Highlands Province (Temple, Mapira et al. 2004). <mark>Semba et al. (2008) and Gibson (1999) showed that improving mothers’ education could significantly reduce child malnutrition in Indonesia, Bangladesh and Papua New Guinea. Sharp (1980) argued that malaria is a significant contributing factor to children’s stunting status in Papua New Guinea’s Highlands Region and</mark> the effect is most marked in children under two years of ag <mark>e. However, in general, the incidence of malaria is lower in highland than lowland areas (Maraga, Sie et al. 2010). Bauze et al. (2012) showed the substantial within-province heterogeneity of under-five mortality and suggests that under-five mortality needs to be addressed at subnational levels. Another study (Wand, Lote et al. 2012) also confirmed the impact of geographical location on the risk factors, which must be recognized as it affects both epidemiology and intervention coverage. Both Angeles (1993) and Gibson (1991) highlighted the importance of the supplement zinc on children’s stunting status through case studies in Indonesia and Papua New Guinea. They argued that lack of zinc may result in r</mark> etarded intrauterine growth.

The objective of this paper is to use the latest national representative survey, PNG Household Income and Expenditure Survey (HIES) 2009-2010, to further shed light on determinants of undernutrition in PNG to guide nutrition-related policies. Due to data limitation, this paper cannot establish the causal links between various factors and nutrition outcomes, nor answer why general economic development has not improved the nutrition outcomes in PNG. Rather, it analyzes the association between the demographic, socioeconomic, environmental and health-related factors on nutritional status for children under 5. Independent of the weak linkage of economic development and child undernutrition at the macro level, the household level analysis shows family wealth is a significant factor associated with the stunting rate. In addition, quality of food (for example, intake of protein) and the history of incidence of malaria are highly correlated with the likelihood of stunting.

The policy recommendations are based on empirical findings, syntheses from broader international literature and local consultations.

# **2. Data and Methods**

The analysis in this paper uses the data from the 2009-2010 Papua New Guinea Household Income and Expenditure Survey (2009-2010 PNG HIES). The 2009-2010 HIES was the first comprehensive and nationally representative survey of the socioeconomic status of PNG households since the 1996 Household Survey of PNG conducted by Unisearch from the University of Papua New Guinea (UPNG) and the Institute of National Affairs (INA).

The 2009-2010 PNG HIES contains the final cross-section sample of 4,191 households. The sample of households was selected from a nationally representative sample frame. A comprehensive set of multi-topic questionnaires was designed to elicit information on key topics such as family demography, education, health, employment, and consumption. The survey is population based and contains records on height, weight, date of birth for children under age 5 allowing a more in-depth analysis on children’s malnutrition. The final sample contains 3,000 children under 5 years old. The data are nationally representative at the regional level.

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