The Composite Index of Anthropometric Failure (CIAF): An Alternative Indicator for Malnutrition in Young Children

Abstract

Malnutrition is a serious problem in many developing countries. It is one of the main causes of child morbidity and contributes significantly to premature mortality. This chapter discusses the design and use of an alternative indicator of malnutrition – the composite index of anthropometric failure (CIAF). It argues the three most commonly used anthropometric indicators of stunting, wasting and underweight, while providing valuable information about distinct biological processes, are individually unable to provide a comprehensive picture of the overall burden of malnutrition among young children in a population. They are frequently used to predict health and mortality risk, but provide quite limited information on the relationship between malnutrition and disease. The CIAF, however, can also be used to predict morbidity risk, and in its disaggregated form provides a more useful picture of the relationship between ill health and malnutrition. It can also be used to examine the relationship between different forms of malnutrition and poverty. Using the new World Health Organization (WHO) reference population norms and recent anthropometric data on 45,377 Indian children aged under 5 years, the prevalence of stunting, wasting and underweight are calculated and compared to prevalence estimates by the CIAF. Age adjusted logistic regression is used to see how well different indicators predict morbidity risk. Analysis of variance is used to see the relationship between groups of anthropometric failure and poverty. This chapter also provides information on how reliable, nationally representative anthropometric data from household surveys can be freely accessed by researchers to pursue their own study.