Do childhood growth indicators in developing countries cluster? Implications for intervention strategies. Public Health Nutrition 7

Objective: The effectiveness of geographic targeting in nutrition programmes depends largely on the degree to which malnutrition clusters within particular areas. This study investigates the extent to which the childhood nutrition indicators, stunting (height-for-age Z-score,22) and wasting (weight-for-height Z-score,22), are spatially clustered; this information is used to determine the implications of spatial clustering for the effectiveness of geographic targeting. Design: Analysis of data from Demographic and Health Survey (DHS) results. Clustering is assessed by calculating intra-cluster correlation coefficients (ICCs). Estimating the proportion of malnourished children covered by a programme successfully targeting 10 % of clusters with the highest malnutrition prevalences allows an assessment of the effectiveness of geographic targeting. Setting: Fifty-eight DHS III (1992–1997) and DHS IV (1998–2001) reports from 46 developing countries. Subjects: Pre-school children of mothers interviewed by DHS