Journal of Public Health Policy

, Volume 32, Issue 3, pp 281–292

Comparison of estimates of malnutrition in children aged 0–5 years between clinic-based nutrition surveillance and national surveys


  • Maria Nnyepi
    • Department of Family and Consumer Sciences, University of Botswana,
  • Kesitegile S M Gobotswang
    • Department of Family and Consumer Sciences, University of Botswana,
  • Patrick Codjia
    • UNICEF Botswana,
Original Article

DOI: 10.1057/jphp.2011.32

Cite this article as:
Nnyepi, M., Gobotswang, K. & Codjia, P. J Public Health Pol (2011) 32: 281. doi:10.1057/jphp.2011.32


This study documents a marked discrepancy between the nutritional status of children aged 0–5 years in Botswana when measured by national surveys compared to clinic-based surveillance. We compared the average prevalence of underweight (weight-for-age z-scores below 2 standard deviations of the mean of the Center for Disease Control (CDC)/WHO reference standards) in children 0–5 years of age. According to clinic surveillance, prevalence of underweight has fallen from 14.6±0.03 to 3.5±0.04 per cent between 1993 and 2010. In national surveys, it had fallen from 14.6±0.01 to 11.5±0.01 per cent between 1993 and 2007. We explored several possibilities to explain this discrepancy, and conclude that it is because of sampling bias in the clinic surveillance. This finding underlines the need for properly conducted surveys to ensure accurate information about the nutritional status of children.


nutrition surveillancemalnutritionhealth information systemsunderweightBotswana

Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2011