Undernutrition status of children under 5 years in Chinese rural areas - data from the National Rural Children Growth Standard Survey, 2006

Purpose: To assess the nutritional status among rural children under five years in China relative to WHO Child Growth Standards 2006, and to explore risk factors for undernutrition. Design: Crosssectional study of rural areas in 10 provinces of China. A total of 84,009 children under five recruited through multi-level sampling. Main findings: A total of 17.92% of children have at least one form of undernutrition. The prevalence of stunting, underweight and wasting, were 14.59%, 7.19% and 3.07%, respectively. The corresponding mean z-score in height-for-age, weight-for-age, and weightfor-height were -0.732, -0.410 and -0.001. An upward trend with age in stunting and underweight was observed, and higher risks noticed among older children in contrast with children under 6 months in terms of stunning and underweight. The inter-provincial variation of undernutrition remains very large. Low birth weight, multi parity, preterm birth, multiple birth, maternal illiteracy, low provincial GDP, and low household income are identified as significant factors associated with stunting. Parity shows no corresponding significant relationship with underweight, and wasting was not found to be associated with either preterm or multiple births. Conclusion: The nutritional status among children under five in rural areas of China, although greatly improved in the past decades, still lags behind the WHO Child Growth Standards. Stunting and underweight occur mostly before two years of age. Intervention strategies and programs should be developed to target the preventable risk factors.