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Trends in Nutritional Status of Adult Women in Sub-Saharan Africa

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Trends in Nutritional Status of Adult Women in Sub-Saharan Africa DHS COMPARATIVE REPORTS 27 DHS COMPARATIVE TRENDS IN NUTRITIONAL STATUS OF ADULT WOMEN IN SUB-SAHARAN AFRICA TRENDS IN NUTRITIONAL STATUS OF ADULT WOMEN IN SUB-SAHARAN OF ADULT AFRICA TRENDS IN NUTRITIONAL STATUS DHS COMPARATIVE REPORTS 27 JULY 2011 This publication was produced for review by the United States Agency for International Development (USAID). The report was prepared by Michel Garenne, Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, Paris, France. MEASURE DHS assists countries worldwide in the collection and use of data to monitor and evaluate population, health, and nutrition programs. Additional information about the MEASURE DHS project can be obtained by contacting ICF Macro, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705 (telephone: 301-572-0200; fax: 301-572-0999; e-mail: [email protected]; internet: www.measuredhs.com). The main objectives of the MEASURE DHS project are: • to provide decisionmakers in survey countries with information useful for informed policy choices; • to expand the international population and health database; • to advance survey methodology; and • to develop in participating countries the skills and resources necessary to conduct high-quality demographic and health surveys. DHS Comparative Reports No. 27 Trends in Nutritional Status of Adult Women in Sub-Saharan Africa Michel Garenne ICF Macro Calverton, Maryland, USA July 2011 Corresponding author: Michel Garenne, Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, 25 rue du Docteur Roux, 75724 Paris, France; Phone: +33-1-40-61-39-58; Email: [email protected] Editor: Bryant Robey Document Production: Christopher Gramer and Yuan Cheng This study was carried out with support provided by the United States Agency for International Development (USAID) through the MEASURE DHS project (#GPO-C-00-08-00008-00). The views expressed are those of the authors and do not necessarily reflect the views of USAID or the United States Government. Recommended citation: Garenne, Michel. 2011. Trends in Nutritional Status of Adult Women in Sub-Saharan Africa. DHS Comparative Reports No. 27. Calverton, Maryland, USA: ICF Macro. Table of Contents Tables and Figures .................................................................................................................................... vii Preface ......................................................................................................................................................... xi Acknowledgements .................................................................................................................................. xiii Executive Summary .................................................................................................................................. xv Introduction ................................................................................................................................................. 1 Background ...................................................................................................................................... 1 Study objectives ............................................................................................................................... 2 Data and Methods ....................................................................................................................................... 3 Data .................................................................................................................................................. 3 DHS surveys .............................................................................................................................. 3 Sampling biases ......................................................................................................................... 3 Precision of estimates ................................................................................................................ 3 Digit preference ......................................................................................................................... 4 Reference sets ............................................................................................................................ 5 Methods ........................................................................................................................................... 5 Country analysis ........................................................................................................................ 5 Trends ........................................................................................................................................ 6 Coverage .................................................................................................................................... 6 Body Mass Index of adult women and body shape ................................................................... 6 Merging countries ...................................................................................................................... 6 Differential analysis .................................................................................................................. 6 Other sources of data ................................................................................................................. 7 Results .......................................................................................................................................................... 9 Part I: Overview on Anthropometric Indicators .............................................................................. 9 1.1 Typology of body shapes ................................................................................................. 9 1.2 Age pattern of height of adult women ........................................................................... 11 1.3 Age pattern of BMI by group of body shape ................................................................. 11 1.4 Average anthropometric indicators of adult women (raw data) .................................... 13 1.5 Distribution of heights in African populations .............................................................. 14 1.6 Distribution of BMI in African populations .................................................................. 15 1.7 Changes from survey to survey in the same country ..................................................... 15 Height ............................................................................................................................ 16 Weight and BMI ............................................................................................................ 16 1.8 Relationship of anthropometric indicators with wealth ................................................. 17 iii Part II: Trends and Differentials in Height .................................................................................... 18 2.1 Trends in height of adult women ................................................................................... 18 2.2 Trends in height: differential analysis ........................................................................... 18 2.3 Multivariate analysis on height of adult women ............................................................ 20 2.4 Height and income per capita ........................................................................................ 21 2.5 Height and income, by body shape ................................................................................ 21 2.6 Height and income at country level ............................................................................... 22 2.7 Recent trends (cohorts 1982-1992) ................................................................................ 23 Part III: Trends in Weight and Body Mass Index .......................................................................... 24 3.1 Underlying age patterns of BMI (net effect) ................................................................. 24 3.2 Interpretation of BMI trend figures ............................................................................... 25 A. Madagascar: no age effect, no cohort effect ............................................................. 25 B. Rwanda: no age effect, increasing cohort effect ....................................................... 25 C. Senegal: changing age effect, no cohort effect ......................................................... 26 3.3 Trends in standardized BMI .......................................................................................... 26 3.4 Trends in standardized BMI by population group ......................................................... 27 3.5 Multivariate analysis of BMI (raw data) ....................................................................... 28 Trends in BMI (net effect) ............................................................................................. 28 3.6 Correlation with economic development ....................................................................... 29 3.7 Average BMI and prevalence of thinness and obesity .................................................. 29 Discussion .................................................................................................................................................. 31 References .................................................................................................................................................. 33 Appendix
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