Comparison of a possession score and a poverty index in predicting anaemia and undernutrition in pre-school children and women of reproductive age in rural and urban Côte d'Ivoire

Public Health Nutr. 2012 Sep;15(9):1620-9. doi: 10.1017/S1368980012002819. Epub 2012 Jun 12.


Objective: To determine whether a possession score or a poverty index best predicts undernutrition and anaemia in women of reproductive age (15-49 years; WRA) and children aged 6-59 months living in Côte d'Ivoire.

Design: Anthropometric measurements were converted to Z-scores to assess stunting, wasting and underweight in children, and converted to BMI in WRA. A venous blood sample was drawn, and Hb concentration and Plasmodium spp. infection were determined. A possession score was generated with categories of zero to four possessions. A five-point (quintile) poverty index using household assets was created using principal component analysis. These socio-economic measures were compared for their ability to predict anaemia and malnutrition.

Setting: Data were from a nationally representative survey conducted in Côte d'Ivoire in 2007.

Subjects: A sample of 768 WRA and 717 children aged 6-59 months was analysed.

Results: Overall, 74·9 % of children and 50·2 % of WRA were anaemic; 39·5 % of the children were stunted, 28·1 % underweight and 12·8 % wasted, while 7·4 % of WRA had BMI < 18·5 kg/m2. In general, there were more stunted and underweight children and thin WRA in rural areas. The poverty index showed a stronger relationship with nutritional status than the possession score; mean Hb difference between the poorest and wealthiest quintiles in children and WRA was 8·2 g/l and 6·5 g/l, respectively (13·9 % and 19·8 % difference in anaemia, respectively; P < 0·001), and Z-scores and BMI were significantly better in the wealthiest quintile (P < 0·001).

Conclusions: The poverty index was generally a better predictor of undernutrition in WRA and pre-school children than the possession score.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia / complications
  • Anemia / epidemiology*
  • Body Height
  • Body Mass Index
  • Child, Preschool
  • Cluster Analysis
  • Cote d'Ivoire / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hemoglobins / analysis
  • Humans
  • Infant
  • Logistic Models
  • Malaria / complications
  • Malaria / epidemiology
  • Malnutrition / complications
  • Malnutrition / epidemiology*
  • Middle Aged
  • Nutrition Surveys
  • Nutritional Physiological Phenomena
  • Nutritional Status
  • Plasmodium / isolation & purification
  • Poverty*
  • Prevalence
  • Rural Population / statistics & numerical data
  • Socioeconomic Factors
  • Thinness / epidemiology
  • Urban Population / statistics & numerical data
  • Young Adult


  • Hemoglobins