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Evaluation report

1999 Iran: The Nutritional Status of Children



Executive summary

Background

During the last twenty years, the public health departments of l.R. Iran's medical science universities have provided remarkable services for improving the level of wellbeing in society. For the first time in 1991, the prevalence of underweight (measurement of weight-for-age) children nationally was determined using the percentile method in both urban and rural areas. In 1995, anthropometric indices were calculated nationally for children using the Z-score method. With the goal of determining the achievement rate of objectives set for the mid-decade, this study presented further information on the national anthropometric indices for boys and girls in both urban and rural areas. The decision was taken in 1998 to look at anthropometric indices using the same method as in the 1995 study, but this time at provincial level and with greater variety.

Purpose / Objective

- Determine anthropometric indices by age and gender, in rural and urban children under six years old at provincial and national level in 1998
- Determine the awareness and performance of the mothers of children under six in the areas of growth monitoring and their child(ren)'s nutrition in urban and rural areas at provincial and national level in 1998
- Determine the pattern of nutrition (food frequency) by age in urban and rural children under the age of three at provincial and national level in 1998

Methodology

Sampling was carried out by cluster, with twelve children under the age of six in each cluster. 50 urban and 50 rural areas in each province were selected. Data were collected through direct interview and the completion of a questionnaire to determine the mother's level of awareness. Height, weight and age measurements of the children were taken.

Key Findings and Conclusions

5% of children under five (nearly 310,000) suffer from moderate to severe wasting. Within well-fed reference populations, about 2.3% of the community suffer from moderate to severe wasting caused by constitutional traits or other factors unrelated to nutrition. The prevalence of wasting is higher in southern than in northern provinces. Wasting is also observed with greater frequency in the urban areas of provinces where there are urban areas with a high population density. At the national level, the prevalence of wasting is similar in boys and girls, but differences are observed at the provincial level.

15% of children under five (one in every seven children) in I. R. Iran suffer from moderate to severe stunting. 2.3% of children in this age group probably owe their stunting to constitutional traits or other factors unrelated to nutrition. The prevalence of stunting is higher in eastern than in central, western, and northern provinces. The prevalence of stunting is significantly higher (two times) in rural areas than in urban ones. There is no significant difference between boys and girls in the prevalence of stunting.

The weight of nearly 11% of children under five (one in every nine children) is lower than expected for their age. Underweight children are significantly more prevalent in rural than in urban regions at 13.7% vs 9.6%. Although underweight-ness appears to be more prevalent among boys 11.9% than girls 9.7%, the difference is not statistically significant.

Comparison of this study to past studies shows that the nutritional status of children has generally improved during a seven-year period. However, a significant difference persists between the prevalence of underweight children in urban and rural areas, and the extent of malnutrition still constitutes a major problem. Furthermore, the proportion of children whose weight is regularly measured and/or registered on growth charts was shown to be low.

A natural consequence of a period of transition is that society simultaneously confronts aspects of dietary insufficiency (such as underweight, wasting and stunting) and dietary excess (such as overweight). This explains why climatic variation, differences in the regions' levels of development and variation in cultural and social characteristics lead to both nutritional characteristics being observed: dietary insufficiency on one hand and dietary excess along with poor eating habits on the other. It is necessary to understand this problem and adopt a suitable response towards it.

Recommendations

The expansion in health care networks presents a suitable basis for the provision of services that have not so far been employed adequately in the battle against malnutrition. For a logical approach to the problem, a co-ordinated effort by various sectors in development and social welfare fields is required.

The goal of nutrition programs should be the prevention rather than the treatment of underweight children. Instead of relying solely on weight measurements at each visit, both the weight and height of the child should be measured at each visit and attention should focus on the gain in height and weight. Measures based solely on weight for age measurements are initiated to treat malnutrition only when malnutrition has already occurred.

NOTE: Because of the many graphs in the report, it could not be attached. Only select sections are given below. For the full report, please contact Lourdes SanAgustin at lsanagustin@unicef.org.



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Report information

Date:
1999

Region:
MENA

Country:
Iran

Type:
Survey

Theme:
Health - Nutrition

Partners:
Ministry of Health and Medical Education

PIDB:

Follow Up:

Language:
English

Sequence Number:
1999/002

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