Dissertation for the degree of philosophiae doctor (PhD) at the University of Bergen
Dissertation date:
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Scientific environment
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Contents
SCIENTIFIC ENVIRONMENT...II ACKNOWLEDGEMENTS ... VI LIST OF PUBLICATIONS ... XIII
1. INTRODUCTION ...1
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1.12.1 Household food security ...17 1.12.2 Individual food security ...21
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2. RATIONALE AND OBJECTIVES... 28
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3. MATERIAL AND METHODS ... 31
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4. RESULTS ... 54 3$3(5,,1&,'(1&($1'&2856(2)&+,/'0$/1875,7,21$&&25',1*72&/,1,&$/25
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5. DISCUSSION... 59
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5.7.1 Diet and the development of kwashiorkor...71
5.7.2 Food and nutrition security ...74
5.7.3 The macro socio-economic context of malnutrtion ...78
5.7.4 Social inequalities in malnutrition ...79
6. RECOMMENDATIONS AND CONCLUSIONS...81
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Acknowledgements
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Abstract in English Background
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List of abbreviations
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Glossary
AccuracyWKHDFFXUDF\RIDPHDVXUHPHQWLVLWVGHJUHHRIFORVHQHVVWRWKDWTXDQWLW\VWUXH YDOXH$FFXUDF\LVDVVRFLDWHGZLWKV\VWHPDWLFHUURUV
Clinical severe childhood malnutrition;DWHUPXVHGIRUWKHWKUHHFOLQLFDOV\QGURPHVRI FOLQLFDOVHYHUHPDOQXWULWLRQLQFOXGLQJPDUDVPXVNZDVKLRUNRUDQGPDUDVPLFNZDVKLRUNRU Determinant; DIDFWRUUHODWHGWRDQRXWFRPHVXFKDVDKHDOWKRXWFRPHXVHGZLWKRUZLWKRXW DQ\FRQQRWDWLRQDVWRZKHWKHUWKHUHODWLRQVKLSLVFDXVDORUQRQFDXVDO
Hidden hunger; PLFURQXWULHQWGHILFLHQFLHV
Incidence;WKHQXPEHURIQHZFDVHVRIDGLVHDVHWKDWRFFXUVGXULQJDVSHFLILFSHULRGLQD SRSXODWLRQDWULVNRIGHYHORSLQJWKHGLVHDVH
Kwashiorkor; DIRUPRIVHYHUHPDOQXWULWLRQZKHUH WKHSUHVHQFHRIRHGHPDLVWKHPRVW VLJQLILFDQWIHDWXUH
Malnutrition;DFRQGLWLRQWKDWRFFXUVDVDFRQVHTXHQFHRIFRQVXPLQJDGLHWWKDWFRQWDLQV LQVXIILFLHQWRUWRRPDQ\QXWULHQWVRUDVDUHVXOWRIIDXOW\GLJHVWLRQRUXWLOLVDWLRQRIIRRGV Marasmic-kwashiorkor;DW\SHRIVHYHUHPDOQXWULWLRQDQGDPL[HGIRUPRIPDUDVPXVDQG NZDVKLRUNRU,WLVFKDUDFWHUL]HGE\WKHSUHVHQFHRIERWKZDVWLQJDQGSLWWLQJRHGHPD
Marasmus;QRQRHGHPDWRXVVHYHUHFKLOGPDOQXWULWLRQDQGFKDUDFWHULVHGE\H[WUHPHZDVWLQJ
Mid upper arm circumference08$&LQFKLOGUHQD08$&EHWZHHQDQGFP LQGLFDWHVPRGHUDWHPDOQXWULWLRQDQGD08$&EHORZFPVHYHUHPDOQXWULWLRQ Obese;FKLOGUHQZLWKD%0,=VFRUHRIDQGKLJKHU
OverweightFKLOGUHQZLWKD%0,=VFRUHRIWR
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Prevalence; WKHSURSRUWLRQRIDSRSXODWLRQKDYLQJDGLVHDVHDWDVSHFLILFSRLQWLQWLPH Sensitivity;RIDQLQGLFDWRUWKHDELOLW\WRLGHQWLI\DQGFODVVLI\SHUVRQVDVKDYLQJDGLVHDVH Specificity; RIDQLQGLFDWRUWKHDELOLW\WRLGHQWLI\DQGFODVVLI\SHUVRQVDVQRQGLVHDVHG
Stunted;FKLOGUHQZKRKDYHD+$=VFRUHRIWRDUHDVVHVVHGDVPRGHUDWHO\VWXQWHGDQG FKLOGUHQZKRKDYHD+$=VFRUHRIDUHDVVHVVHGDVVHYHUHO\VWXQWHG
Undernutrition; SURFHVVRILQVXIILFLHQWQXWULHQWLQWDNHDQGRUQXWULHQWDEVRUSWLRQ
Underweight;FKLOGUHQZLWKD:$=VFRUHRIWRDUHDVVHVVHGDVPRGHUDWHO\XQGHUZHLJKW DQGRIRUEHORZDVVHYHUHO\XQGHUZHLJKW
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Z-score;WKHQXPEHURIVWDQGDUGGHYLDWLRQVDQHOHPHQWLVIURPWKHPHDQ
1. Introduction
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Figure 1 Signs of kwashiorkor
Figure 2 Signs of marasmus
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Figure 3 Percentage of children under 5 who are stunted, by region, 1990 to 2013
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Figure 4 Number in millions of children under 5 who are stunted, by region, 1990 to 2013
Figure 5 Percentage of children under 5 who are underweight, by region, 1990 to 2013
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Figure 6 Number in millions of children under 5 who are underweight, by region, 1990 to 2013
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Land tenure
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Other drivers of household food security
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1.12.2 Individual food security
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