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Issue 24 | December 13, 2018

New Prevalence Thresholds for Stunting, Wasting and Overweight in Children

©UNICEF/UN040335/Thuentap
Dear colleagues,

Did you know that we have new prevalence thresholds for what is considered very low, low, medium, high, and very high stunting, wasting and overweight in children under five years of age? 

In this issue of UNICEF Working to Improve Nutrition at Scale, we share an important paper by WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM), who revised the stunting and wasting thresholds using updated data, and developed prevalence thresholds for overweight.

Table 1 from the paper summarizes the new thresholds: 
The revised thresholds are recommended to replace those in current use. WHO and UNICEF have started using them in the annual Joint Malnutrition Estimates. Previously, stunting prevalence of 30-39% was labelled as high. With the new thresholds, 20-30% is high and ≥30% is very high, increasing the number of countries classified as having very high stunting levels. Based on data from 134 countries, the old thresholds would have classified 15 countries as having very high stunting levels, in comparison to 43 countries using the revised prevalence threshold classifications.

As prevalence thresholds are important to communicate the level of severity of malnutrition and to monitor overall progress, it is important for the nutrition community to take note of these revised prevalence thresholds. Stakeholders should evaluate and update their advocacy and communication tools to highlight priority countries for action and trigger advocacy and actions aimed at achieving low or very low levels of malnutrition. 
Read and share!
 
Víctor M. Aguayo, PhD, MPH 
Associate Director, Programme Division
Chief, Nutrition Programme | UNICEF New York

Mark Hereward, PhD
Associate Director, Division of Data, Research and Policy
Chief, Data & Analytics | UNICEF New York
Stunting levels based on previous threshold classifications, 15 countries were categorized with 'very high' stunting levels.
Stunting levels based on current revised threshold classifications, 43 countries now categorized with 'very high' stunting levels.
Why did it have to change?
The prevalence ranges are used to monitor the nutritional status of children under five years of age, helping prioritize resources and plan relevant nutrition programmes. The review was prompted by key developments:
  • The WHO child growth standards in 2006 changed survey estimates compared to the previously used international growth reference;
  • The labels used to refer to the prevalence categories across stunting, wasting and overweight had to be harmonized;
  • Finally, there was a need to develop prevalence ranges for overweight.
UNICEF: Working to Improve Nutrition at Scale is a knowledge dissemination tool intended to share UNICEF’s work on Maternal and Child Nutrition with staff and partners around the world. To include UNICEF colleagues in this distribution list please send an email to nutrition@unicef.org.
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