Sociodemographic factors associated with concurrent stunting and wasting among children experiencing extreme poverty in the Philippines: A cross-sectional study.

Background: The coexistence of stunting and wasting in a child increases the risk of mortality and requires more intensive treatment and care. However, there is limited research on the burden of concurrent stunting and wasting among children and the socioeconomic factors that are correlated with having both conditions. Aim: To understand the prevalence and sociodemographic correlates of stunting, wasting, and concurrent stunting and wasting among a sample of children ages 6-144 months experiencing poverty in the Philippines. Methods: Cross-sectional data were drawn from nutrition screening and sociodemographic surveys conducted by International Care Ministries in 2018-2019. Descriptive statistics were calculated to determine the prevalence of stunting, wasting, and concurrent stunting and wasting. Multilevel logistic regression modelling was conducted to understand the sociodemographic factors that were associated with stunting and wasting. Results: Among the 3005 children in this sample, the prevalence of stunting, wasting, and concurrent stunting and wasting was 49.9%, 9.3%, and 4.6%, respectively. Children experiencing concurrent stunting and wasting lived in households in lower wealth index quintiles, had a household head with fewer years of education, and were more likely to experience food insecurity compared to children who were not stunted or wasted. The education of the household head, the number of household members, and the wealth of the household were correlated with stunting across age groups, while food insecurity was correlated with wasting among younger children. Conclusion: The presence of concurrent stunting and wasting among children provides the impetus to integrate both conditions into nutrition monitoring, prevention, and treatment interventions.

Examining the Association Between Household Enrollment in the Pantawid Pamilyang Pilipino Program (4Ps) and Wasting and Stunting Status Among Children Experiencing Poverty in the Philippines: A Cross-Sectional Study.

This study assessed whether enrollment in a national conditional cash transfer program was associated with wasting and stunting among children experiencing extreme poverty in the Philippines. Data were drawn from cross-sectional surveys collected from 10 regional areas in the Philippines between April 2018 and May 2019. A total of 2945 children aged between six months and 12 years comprised the analytical sample. Multilevel logistic regression was conducted to estimate the association between enrollment in Pantawid Pamilyang Pilipino Program (4Ps) and stunting and wasting, controlling for sociodemographic factors and clustering by region. There was no meaningful association between household enrollment in 4Ps and the wasting status of children, but enrollment in 4Ps was associated with lower odds of stunting and differed by geography type. Findings suggest that the current design of 4Ps may not address sudden shocks that contribute to wasting, but may address the underlying socioeconomic risk factors associated with stunting.

Current dichotomous metrics obscure trends in severe and extreme child growth failure.

Historically, the prevalence of child growth failure (CGF) has been tracked dichotomously as the proportion of children more than 2 SDs below the median of the World Health Organization growth standards. However, this conventional "thresholding" approach fails to recognize child growth as a spectrum and obscures trends in populations with the highest rates of CGF. Our analysis presents the first ever estimates of entire distributions of HAZ, WHZ, and WAZ for each of 204 countries and territories from 1990 to 2020 for children less than 5 years old by age group and sex. This approach reflects the continuous nature of CGF, allows us to more comprehensively assess shrinking or widening disparities over time, and reveals otherwise hidden trends that disproportionately affect the most vulnerable populations.