 210 1,707 484 1,433 1,917 

Ethiopia 2000 36.7 38.3 35.4 48.0 34.5 43.0 31.4 1,528 1,895 563 2,860 1,573 1,850 3,423 

Eritrea 1995 28.2 28.6 27.9 28.2 28.1 32.0 25.1 433 804 249 988 544 694 1,238 

Gabon 2000 27.8 32.6 26.4 (44.0) 27.2 35.4 26.4 257 918 39 1,136 181 994 1,175 

Ghana 1998 25.7 31.7 24.3 27.1 25.4 32.0 23.2 186 793 170 809 281 698 979 

Guinea 1999 30.1 33.9 28.9 43.0 27.7 40.1 26.1 281 924 186 1,019 341 864 1,205 

Kenya 1998 22.8 26.3 21.3 26.7 22.5 31.1 20.6 509 1,132 137 1,503 342 1,298 1,641 

Madagascar 1997 32.8 35.8 29.9 35.4 32.6 36.8 29.8 937 934 179 1,692 811 1,060 1,871 

Malawi 2001 32.5 34.3 31.1 35.9 32.1 37.6 30.3 1,550 2,004 328 3,227 1,060 2,494 3,555 

Mali 1995-96 28.9 36.3 26.2 37.4 25.5 36.1 23.9 712 1,944 765 1,891 1,098 1,559 2,656 

Mozambique 1997 26.4 26.3 26.5 44.6 24.4 33.2 23.9 576 1,156 173 1,559 477 1,255 1,732 

Niger 1998 44.1 45.7 43.0 52.9 41.0 48.6 38.9 976 1,377 619 1,734 1,260 1,093 2,353 

Tanzania 1999 23.4 24.4 22.8 18.4 23.8 27.2 21.7 376 585 72 889 300 660 960 

Togo 1998 35.8 44.2 33.5 39.2 35.1 42.6 33.2 405 1,481 299 1,587 515 1,371 1,886 

Uganda 2000-01 32.5 34.9 31.1 33.6 32.4 37.1 30.7 815 1,411 152 2,074 625 1,601 2,226 

Zambia 1996 39.2 38.2 39.7 42.9 38.8 43.6 37.4 783 1,312 160 1,934 592 1,502 2,094 

Zimbabwe 1999 25.6 26.9 25.1 21.9 26.0 33.8 24.3 260 626 76 811 127 760 886 

North Africa/West 

Asia/Europe 

Egypt 2000 11.6 11.5 11.6 11.0 11.6 14.0 11.5 733 2,730 114 3,349 195 3,268 3,463 

Jordan 1997 32.0 34.3 31.8 (27.6) 32.1 35.8 31.8 156 1,746 44 1,858 104 1,797 1,902 

Turkey 1998 43.6 61.1 41.4 (45.5) 43.6 56.5 42.4 108 835 29 914 82 861 943 

Yemen 1997 37.7 39.9 35.9 44.4 36.2 41.7 34.4 1,348 1,598 546 2,401 1,354 1,593 2,946 

Central Asia 

Kazakhstan 1999 22.1 * 20.8 * 21.2 * 19.9 24 175 4 195 12 187 199 

Kyrgyz Rep 1997 23.7 28.5 22.0 (16.2) 24.1 28.5 22.9 150 417 30 537 83 484 567 

Uzbekistan 1996 7.2 6.3 7.7 7.9 7.1 6.0 7.5 205 372 71 506 122 454 576 

South/Southeast Asia 

Bangladesh 2000 10.7 11.5 10.2 13.6 10.2 11.9 9.6 758 1,079 272 1,565 899 938 1,837 

Cambodia 2000 29.3 33.6 27.1 32.0 28.7 34.6 26.2 344 680 179 844 381 643 1,024 

India 2001 23.0 24.1 22.1 26.3 22.2 25.6 20.7 6,176 7,637 2,512 11,300 6,507 7,306 13,812 

Nepal 1996 34.4 37.4 31.9 43.2 32.9 38.6 30.6 997 1,198 320 1,875 1,040 1,155 2,195 

Latin America/Caribbean 

Bolivia 1998 29.4 34.3 27.8 (26.3) 29.5 38.3 28.4 493 1,547 43 1,997 199 1,841 2,040 

Brazil 1996 19.6 21.2 19.4 (24.4) 19.4 26.3 19.2 160 1,175 45 1,290 75 1,260 1,335 

Colombia 2000 21.2 24.7 20.6 * 21.1 35.9 20.1 209 1,233 15 1,427 100 1,342 1,442 

Dominican Rep 1996 25.6 29.3 25.1 (34.6) 25.4 32.3 25.1 141 1,074 26 1,189 84 1,131 1,215 

Guatemala 1999 23.8 26.6 21.8 29.1 23.6 26.5 22.8 510 714 55 1,170 320 904 1,224 

Haiti 2001 42.5 49.0 41.0 48.5 42.0 47.3 41.6 376 1,597 140 1,833 319 1,654 1,973 

Peru 2000 24.2 30.0 22.6 (23.6) 24.2 32.3 23.5 725 2,717 48 3,394 276 3,166 3,442 

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has 

been suppressed. 


DHS Comparative Reports Series 

1. Westoff, Charles F. 2001. Unmet Need at the End of the Century.

2. Westoff, Charles F. and Akinrinola Bankole. 2002. Reproductive Preferences in Developing 

Countries at the Turn of the Century.

3. Rutstein, Shea O. 2002. Fertility Levels, Trends, and Differentials 1995-1999.

4. Mahy, Mary. 2003. Childhood Mortality in the Developing World: A Review of Evidence from 

the Demographic and Health Surveys.

5. Westoff, Charles F. 2003. Trends in Marriage and Early Childbearing in Developing Countries.

6. Rutstein, Shea O. and Kiersten Johnson. 2004. The DHS Wealth Index.

7. Yoder, P. Stanley, Noureddine Abderrahim, and Arlinda Zhuzhuni. 2004. Female Genital Cutting 

in the Demographic and Health Surveys: A Critical and Comparative Analysis.

8. Stallings, Rebecca. 2004. Child Morbidity and Treatment Patterns.

9. Rutstein, Shea O. and Iqbal H. Shah. 2004. Infecundity, Infertility, and Childlessness in 

Developing Countries.

10. Mukuria, Altrena, Jeanne Cushing, and Jasbir Sangha. 2005. Nutritional Status of Children: Results 

from the Demographic and Health Surveys, 1994–2001. 

11. Mukuria, Altrena, Casey Aboulafia, and Albert Themme. 2005. The Context of Women’s Health: 

Results from the Demographic and Health Surveys, 1994-2001.