Persistent undernutrition amongst preschool children a decade after democracy

Abstract

An investigation was undertaken in 2004 by the KwaZulu-Natal Income Dynamics Study (KIDS) which provided an opportunity to assess the nutritional status of preschool children (6 months to less than 7 years) a decade after democracy. During the past decade, Government has initiated a range of nutritional programmes to improve children's health and nutritional status. The KIDS survey investigated over 1200 households selected via census enumerator areas throughout the province. Of the 1146 children, 574 (50.1%) were boys and 572 (49.9%) girls, with a mean age of 47.0 (SD 22.6) months for boys and 44.8 (SD 22.2) months for girls. There were statistically significant gender differences for height with boys taller than girls (p=0.002). Mean weight of boys and girls was similar (p=0.87), as was BMI (p=0.17). Overall, 1.6% of children were wasted, 7.5% were underweight and 19.8% were stunted; boys were significantly more wasted than girls (p=0.007) and more underweight (p=0.002), but not stunted (p=0.2). Chi-square tests of trend over age group found a significant decrease in wasting from 1-6 years of age (p=0.03), but not for underweight (p=0.75). There was a significant decrease in overweight (p<0.0005) and in stunting (p=0.006) from 1-6 years. The persistence of an unacceptably high prevalence of under-nutrition constitutes a public health problem amongst KwaZulu-Natal children. The key finding of this study was that the prevalence of stunting among preschool children shows minimal change when compared with the 1994 SAVACG study: wasting of 0.79% (1994) vs 1.6% (2004), overweight of 4.2% (1994) vs 7.5% (2004) and stunting of 15.6% (1994) vs 19.6% (2004). In addition to nutritional programmes, other multi-factorial interventions targeting factors such as poverty, HIV/AIDS, and concomitant infections, as reflected in the UNICEF conceptual framework, are required to address persistent stunting among young children.