Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014

Sudeep Shrestha, Andrew L. Thorne-Lyman, Swetha Manohar, Binod Shrestha, Sumanta Neupane, Ruchita Rajbhandary, Raman Shrestha, Rolf D.W. Klemm, Bareng A.S. Nonyane, Ramesh K. Adhikari, Patrick Webb, Keith P. West

Research output: Contribution to journalArticlepeer-review


Background and Objectives: Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional sta-tus following the earthquake in Nepal in 2015. Methods and Study Design: A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. Results: Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. Conclusions: Two midyear surveys in Nepal re-vealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunt-ing noted in previous years. The same period saw a slight reduction in wasting and improved household food se-curity.

Original languageEnglish (US)
Pages (from-to)624-637
Number of pages14
JournalAsia Pacific journal of clinical nutrition
Issue number3
StatePublished - May 1 2018


  • Household food insecurity
  • Malnutrition
  • National survey
  • Nepal
  • Nutrition surveillance

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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