IJE Advance Access originally published online on May 20, 2004
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International Journal of Epidemiology, Volume 33, Number 3, pp. 589-595
IJE vol.33 no.3 © International Epidemiological Association 2004; all rights reserved.
Weight-for-age malnutrition in Indonesian children, 1992–1999
1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
2 The World Bank, Washington, DC, USA
3 Badan Pusat Statistik, Jakarta, Indonesia
4 The World Bank, New Delhi, India
Correspondence: Hugh Waters, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Room 8132, Baltimore, MD 21205, USA. E-mail: hwaters{at}jhsph.edu
Background This article measures changes over time in Indonesia in the prevalence of moderate and severe child malnutrition, and examines the factors associated with these changes. A child with a weight-for-age Z-score below –2.0 is classified as underweight and either moderately or severely malnourished.
Methods A pooled cross-sectional dataset of 163 986 children <5 years of age from the 1992, 1995, 1998, and 1999 Indonesia Socioeconomic Household Surveys was analysed using multivariate logistic regression, and by running separate pooled regressions to calculate the effect of the each of the principal independent variables separately for each year. Robust regression techniques corrected for non-constant variance resulting from multilevel modelling.
Results The overall percentage of children <5 years that are underweight decreased from 37.7% in 1992 to 28.5% in 1999. Nearly all of the gains occurred in children over one year of age. Child nutritional status improved for all major social groups in Indonesia. There was no measurable general effect of the 1997–1999 East Asian economic crisis on levels of underweight children.
Conclusions Disparities among social and economic groups have narrowed over time in Indonesia; the relatively high risk of male children compared with females has also decreased. Maternal education and economic status—as measured by quintile of adjusted per-capita household expenditures—have continued to be very strong predictors of children's nutritional outcomes.
Keywords Child malnutrition, underweight, economics and health, pooled cross-sectional analysis, Indonesia
Accepted 17 November 2003
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