… but still a public health issue as per the WHO classification

Health: About 21 percent of the Bhutanese children below five years were stunted while 4.3 percent were wasting away and nine percent underweight.

These are the key findings on the prevalence of child under nutrition of the National Nutrition Survey (NNS) 2015 launched yesterday.

Although the findings indicate a significant drop, it is still a health concern. In 2010, 33.5 percent of the children under five were stunted and 12.7 percent underweight while 5.9 percent were wasting away according to the Bhutan Multiple Indicator Survey.


The survey team attributed the drop to improved breastfeeding, ante-natal care visits, diet and food security besides improved hygiene and sanitation.

Health ministry’s senior programme officer of nutrition programme Laigden Dzed said that sanitation is important for nutrition as all types of diseases occur due to poor sanitation.

As per the World Health Organization (WHO) classification, the three indicators of under nutrition of stunting, wasting and underweight is of low or moderate public health significance. WHO’s average cut-off to be listed as a moderate public health problem for stunting, underweight and wasting is 20, 10 and five percent.

Through this classification, the study indicates a higher prevalence of stunting, wasting and underweight in the eastern region and rural areas when compared with western and central region and  in urban areas.

Stunting (height for age) is a growth deficiency associated with chronic insufficient dietary intake, recurrent infections and poor feeding practices over a long period of time. Wasting (weight for height) occurs as a result of recent nutrition deficiencies affected by seasonal shifts associated with food availability, hygiene, sanitation or disease prevalence. Underweight reflects a child’s total body mass.

The NNS 2015 is the second nutrition survey with updates on nutritional status, anemia, infant and young child feeding and WASH indicators. The survey was conducted with support from UNICEF to track progress of nutrition indicators particularly of malnutrition and anemia in women and young children.

A total of 5,176 women aged 10 to 49 years, 1,449 children (below five) and 148 pregnant women from 3,571 households were surveyed. The data was collected from March to May last year.

Health minister Tandin Wangchuk, at the launch of the report, said problems associated with nutrition begin with conception. Mothers with nutrition problem, lyonpo said is more likely to have children with nutrition issues.

“The survey is timely as it provides the much needed update on the nutrition status of children and women in Bhutan.”

The survey states that stunting among children increased rapidly between the first and second year of life. About one third of the children in their fourth year of life were also stunted. Child wasting declined after three years of age and the proportion of children underweight only increased slightly with age.

Under nutrition among children was strongly related to wealth of the household. Children from richer families suffered from less nutrition issues while under nutrition was more prominent among children from poorer families.

The survey states that despite progress in reducing child under nutrition in Bhutan, there are still regions and demographic group that remain vulnerable and had high rates of stunted, wasted and underweight children.

The NNS 2015 also indicates a significant drop in anemia rates in the last 12 years among children and non-pregnant women (10 to 49 years). The last anemia study was done in 2003. Anemia among children dropped from 80.6 percent in 2003 to 43.8 percent in 2015. Among non-pregnant women, it dropped to 36.1 percent from 54.8 percent in the same period.

However, it is still a severe public health problem, the survey states.

Kinga Dema


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