Critical examination of evidence for the nutritional status of children in Papua New Guinea – a systematic review

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Background and Objectives: Undernutrition remains a significant cause of childhood illness, poor growth, development, and death in Papua New Guinea (PNG). Studies on child nutritional outcomes in PNG vary by design, measurement protocols and quality. We conducted a systematic review to assess the evidence for the prevalence of child undernutrition across different study populations, geographical locations and time periods. Methods and Study Design: Six electronic databases and additional grey literature were searched for articles describing the nutritional status by wasting, stunting and underweight, of PNG children under five years of age, published between 1990 and April 2015. Prevalence data using different scales of measurement and reference populations were standardized according to WHO protocols. Results: The search yielded 566 articles, of which, 31 studies met the inclusion criteria. The prevalence of child undernutrition varied from 1% to 76% for wasting (median 11%), 5% to 92% for stunting (median 51%), and 14% to 59% for underweight (median 32%). Wide variations exist according to the index used for measurement, the population characteristics and the geographical region in which they live. Prevalence estimates increase significantly when data using different scales of measurement and population references are standardized to the WHO protocols. Conclusions: Child undernutrition in PNG is regionally variable due to a complex interplay of poverty, disease, food-security, cultural, environmental and sociopolitical issues requiring a complex mix of solutions by governments, health systems and local communities. Area-specific surveys using multiple measures are necessary to inform local solutions for this important problem.

Authors & affiliation: 
Peter J McGlynn MPH 1,2 , Andre ΜΝ Renzaho MPH, PhD 2,3 , Minh D Pham MD, MPH 1,2 , Mike Toole MBBS, DTM&H 1,2 , Jane Fisher PhD 4 , S tanley Luchters MD, MPH, PhD 1,2,5 1 Burnet Institute, Melbourne, Victoria, Australia 2 Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia 3 Department of Humanitarian a nd Development Studies, School of Social Sciences and Psychology, Univers i ty of Western Sydney (UWS), Penrith, NSW, Australia 4 Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Faculty of Medicine Nurs ing and Health Science, Mona sh University, Victoria, Australia 5 International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Faculty of Med i cine and Health Sciences, Ghent University, Ghent, Belgium
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Published In: 
Asia Pac J Clin N utr 20 1 8 ; 2 7 ( 1 ): 1 - 18
Publication date: 
Monday, January 1, 2018