Trends in the nutritional status of Salvadorian children: the post-war experience

Bull World Health Organ. 1996;74(4):369-74.

Abstract

This article examines trends in the nutritional status of children in EI Salvador between 1988 and 1993 (before and after the signing of a peace accord that ended the civil war.) The data derive from two national surveys, each of which included measurements of the height and weight of children aged 3-59 months. The prevalence of low weight-for-age (< -2 SD) dropped from 15% in 1988 to 10.5% in 1993. The prevalence of low weight-for-height (< -2 SD) was minimal in both surveys: falling from 3.9% to 2.9%. The prevalence of low height-for-age (< -2 SD) fell from 28.1% to 22%. These declines in malnutrition indicators resulted from an upward shift in the distributions of weight and height of children, not from thinner lower tails of the distributions. The quality of anthropometric data appears to be high for both surveys: < 1% of surveyed children had heights or weights outside the expected range. This analysis demonstrates the value of repeated surveys of nutritional status.

PIP: This study uses anthropometric measurement data from a family health survey in 1993 and a general nutritional survey in 1988 in El Salvador in order to determine whether child health improved after the signing of the peace accord. Data were weighted to account for lack of access to some census sectors engaged in war activity in 1988. Low weight-for-age is the measure of general malnutrition. Low weight-for-height indicates acute malnutrition and wasting. Low height-for-age means chronic malnutrition or stunting. Socioeconomic factors are included in the analysis. Greater analytical attention is directed to chronic malnutrition, due to its greater prevalence. Findings indicate that low weight-for-age rates declined from 15% in 1988 to 10.5% in 1993. Low weight-for-height rates remained low and without any statistically significant change. Low height-for-age rates declined from 28.1% in 1988 to 22% in 1993. Z-score distributions for weight-for-age and height-for-age shifted closer to the reference population over time. Weight-for-height Z-scores were close to the reference group in both years. Over the 5-year period, 22% of the gap between the Salvadorian population and the reference population closed for the mean weight-for-age Z-scores. 16% of the gap closed for the height-for-age Z-scores. The standard deviation of the Z-scores remained identical during 1988-93, which suggests that improvement was unrelated to thinner, lower tails in the distributions. The prevalence of chronic malnutrition increased with age and peaked in the third year of life. Rates were highest among children of rural mothers with limited education and lower socioeconomic status in both years. Improvements in socioeconomic status accounted for almost 40% of the decline in chronic malnutrition.

MeSH terms

  • Adult
  • Anthropometry
  • Child
  • Child Nutrition Disorders / epidemiology
  • Child Nutritional Physiological Phenomena*
  • Child, Preschool
  • Demography
  • El Salvador / epidemiology
  • Female
  • Humans
  • Infant
  • Male
  • Nutrition Surveys*
  • Nutritional Status*
  • Socioeconomic Factors
  • Warfare