Identification of undernutrition in under five children: Z score or a composite index of anthropometric failure?


  • Reena Titoria MAMTA Health Institute for Mother and Child, New Delhi
  • Prabhu Ponnusamy MAMTA Health Institute for Mother and Child, New Delhi
  • Sunil Mehra MAMTA Health Institute for Mother and Child, New Delhi



Composite index of anthropometric failure, Stunting, Under-five children, Underweight, Wasting, Z score


Background: Undernutrition continues to be the primary cause of ill health and premature mortality. The sustainable development goal 2 aims to end all forms of hunger by 2030 and lead towards an improvement in child health. The national data categorize the level of undernutrition as underweight, wasting and stunting. The weight for age estimates used under ICDS misses out the other forms of malnutrition. This study was conducted to assess the prevalence of undernutrition using a composite index of anthropometric failure (CIAF) and compare it with conventional indices.

Methods: A community based setting and cross-sectional study design. By simple random sampling 265 under-five children residing in a marginalized community of North West district of Delhi. Interviewer administered questionnaire was used to collect information and anthropometric measurements were taken using standard operative procedures. Z scores were calculated by WHO-ANTHRO software version 3.2.2. Descriptive analysis was conducted using statistical package for social sciences version 22.

Results: The prevalence of anthropometric failure by CIAF was 60.5% and based on other indices undernutrition was found as 44.5% stunting, 35.4% underweight and 26.4% wasting. MUAC detected 23.7% of undernourished. CIAF provides a better picture of undernutrition compared to other indices.

Conclusions: Since CIAF is more than that estimated by any of the conventional indicators, it proves to be a better indicator in assessing the overall burden of under-nutrition in a population. Development of policies based on CIAF to reduce the burden of undernutrition may prove to be more effective. 

Author Biographies

Reena Titoria, MAMTA Health Institute for Mother and Child, New Delhi

MD Community Medicine, University College of Medical Sciences, University of Delhi

MBBS, Lady Hardinge Medical College, University of Delhi 


Sunil Mehra, MAMTA Health Institute for Mother and Child, New Delhi

MD Pediatrics, BHU


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How to Cite

Titoria, R., Ponnusamy, P., & Mehra, S. (2019). Identification of undernutrition in under five children: Z score or a composite index of anthropometric failure?. International Journal Of Community Medicine And Public Health, 6(7), 3150–3155.



Original Research Articles