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CHILD NUTRITION IN CHINA: WITH SOME COMPARISON TO INDIA. WANG ZHEN INSTITUTE OF ECONOMICS, CASS 11, NOV, 2013. Introduction. Continued from Stanford discuss on child nutrition. - PowerPoint PPT Presentation
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CHILD NUTRITION IN CHINA: WITH SOME COMPARISON TO INDIA
WANG ZHENINSTITUTE OF ECONOMICS, CASS
11, NOV, 2013
Introduction• Continued from Stanford discuss on child nutrition. • Trends of child nutritional status in China; underlying
determinants; policy framework; with some comparison to India; and talk about the further step
• Data sources: – WHO, UNICEF– Ministry of Health, China; Ministry of Health and Family Welfare,
India– Original sources: China Food and Nutrition Surveillance System
(CFNSS), conducted by CDC China; – National Family Health Survey (NFHS), conducted by MoHFW
India; NFHS-1: 1992-93; NFHS-2: 1998-99; NFHS-3: 2005-06
Indicators on child nutritional status• Anthropometric indicators of nutritional status• Z-score: Z=(X-S)/SD
– X: height, weight, or other measures; S: standards from WHO (NCHS); SD: standard deviation
• HAZ: Height for Age; if HAZ below minus two, refers to STUNTING, implying chronic, long term undernutrition;
• WAZ: Weight for Age; if WAZ below minus two, refers to UNDERWEIGHT, implying a composite form of undernutrition ;
• WHZ: Weight for Height; if WHZ below minus two, refers to WASTING, implying acute, short term undernutrition.
• Overview: Child nutritional status in China: • Undernutrition prevalence decreased very quickly; child nutritional
status improved obviously. • In 2010: the stunting prevalence in Europe: 8.2% [4.1-15.8%];
underweight: 1.8% [1.1-2.9%]; wasting: 1.6% [0.7-3.3%]
• Overview: Child nutritional status: India• Undernutrition prevalence decreased with a fast speed; But still at a high level; much
higher compared with China.
• Comparison between India and China: • India: NFHS-1, NFHS-2, NFHS-3• In 2006 (2005), India: China
– Stunting 47.9%: 11.7%– Underweight 43.5%: 4.5%– Wasting 20%: 2.9%
• Gender differential: China• Girl’s nutritional status, in most of the years, is better than boy’s. • Only three points that girl’s indicators worse than boy’s. • However, the differences are very small, and most of the differences
are insignificant statistically.
• Gender differential of child nutritional status, China, 2010• Prevalence (%): there is no significant difference between boy’s and
girl’s; • Mean of WAZ, HAZ and WHZ: the mean scores of the three indicators
show that boy’s score is higher than girl’s significantly, implying that girl’s nutritional status worse than boy’s.
• Boy’s-Girl’s: – +: prevalence of boys higher than girls, implying boy’s worse nutritional status than
girl’s – -: prevalence of boys lower than girls, implying boy’s better nutritional status than
girl’s
• India, as well as China, girl’s nutritional status hardly to say being worse than boy’s.
• Urban-rural differential of child nutritional status:
• There is an obvious urban-rural differential of child nutritional status, although the differential became narrow in the last two decades.
• Especially in poor rural areas in China, child nutrition is the worst; 5-6 times higher than urban areas.
Underlying determinants affecting child’s nutritional status
• Family income and nutrition in-take: • Maternal status:
– Health– Education– Caring– Income
• Affordability and availability of public health service– Vaccination
• Public health expenditures• Social protection• Water and living environment
• Comparison of factors affecting child’s nutrition: India vs. China• China’s better than India in all the nine factors
Policy framework• “National Program of Action for Child Development in China”: 1990s, 2001-2010, and
the newest one, 2011-2020; Issued by State Council• The goal, task, and policy on child nutrition are designed: • Goal (2011-2020):
– stunting prevalence: under 7%– underweight prevalence: under 5%– low birth weight prevalence under 4%– child anemia (under 5) under 12%
• Strategy and measures: • 13 measures are designed, including to increase public expenditure on child
development, strengthening health care system for child. • Improving child nutritional status:
– promoting mother breastfeeding– Intervention on supplementary nutrient feeding; – Implement intervention programs on child nutrition and health for pre-school children; (the State Council has
implemented the "Nutrition Improvement Plan for Rural Compulsory Education Students" in 2011);
Discussion• How to explain the very different performance of child nutritional
status in China and India? The two countries have very different social, economic, and cultural environment; but, are there some similarities affecting child nutritional status?– Income gradient: – Family planning, and China’s one-child policy: – Intervention programs: – Policy framework:
• Challenges faced by China on child nutrition: – Urban-rural gap, with quick urbanization process, becoming a “within-urban
dualism” that the gap between urban locals and rural migrants. – Left-behind children, lack of parents’ caring.
• Comparable datasets: it is possible to make comparative analysis: – China: CHNS (China Health Nutrition Survey), panel data, 1989, 1991, 1993, 1997,
2000, 2004, 2006, 2008, conducted by CDC of China; public dataset. The design is very similar to CFNSS.
– India: NHFS (National Health and Family Survey)
• Further step?
THANK YOU!