Magnitude of undernutrition in children aged 2 to 4 years using CIAF and conventional indices in the slums of Mumbai city|
Savanur, Mitravinda S. & Ghugre, Padmini S.
Conventional indicators – weight-for-age, height-for-age, weight-for-height and mid-upper arm circumference
(MUAC) reflect different facets of the nutritional status. Weight-for-age is the most commonly used indicator. When
used individually or in combination, conventional indices fail to depict the overall magnitude of undernutrition in
the population. Composite Index of Anthropometric Failure (CIAF) is an alternative classification system which attempts
to fill this lacuna. Thus, we undertook this study with the objective to compare the prevalence of undernutrition using
CIAF and the conventional indices. We included 634 children aged between 2 to 4 years from anganwadis located
in three areas of Mumbai. Weight, height and MUAC measurements were taken. Z scores were computed for
weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) using WHO Anthro software. Children
were classified as per the conventional indices and CIAF. The prevalence of underweight, stunting and wasting
was 35.7 %, 33.8 % and 18.5 % respectively. None of the children had MUAC < 11.5 cm. About 1 % of the children
were moderately wasted according to MUAC. As per CIAF, 47.8 % children were undernourished. According to
CIAF, one-third of the undernourished children had single anthropometric failure while half of them had dual
failure and 17.1 % had multiple failures. When compared with the conventional indices, CIAF could recognize
12.1 %, 14.0 %, 29.3 % and 46.7 % more undernourished children than WAZ, HAZ, WHZ and MUAC respectively.
In conclusion, CIAF is seen to have many advantages over the conventional indices. CIAF is useful in assessing
the overall magnitude of undernutrition and identifying children with multiple anthropometric failures. It also
recognizes more undernourished children than all the conventional indices. Therefore, CIAF should be used more
widely as a tool for nutritional assessment particularly in developing countries where the burden of undernutrition is high.
CIAF; Underweight; Stunting; Wasting; Nutritional status; Children; India