Levels and trends in child malnutrition: UNICEF / WHO / The World Bank Group joint child malnutrition estimates: key findings of the 2020 edition

LEVELS AND TRENDS IN CHILD MALNUTRITION UNICEF / WHO / World Bank Group Joint Child Malnutrition Estimates Key findings of the 2020 edition These new estimates supersede former analyses and results published by UNICEF, WHO and the World Bank Group. STUNTING 144 million Stunting affected an estimated 21.3 per cent or 144.0 million children under 5 globally in 2019. In 2019, wasting continued to threaten the lives of an estimated 6.9 per cent or 47.0 million children under 5 globally. WASTING 47 million An estimated 5.6 per cent or 38.3 million children under 5 around the world were overweight in 2019. OVERWEIGHT 38 million The ultimate aim is for all children to be free of malnutrition in all its forms Good nutrition allows children to survive, grow, develop, learn, play, participate and contribute – while malnutrition robs children of their futures and leaves young lives hanging in the balance. Stunting is the devastating result of poor nutrition in-utero and early childhood. Children suffering from stunting may never attain their full possible height and their brains may never develop to their full cognitive potential. Globally, 144.0 million children under 5 suffer from stunting. These children begin their lives at a marked disadvantage: they face learning diffi culties in school, earn less as adults, and face barriers to participation in their communities. Wasting in children is the life-threatening result of poor nutrient intake and/or disease. Children suffering from wasting have weakened immunity, are susceptible to long term developmental delays, and face an increased risk of death, particularly when wasting is severe. These children require urgent feeding, treatment and care to survive. In 2019, 47.0 million children under 5 were wasted of which 14.3 million were severely wasted. There is also an emerging face of malnutrition: childhood overweight and obesity. There are now 38.3 million overweight children globally, an increase of 8 million since 2000. The emergence of overweight and obesity has been shaped, at least in part, by industry marketing and greater access to processed foods, along with lower levels of physical activity. While malnutrition can manifest in multiple ways, the path to prevention is virtually identical: adequate maternal nutrition before and during pregnancy and lactation; optimal breastfeeding in the fi rst two years of life; nutritious, diverse and safe foods in early childhood; and a healthy environment, including access to basic health, water, hygiene and sanitation services and opportunities for safe physical activity. These key ingredients can deliver a world where children are free from all forms of malnutrition. Despite this opportunity, the UNICEF, WHO, World Bank global and regional child malnutrition estimates reveal that we are still far from a world without malnutrition. The joint estimates, published in March 2020, cover indicators of stunting, wasting, severe wasting and overweight among children under 5, and reveal insuffi cient progress to reach the World Health Assembly targets set for 2025 and the Sustainable Development Goals set for 2030. Improving children’s nutrition requires effective and sustained multi-sectoral nutrition programming over the long term, and many countries are moving in the right direction. Regular data collection is critical to monitor and analyse country, regional and global progress going forward. Forms of malnutrition* highlighted in this key fi ndings report Overweight and stunted Stunted and wasted Stunting refers to a child who is too short for his or her age. These children can suffer severe irreversible physical and cognitive damage that accompanies stunted growth. The devastating effects of stunting can last a lifetime and even affect the next generation. Overweight refers to a child who is too heavy for his or her height. This form of malnutrition results from energy intakes from food and beverages that exceed children’s energy requirements. Overweight increases the risk of diet-related noncommunicable diseases later in life. Wasting refers to a child who is too thin for his or her height. Wasting is the result of recent rapid weight loss or the failure to gain weight. A child who is moderately or severely wasted has an increased risk of death, but treatment is possible. * Some children suffer from more than one form of malnutrition – such as stunting and overweight or stunting and wasting. There are currently no joint global or regional estimates for these combined conditions. 2 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition GLOBAL OVERVIEW Number (millions) of stunted, overweight and wasted children under 5, global, 2000–2019 Percentage of stunted, overweight and wasted children under 5, global, 2000–2019 Africa and Asia bear the greatest share of all forms of malnutrition Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. See Notes on Data on page 14 on why only one time point is presented for wasting on the graphs above. In 2019, more than half of all stunted children under 5 lived in Asia and two out of fi ve lived in Africa. Asia 54% Africa 40% P er ce n ta g e stunting overweightwasting 95% confidence interval N u m b er ( m ill io n s) 20192000 0 5 10 15 20 25 30 35 40 20192015201020052000 0 40 80 120 160 200 38.336.8 47.0 34.1 31.530.3 199.5 183.4 169.8 144.0 155.0 4.9 32.4 5.6 6.9 21.3 2015201020052000 In 2019, almost half of all overweight children under 5 lived in Asia and one quarter lived in Africa. Asia 45% Africa 24% In 2019, more than two thirds of all wasted children under 5 lived in Asia and more than one quarter lived in Africa. Asia 69% Africa 27% Malnutrition rates remain alarming. Stunting is declining too slowly while wasting still impacts the lives of far too many young children UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 3 4 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***Northern America sub-regional estimate based on United States data. There is no estimate available for the sub-regions of Europe or Australia and New Zealand due to insuffi cient population coverage. These maps are stylized and not to scale and do not refl ect a position by UNICEF, WHO or World Bank Group on the legal status of any country or territory or the delimitation of any frontiers. Seven sub-regions have a high or very high stunting prevalence Percentage of stunted children under 5, by United Nations sub-region, 2019 Stunting PREVALENCE Large disparities in stunting reduction exist within regions/between sub-regions Trends in the percentage of stunted children under 5, by United Nations region/sub-region, 2000 and 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Asia and Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***Northern America sub-regional estimates based on United States data. There is no estimate available for the More Developed Region or for sub-regions of Europe or Australia and New Zealand due to insuffi cient population coverage. †represents regions/sub-regions where the change has been statistically signifi cant; see page 12 for the 95% confi dence intervals for graphed estimates. 21.3% 144.0 million GLOBAL GLOBAL 6.9% 47.0 million GLOBAL GLOBAL 5.6% 38.3 million GLOBAL GLOBAL Pe rc en ta ge 2000 2019 0 10 20 30 40 50 Global†Northern America*** Oceania**Latin America and the Caribbean† Asia*†Africa† 37.9 45.8 39.7 32.8 36.0 24.2 37.8 49.7 38.5 23.0 28.2 19.2 16.8 23.7 15.3 13.8 37.0 3.0 32.4 29.1 34.5 31.5 29.0 27.7 17.6 21.8 31.7 24.7 12.7 9.9 4.5 9.0 12.6 8.1 7.3 38.4 2.6 21.3 South America Central America CaribbeanSouthern Asia† South- eastern Asia† Eastern Asia*† Western Asia Central Asia† Eastern Africa† Western Africa† Middle Africa Northern Africa Southern Africa UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 5 17.8 5.1 9.5 23.1 Africa 57.5 million Oceania** 0.6 million Eastern Africa Latin America and Caribbean 4.7 million Caribbean Central America South America Middle Africa Southern Africa Western Africa Northern Africa Western Asia Central Asia Eastern Asia* 3.4 13.9 55.9 4.1 0.8 0.3 Asia* 78.2 million 2.4 2.0 Southern Asia South-eastern Asia 2.0 Northern America*** 0.6 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***The Northern America sub-regional estimate based on United States data. There is no estimate available for the More Developed Region or for sub-regions of Europe or Australia and New Zealand due to insuffi cient population coverage. Aggregates may not add up due to rounding and/or lack of estimates for the More Developed Region. Africa is the only region where the number of stunted children has risen Trends in the number (millions) of stunted children under 5, by United Nations region/sub-region, 2000 and 2019 Stunting NUMBERS AFFECTED Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Asia and Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***Northern America sub-regional estimates based on United States data. There is no estimate available for the More Developed Region or for sub-regions of Europe or Australia and New Zealand due to insuffi cient population coverage. †represents regions/sub-regions where the change has been statistically signifi cant; see page 13 for the 95% confi dence intervals for graphed estimates. 21.3% 144.0 million GLOBAL GLOBAL 6.9% 47.0 million GLOBAL GLOBAL 5.6% 38.3 million GLOBAL GLOBAL 0 20 40 60 80 100 120 140 160 2017 2000 OceaniaLatin AmericaAsiaAfrica N um be r (m ill io ns ) N um be r (m ill io ns ) Africa† Asia*† 20192000 -39% -47% 16% 50.6 58.7 134.6 83.6 9.7 5.1 0.4 0.5 50.6 million 2000 58.7 million 9.7 million to 5.1 million134.6 million to 83.6 million 49.7 million 57.5 million 136.6 million 78.2 million Latin America and Caribbean† 9.5 million 4.7 million 0 10 20 30 40 50 60 70 80 90 North America*** Oceania**South America Central America CaribbeanSouthern Asia† South- eastern Asia Eastern Asia*† Western Asia Central Asia† Eastern Africa Western Africa Middle Africa Northern Africa Southern Africa 2.0 5.1 9.5 17.8 23.1 0.8 3.4 4.1 13.9 55.9 0.3 2.0 2.4 0.61.9 5.0 7.0 14.8 21.1 1.7 5.3 18.4 21.0 90.2 0.6 3.9 5.0 0.5 0.60.7 Number (millions) of stunted children under 5, by United Nations sub-region, 2019 Nearly two out of fi ve stunted children in the world live in Southern Asia 6 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition Southern Asia is the sub-region with the highest wasting prevalence in the world Percentage of wasted children under 5, by United Nations sub-region, 2019 Millions of young lives are in jeopardy around the globe due to wasting Percentage of wasted children under 5, by United Nations region, 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Includes 95% confidence interval. Note: *Asia excluding Japan; **Oceania excluding Australia and New Zealand. There is no estimate available for the More Developed Region due to insufficient population coverage. Wasting PREVALENCE Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***Northern America sub-regional estimate based on United States data. There is no estimate available for the sub-regions of Europe or Australia and New Zealand due to insufficient population coverage. These maps are stylized and not to scale and do not reflect a position by UNICEF, WHO or World Bank Group on the legal status of any country or territory or the delimitation of any frontiers. The legend contains a category for ≥15 per cent (pink) but there is no sub-region with a prevalence this high. 21.3% 144.0 million GLOBAL GLOBAL 6.9% 47.0 million GLOBAL GLOBAL 5.6% 38.3 million GLOBAL GLOBAL 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Africa Latin America and Caribbean Asia* Oceania** 6.4 9.1 1.3 9.5 In Asia and Oceania, wasting is putting nearly one in ten children under 5 at increased risk of death P er ce nt ag e UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 7 Africa 12.7 million Latin America and Caribbean 0.7 million Caribbean Central America South America Middle Africa Southern Africa Asia* 32.6 million Eastern Africa Northern Africa Western Africa 1.0 4.7 25.2 1.5 0.2 Western Asia Central Asia South-eastern Asia Southern Asia Eastern Asia* 4.8 0.2 2.1 2.0 3.6 0.4 0.1 0.1 Oceania** 0.1 million Northern America*** 0.1 Asia is home to the majority of children under 5 suffering from wasting and severe wasting Number of wasted and severely wasted children under 5, by United Nations region, 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Asia excluding Japan; **Oceania excluding Australia and New Zealand. There is no estimate available for the More Developed Region due to insuffi cient population coverage. Aggregates may not add up due to rounding and/or lack of estimates for the More Developed Region. Wasting NUMBERS AFFECTED Number (millions) of wasted children under 5, by United Nations sub-region, 2019 More than half of all wasted children in the world live in Southern Asia Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***The Northern America sub-regional estimate based on United States data. There is no estimate available for the More Developed Region or for sub-regions of Europe or Australia and New Zealand due to insuffi cient population coverage. Aggregates may not add up due to rounding and/or lack of estimates for the More Developed Region. 21.3% 144.0 million GLOBAL GLOBAL 6.9% 47.0 million GLOBAL GLOBAL 5.6% 38.3 million GLOBAL GLOBAL Africa GlobalLatin America and Caribbean Asia* Oceania** 10.5 3.5 14.30.140.7 0.050.1 47.0 million wasted of which 14.3 million are severely wasted Number of children under 5 wasted (moderate and severe) Number of children under 5 wasted (severe only) 32.6 12.7 47.0 8 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 4.7 6.7 4.7 4.3 8.4 10.2 1.9 3.7 3.0 4.85.0 5.1 11.3 12.7 4.0 2.4 3.2 6.7 6.26.3 2.5 9.6 6.4 4.8 7.5 8.4 6.6 5.9 5.1 7.1 6.9 7.5 7.0 7.9 9.4 8.9 4.9 5.6 Pe rc en ta ge 2000 2019 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 GlobalAustralia and New Zealand*** Northern America† Oceania**Central America CaribbeanSouth America Latin America and the Carribean Southern Asia Central Asia Eastern Asia* South- eastern Asia† Western Asia Asia*Western Africa Eastern Africa Middle Africa Northern Africa Southern Africa Africa 8.7 20.7 Overweight is a concern in almost all regions of the world Percentage of overweight children under 5, by United Nations sub-region, 2019 There has been no progress to stem the rate of overweight in nearly 20 years Trends in the percentage of overweight children under 5, by United Nations region/sub-region, 2000 and 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note:*Asia and Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand. ***The Australia and New Zealand sub-regional estimates are based only on Australia data. There is no estimate available for the More Developed Region or for the sub-region of Europe due to insufficient population coverage. †represents sub-regions where the change has been statistically significant; see page 12 for the 95% confidence intervals for graphed estimates. Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand, ***The Australia and New Zealand sub-regional estimate is based only on Australia data. There is no estimate available for the sub-region of Europe due to insufficient population coverage. These maps are stylized and not to scale and do not reflect a position by UNICEF, WHO or World Bank Group on the legal status of any country or territory or the delimitation of any frontiers. Overweight PREVALENCE 21.3% 144.0 million GLOBAL GLOBAL 6.9% 47.0 million GLOBAL GLOBAL 5.6% 38.3 million GLOBAL GLOBAL UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 9 Africa 9.3 millionLatin America and Caribbean 3.9 million Caribbean Central America South America Middle Africa Southern Africa Western Asia Central Asia Asia* 17.2 million South-eastern Asia 2.3 4.2 4.5 5.7 0.5 Australia and New Zealand*** 0.4 Southern Asia Eastern Asia* 1.2 1.9 0.9 3.3 1.5 2.5 Eastern Africa Northern Africa Western Africa 2.6 1.1 0.2 Oceania** 0.1 million Northern America South-eastern Asia and Northern America are the only sub-regions which had a signifi cant increase in the number of overweight children since 2000 Number (millions) of overweight children under 5, by United Nations region/sub-region, 2000 and 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *Asia and Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand. ***The Australia and New Zealand sub-regional estimates are based only on Australia data. There is no estimate available for the More Developed Region or for the sub-region of Europe due to insuffi cient population coverage. †represents sub-regions where the change has been statistically signifi cant; see page 13 for the 95% confi dence intervals for graphed estimates. Overweight NUMBERS AFFECTED Number (millions) of overweight children under 5, by United Nations sub-region, 2019 Europe is the only sub-region without an overweight estimate Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note:*Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand. ***The Australia and New Zealand sub-regional estimate is based only on Australia data. There is no estimate available for the More Developed Region or for the sub-region of Europe due to insuffi cient population coverage. Aggregates may not add up due to rounding and/or lack of estimates for the More Developed Region. 21.3% 144.0 million GLOBAL GLOBAL 6.9% 47.0 million GLOBAL GLOBAL 5.6% 38.3 million GLOBAL GLOBAL Africa Asia* 20192000 6.5 million 9.3 million 14.4 million 17.2 million Latin America and Caribbean 3.8 million 3.9 million 4.2 4.4 0.14 1.9 0.9 1.2 1.5 2.5 3.3 0.6 1.2 0.8 2.2 1.8 0.5 2.3 0.6 1.6 1.7 5.7 4.5 6.1 0.2 1.1 2.6 0.2 1.0 2.6 0.06 0.4 0.14 1.4 N um be r (m ill io ns ) add beside Northern America ***Australia and New Zealand 0.1 in 2000 0.4 in 2019 0 1 2 3 4 5 6 7 8 9 10 Australia and New Zealand*** Northern America† Oceania**South America Central America CaribbeanEastern Asia* Southern Asia South- eastern Asia† Western Asia Central Asia Northern Africa Eastern Africa Middle Africa Western Africa Southern Africa 10 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition stunting overweightwasting 95% confidence interval 45.6 30.1 4.3 4.7 0 10 20 30 40 50 60 20192000 20192000 20192000 20192000 Low-income Upper-middle-income High-income*Lower-middle-income 10.9 47.4 34.1 3.6 2.7 6.6 18.9 6.06.9 8.8 1.8 2.83.4 7.65.4 0.5 Pe rc en ta ge Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *High-income countries: low (<50 per cent) population coverage in all time periods for overweight and wasting, and consecutive low population coverage in 2000 for stunting; interpret with caution. Upper-middle-income countries reduced their stunting prevalence by more than two-thirds since 2000, while low-income and lower-middle income countries only achieved a decrease of one third Percentage of stunted, overweight and wasted children under 5, by country income classifi cation, 2000 – 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. Note: *High-income countries: consecutive low (<50 per cent) population coverage in 2000 and 2019 for overweight and in 2000 for stunting; interpret with caution. Based on FY2020 World Bank income classifi cation. The values for “percentage change since 2000” are based on calculations using unrounded estimates and therefore might not match values calculated using the rounded estimates presented in this brochure. There has been no progress to stem the rate of overweight in nearly 20 years in any country- income group Number of overweight children under 5, by country income classifi cation, 2000 and 2019 N um be r (m ill io ns ) 2019 2000 0 20 40 60 80 100 120 140 160 High income* Upper-middle income Lower-middle income Low income 38.0 39.7 130.1 93.2 34.2 2.3 1.9 -67.9% -28.4% 11.0 N um be r (m ill io ns ) 0 5 10 15 20 25 30 35 40 High income* Upper-middle income Lower-middle income Low income 2.9 3.2 12.3 14.6 12.4 16.1 3.7 5.2 2019 2000 Upper-middle-income countries have the largest relative declines in the number of stunted children of all income groups Number of stunted children under 5, by country income classifi cation, 2000 and 2019 Country Income Classifi cation TRENDS UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 11 Country Income Classifi cation SHARE BY REGION While only about half of all children under-5 live in lower-middle income countries, two-thirds of all stunted children and three-quarters of all wasted children live there Distribution of children under-5 in the world, by country income grouping, 2019 Share* of stunted children under 5 in 2019 of all under-5 children live in high income countries of all under-5 children live in upper-middle income countries of all under-5 children live in lower-middle income countries of all under-5 children live in low income countries Distribution of children under 5 affected by stunting, overweight and wasting in 2019 10%27%46%17% 27% of all stunted children live in low-income countries 64% of all stunted children live in lower-middle- income countries of all stunted children live in upper-middle- income countries 8% of all stunted children live in high-income countries 1% Share* of wasted children under 5 in 2019 Share* of overweight children under 5 in 2019 of all wasted children live in high-income countries of all wasted children live in upper-middle- income countries of all wasted children live in low-income countries 75% of all wasted children live in lower-middle- income countries 17% 7% 1% of all overweight children live in high-income countries of all overweight children live in low-income countries of all overweight children live in lower-middle- income countries 8% 13% of all overweight children live in upper-middle- income countries 37% 41% *Share is relative to the total number affected across the 4 country-income groups. *Share is relative to the total number affected across the 4 country-income groups; this varies from the global totals reported elsewhere in this brochure because the offi cial JME glob l total is based on a model of United Nations regions. The differences are as follows: Stunting offi cial global estimate 144.0 million; sum of 4 country-income groups = 145.8 million. Wasting offi cial global estimate 47.0 million; sum of country-income groups = 45.3 million. Overweight offi cial global estimate 38.3 million; sum of 4 country-income groups = 39.1 million). 12 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition PREVALENCE ESTIMATES TABLES* Footnotes 1. Only estimates for Less Developed Regions are displayed; the More Developed Region estimates are not displayed due to insufficient population coverage. 2. Asia excluding Japan; Eastern Asia excluding Japan. 3. Oceania excluding Australia and New Zealand. 4. The Northern America estimates are derived applying mixed-effect models with sub-regions as fixed effects; for stunting, wasting and severe wasting, data were available only for the United States, preventing the estimation of standard errors (and confidence intervals). The Australia and New Zealand estimates are based only on Australian data applying linear regression; for stunting, only two data points were available, and thus estimation of standard errors (and confidence intervals) was not possible. Further details on the methodology are described in de Onis M. et al. Estimates of global prevalence of childhood underweight in 1990 and 2015. JAMA vol. 291, 2004:2600-6. Model selection is based on best fit. 5. Consecutive low population coverage; interpret with caution. 6. Eastern Europe and Central Asia excluding Russia. Stunting Wasting and Severe Wasting Overweight 2000 2019 2019 2019 2000 2019 % stunted (moderate and severe) fo ot no te % stunted (moderate and severe) fo ot no te % wasted (moderate and severe) fo ot no te % wasted (severe) fo ot no te % overweight (moderate and severe) fo ot no te % overweight (moderate and severe) fo ot no te Global 32.4 [30.9-34.0] 21.3 [19.7-22.8] 6.9 [5.7-8.2] 2.1 [1.6-2.6] 4.9 [4.3-5.5] 5.6 [4.9-6.4] United Nations Regions Less Developed Regions1 35.7 [34.0-37.4] 23.1 [21.4-24.8] 7.6 [6.2-8.9] 2.3 [1.8-2.9] 4.5 [4.0-5.0] 5.0 [4.3-5.7] Africa 37.9 [35.6-40.2] 29.1 [26.8-31.4] 6.4 [5.4-7.5] 1.8 [1.4-2.1] 5.0 [4.1-5.9] 4.7 [3.5-6.0] Eastern Africa 45.8 [41.2-50.5] 34.5 [30.7-38.5] 5.3 [3.8-7.4] 1.1 [0.8-1.5] 4.8 [3.7-6.2] 3.7 [2.9-4.6] Middle Africa 39.7 [34.1-45.6] 31.5 [26.4-37.0] 6.7 [5.1-8.7] 2.2 [1.7-2.9] 4.3 [2.9-6.4] 5.1 [3.3-7.6] Northern Africa 24.2 [18.1-31.6] 17.6 [11.6-25.7] 7.2 [3.6-13.9] 3.1 [1.6-6.2] 8.4 [4.8-14.4] 11.3 [5.6-21.5] Southern Africa 32.8 [28.7-37.2] 29.0 [25.5-32.8] 3.3 [2.2-4.8] 0.9 [0.6-1.2] 10.2 [7.1-14.4] 12.7 [8.6-18.3] Western Africa 36.0 [33.1-39.1] 27.7 [23.8-32.0] 7.5 [6.5-8.6] 1.8 [1.5-2.2] 3.0 [2.3-4.0] 1.9 [1.4-2.5] Asia2 37.8 [35.5-40.2] 21.8 [19.3-24.3] 9.1 [6.9-11.3] 2.9 [2.1-3.8] 4.0 [3.3-4.7] 4.8 [3.8-5.8] Central Asia 28.2 [21.5-36.0] 9.9 [7.9-12.3] 2.4 [1.6-3.6] 0.6 [0.2-1.6] 9.6 [5.9-15.2] 6.2 [3.3-11.3] Eastern Asia2 19.2 [17.8-20.6] 4.5 [4.1-4.9] 1.7 [1.6-1.8] 0.4 [0.4-0.4] 6.4 [5.8-7.1] 6.3 [5.5-7.2] Southern Asia 49.7 [45.6-53.9] 31.7 [27.3-36.4] 14.3 [10.4-19.3] 4.4 [3.1-6.2] 2.4 [1.5-4.1] 2.5 [1.5-4.4] South-eastern Asia 38.5 [32.7-44.7] 24.7 [18.7-31.9] 8.2 [5.9-11.4] 3.6 [1.7-7.6] 3.2 [2.5-4.0] 7.5 [4.3-12.6] Western Asia 23.0 [16.0-31.8] 12.7 [6.2-24.0] 3.7 [1.5-8.7] 1.1 [0.4-2.8] 6.7 [4.9-9.2] 8.4 [4.6-15.0] Latin American and Caribbean 16.8 [13.3-20.2] 9.0 [6.1-11.8] 1.3 [0.8-1.7] 0.3 [0.2-0.4] 6.6 [5.5-7.7] 7.5 [6.7-8.4] Caribbean 15.3 [7.5-28.7] 8.1 [3.5-17.8] 2.9 [2.1-4.0] 0.9 [0.8-1.1] 5.1 [3.9-6.5] 7.0 [3.6-13.2] Central America 23.7 [16.6-32.8] 12.6 [8.0-19.3] 0.9 [0.7-1.0] 0.2 [0.2-0.3] 5.9 [4.7-7.3] 6.9 [5.9-8.2] South America 13.8 [10.4-18.0] 7.3 [4.3-11.9] 5 1.3 [0.8-2.3] 5 0.2 [0.1-0.5] 5 7.1 [5.7-8.9] 7.9 [6.9-9.1] 5 Oceania3 37.0 [20.2-57.6] 38.4 [21.9-58.1] 9.5 [5.9-15.0] 3.6 [2.8-4.5] 4.7 [3.3-6.5] 9.4 [6.1-14.4] More Developed Regions - - - - - - Australia and New Zealand4 0.8 - - - 8.7 [0.0-22.4] 20.7 [4.8-36.5] Europe - - - - - - Northern America4 3.0 2.6 0.4 0.0 6.7 [6.4-6.9] 8.9 [8.6-9.2] UNICEF Regions East Asia and Pacific 24.2 [19.1-29.3] 11.0 [6.9-15.1] 3.7 [2.2-5.2] 1.4 [0.3-2.5] 5.0 [4.1-6.0] 6.8 [4.1-9.5] Europe and Central Asia6 - - - - - - Eastern Europe and Central Asia 20.2 [16.4-24.5] 7.7 [6.4-9.1] 2.0 [1.4-2.9] 0.5 [0.3-0.9] 8.2 [5.8-11.6] 10.8 [7.7-15.0] Western Europe - - - - - - Latin America and Caribbean 16.8 [13.3-20.2] 9.0 [6.1-11.8] 1.3 [0.8-1.7] 0.3 [0.2-0.4] 6.6 [5.5-7.7] 7.5 [6.7-8.4] Middle East and North Africa 22.9 [17.5-29.3] 14.3 [9.0-21.9] 6.7 [4.1-10.8] 2.7 [1.4-5.1] 8.9 [6.6-12.0] 11.0 [6.6-17.8] North America4 3.0 2.6 0.4 0.0 6.7 [6.4-6.9] 8.9 [8.6-9.2] South Asia 51.3 [49.6-53.0] 33.2 [31.2-35.3] 14.8 [11.3-19.2] 4.5 [3.3-6.2] 2.4 [1.4-4.0] 2.5 [1.5-4.2] Sub-Saharan Africa 43.1 [39.7-46.5] 32.7 [30.5-34.9] 6.9 [6.0-7.9] 1.8 [1.5-2.1] 4.4 [3.5-5.3] 3.1 [2.4-3.8] East and Southern Africa 45.6 [39.9-51.4] 32.7 [30.6-35.0] 5.6 [4.1-7.7] 1.3 [0.9-1.8] 4.6 [3.5-6.2] 3.7 [2.6-5.1] West and Central Africa 40.4 [37.2-43.7] 32.7 [29.0-36.6] 8.2 [7.4-9.1] 2.3 [1.9-2.8] 4.2 [3.2-5.5] 2.6 [2.0-3.2] WHO Regions African Region 42.3 [38.6-46.2] 32.5 [29.8-35.3] 6.4 [5.2-7.8] 1.6 [1.2-2.2] 4.6 [3.8-5.5] 3.1 [2.4-3.9] Region of the Americas 11.1 [5.7-20.5] 6.3 [3.8-10.3] 0.8 [0.5-1.4] 0.1 [0.0-0.4] 6.7 [6.1-7.5] 7.3 [6.1-8.7] South-East Asia Region 49.6 [45.8-53.3] 31.0 [26.9-35.4] 14.7 [11.3-18.9] 4.6 [3.3-6.2] 2.4 [1.4-4.1] 3.0 [1.3-6.5] Eastern Mediterranean Region 34.1 [25.1-44.5] 24.2 [15.6-35.5] 7.5 [5.9-9.4] 3.0 [2.2-4.0] 6.0 [4.3-8.4] 5.7 [3.5-9.3] Europe Region - - - - - - Western Pacific Region 20.8 [16.9-25.2] 6.2 [3.4-11.1] 2.1 [1.4-3.2] 0.5 [0.3-0.8] 5.6 [4.1-7.6] 6.2 [5.4-7.1] World Bank Income Low income 47.4 [43.6-51.2] 34.1 [31.6-36.7] 6.6 [5.3-8.2] 1.6 [1.2-2.0] 3.6 [2.6-4.9] 2.7 [2.1-3.5] Middle Income 35.2 [31.9-38.6] 21.1 [18.6-23.7] 7.5 [4.7-10.4] 2.3 [1.4-3.2] 5.3 [4.5-6.2] 6.2 [5.1-7.4] Lower-middle income 45.6 [40.4-51.0] 30.1 [26.4-34.0] 10.9 [7.1-16.3] 3.4 [2.3-5.2] 4.3 [3.3-5.6] 4.7 [3.5-6.4] Upper-middle income 18.9 [16.8-21.1] 6.0 [4.0-8.8] 1.8 [1.5-2.2] 0.4 [0.3-0.6] 6.9 [5.6-8.3] 8.8 [7.2-10.8] High income 3.4 [2.2-5.1] 5 2.8 [2.1-3.8] 0.5 [0.3-1.1] 5 0.0 [0.0-0.1] 5 5.4 [3.8-7.6] 5 7.6 [4.7-12.0] 5 World Bank Regions East Asia and Pacific 24.2 [19.1-29.3] 11.0 [6.9-15.1] 3.7 [2.2-5.2] 1.4 [0.3-2.5] 5.0 [4.1-6.0] 6.8 [4.1-9.5] Europe and Central Asia - - - - - - Latin America and Caribbean 16.8 [13.3-20.2] 9.0 [6.1-11.8] 1.3 [0.8-1.7] 0.3 [0.2-0.4] 6.6 [5.5-7.7] 7.5 [6.7-8.4] Middle East and North Africa 22.8 [17.4-29.3] 14.3 [9.0-21.9] 6.8 [4.1-10.8] 2.7 [1.4-5.1] 8.9 [6.6-12.1] 11.0 [6.6-17.8] North America4 3.0 2.6 0.4 0.0 6.7 [6.4-6.9] 8.9 [8.6-9.2] South Asia 51.3 [49.6-53.0] 33.2 [31.2-35.3] 14.8 [11.3-19.2] 4.5 [3.3-6.2] 2.4 [1.4-4.1] 2.5 [1.5-4.2] Sub-Saharan Africa 42.9 [39.6-46.3] 33.0 [30.7-35.3] 6.8 [5.6-8.2] 1.7 [1.3-2.3] 4.4 [3.7-5.3] 3.0 [2.4-3.7] UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 13 NUMBER (MILLIONS) AFFECTED TABLES* *Complete data series for stunting and overweight (1990, 1995, 2000, 2005, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018 and 2019) and the latest year for wasting (2019) estimates of prevalence and numbers affected can be found at the websites below for global as well as for the following groupings: (i) United Nations regions and sub- regions; (ii) UNICEF regions; (iii) WHO regions; (iv) World Bank country income classifications; (v) World Bank regions; (vi) SDG regions; and (vii) FAO’s low income food deficient countries classification. These websites also contain a file with the country compositions for each grouping: UNICEF <https://data.unicef.org/topic/nutrition/malnutrition/> WHO <www.who.int/nutgrowthdb/estimates> World Bank Group <data.worldbank.org/child-malnutrition> Stunting Wasting and Severe Wasting Overweight 2000 2019 2019 2019 2000 2019 number (millions) stunted (moderate and severe) fo ot no te number (millions) stunted (moderate and severe) fo ot no te number (millions) wasted (moderate and severe) fo ot no te number (millions) wasted (severe) fo ot no te number (millions) overweight (moder- ate and severe) fo ot no te number (millions) overweight (moder- ate and severe) fo ot no te Global 199.5 [190.0-209.0] 144.0 [133.6-154.5] 47.0 [38.7-55.3] 14.3 [11.1-17.5] 30.3 [26.8-33.8] 38.3 [32.9-43.6] United Nations Regions Less Developed Regions1 196.3 [187.0-205.5] 140.9 [130.6-151.2] 46.2 [37.9-54.4] 14.2 [11.1-17.4] 24.8 [22.0-27.6] 30.6 [26.2-35.0] Africa 49.7 [46.7-52.8] 57.5 [53.0-62.0] 12.7 [10.7-14.8] 3.5 [2.8-4.2] 6.5 [5.3-7.8] 9.3 [6.9-11.8] Eastern Africa 21.1 [19.0-23.3] 23.1 [20.6-25.8] 3.6 [2.6-4.9] 0.7 [0.5-1.0] 2.2 [1.7-2.8] 2.5 [2.0-3.1] Middle Africa 7.0 [6.0-8.0] 9.5 [8.0-11.2] 2.0 [1.5-2.6] 0.7 [0.5-0.9] 0.8 [0.5-1.1] 1.5 [1.0-2.3] Northern Africa 5.0 [3.8-6.6] 5.1 [3.4-7.5] 2.1 [1.1-4.0] 0.9 [0.5-1.8] 1.8 [1.0-3.0] 3.3 [1.6-6.3] Southern Africa 1.9 [1.7-2.1] 2.0 [1.7-2.2] 0.2 [0.1-0.3] 0.1 [0.0-0.1] 0.6 [0.4-0.8] 0.9 [0.6-1.2] Western Africa 14.8 [13.6-16.0] 17.8 [15.3-20.6] 4.8 [4.2-5.5] 1.1 [0.9-1.4] 1.2 [0.9-1.6] 1.2 [0.9-1.6] Asia2 136.6 [128.0-145.1] 78.2 [69.1-87.3] 32.6 [24.6-40.6] 10.5 [7.5-13.6] 14.4 [12.0-16.9] 17.2 [13.5-20.9] Central Asia 1.7 [1.3-2.1] 0.8 [0.6-1.0] 0.2 [0.1-0.3] 0.1 [0.0-0.1] 0.6 [0.3-0.9] 0.5 [0.3-0.9] Eastern Asia2 18.4 [17.1-19.7] 4.1 [3.7-4.5] 1.5 [1.5-1.6] 0.4 [0.3-0.4] 6.1 [5.5-6.8] 5.7 [5.0-6.5] Southern Asia 90.2 [82.6-97.7] 55.9 [48.2-64.2] 25.2 [18.4-34.2] 7.8 [5.5-11.0] 4.4 [2.7-7.3] 4.5 [2.6-7.7] South-eastern Asia 21.0 [17.9-24.4] 13.9 [10.5-18.0] 4.7 [3.3-6.4] 2.0 [0.9-4.3] 1.7 [1.4-2.2] 4.2 [2.5-7.1] Western Asia 5.3 [3.7-7.4] 3.4 [1.7-6.5] 1.0 [0.4-2.4] 0.3 [0.1-0.8] 1.6 [1.1-2.1] 2.3 [1.2-4.1] Latin American and Caribbean 9.5 [7.6-11.5] 4.7 [3.2-6.2] 0.7 [0.4-0.9] 0.1 [0.1-0.2] 3.8 [3.1-4.4] 3.9 [3.5-4.3] Caribbean 0.6 [0.3-1.1] 0.3 [0.1-0.6] 0.1 [0.1-0.1] 0.0 [0.0-0.0] 0.2 [0.2-0.2] 0.2 [0.1-0.5] Central America 3.9 [2.8-5.4] 2.0 [1.3-3.1] 0.1 [0.1-0.2] 0.0 [0.0-0.0] 1.0 [0.8-1.2] 1.1 [0.9-1.3] South America 5.0 [3.8-6.5] 2.4 [1.4-3.9] 5 0.4 [0.2-0.7] 5 0.1 [0.0-0.2] 5 2.6 [2.1-3.2] 2.6 [2.2-2.9] 5 Oceania3 0.5 [0.2-0.7] 0.6 [0.3-0.9] 0.1 [0.1-0.2] 0.1 [0.0-0.1] 0.1 [0.0-0.1] 0.1 [0.1-0.2] More Developed Regions - - - - - - Australia and New Zealand4 0.0 - - - 0.1 [0.0-0.3] 0.4 [0.1-0.7] Europe - - - - - - Northern America4 0.7 0.6 0.1 0.0 1.4 [1.4-1.5] 1.9 [1.9-2.0] UNICEF Regions East Asia and Pacific 38.1 [30.1-46.1] 16.9 [10.6-23.2] 5.7 [3.4-8.0] 2.1 [0.5-3.8] 7.9 [6.5-9.4] 10.4 [6.3-14.6] Europe and Central Asia6 - - - - - - Eastern Europe and Central Asia 3.9 [3.2-4.8] 1.6 [1.4-2.0] 0.4 [0.3-0.6] 0.1 [0.1-0.2] 1.6 [1.1-2.3] 2.3 [1.6-3.2] Western Europe - - - - - - Latin America and Caribbean 9.5 [7.6-11.5] 4.7 [3.2-6.2] 0.7 [0.4-0.9] 0.1 [0.1-0.2] 3.8 [3.1-4.4] 3.9 [3.5-4.3] Middle East and North Africa 8.5 [6.5-10.9] 7.1 [4.4-10.8] 3.3 [2.0-5.4] 1.3 [0.7-2.5] 3.3 [2.4-4.5] 5.4 [3.2-8.8] North America4 0.7 0.6 0.1 0.0 1.4 [1.4-1.5] 1.9 [1.9-2.0] South Asia 90.1 [87.1-93.1] 56.1 [52.7-59.6] 25.1 [19.1-32.5] 7.7 [5.6-10.5] 4.2 [2.5-7.1] 4.2 [2.5-7.1] Sub-Saharan Africa 49.5 [45.6-53.4] 57.0 [53.2-60.8] 12.1 [10.4-13.8] 3.1 [2.6-3.7] 5.1 [4.1-6.1] 5.4 [4.2-6.6] East and Southern Africa 27.1 [23.7-30.6] 28.0 [26.1-29.9] 4.8 [3.5-6.6] 1.1 [0.8-1.5] 2.8 [2.1-3.7] 3.1 [2.2-4.4] West and Central Africa 22.4 [20.6-24.2] 29.0 [25.8-32.4] 7.3 [6.6-8.1] 2.0 [1.7-2.5] 2.3 [1.8-3.0] 2.3 [1.8-2.9] WHO Regions African Region 47.2 [43.0-51.4] 55.3 [50.7-60.1] 10.9 [8.9-13.3] 2.8 [2.1-3.7] 5.1 [4.2-6.1] 5.3 [4.1-6.7] Region of the Americas 8.6 [4.4-15.9] 4.6 [2.8-7.6] 0.6 [0.4-1.0] 0.1 [0.0-0.3] 5.2 [4.7-5.8] 5.3 [4.5-6.4] South-East Asia Region 90.6 [83.8-97.4] 52.6 [45.6-60.1] 24.9 [19.1-32.1] 7.7 [5.7-10.5] 4.4 [2.5-7.5] 5.0 [2.3-11.0] Eastern Mediterranean Region 22.4 [16.5-29.2] 20.6 [13.3-30.3] 6.4 [5.0-8.0] 2.6 [1.9-3.5] 4.0 [2.8-5.5] 4.9 [3.0-7.9] Europe Region - - - - - - Western Pacific Region 25.9 [21.1-31.4] 7.5 [4.1-13.3] 2.6 [1.7-3.9] 0.6 [0.4-1.0] 7.0 [5.1-9.5] 7.4 [6.5-8.5] World Bank Income Low income 38.0 [35.0-41.0] 39.7 [36.8-42.8] 7.7 [6.2-9.6] 1.8 [1.4-2.4] 2.9 [2.1-3.9] 3.2 [2.4-4.1] Middle Income 164.2 [148.5-180.0] 104.1 [91.7-116.5] 37.1 [23.2-51.1] 11.4 [7.0-15.9] 24.7 [20.8-28.7] 30.8 [25.2-36.4] Lower-middle income 130.1 [115.0-145.4] 93.2 [82.0-105.2] 33.8 [22.1-50.5] 10.6 [7.0-16.1] 12.3 [9.5-15.9] 14.6 [10.7-20.0] Upper middle income 34.2 [30.4-38.3] 11.0 [7.4-16.1] 3.3 [2.8-4.0] 0.8 [0.6-1.0] 12.4 [10.2-15.0] 16.1 [13.2-19.7] High income 2.3 [1.5-3.6] 5 1.9 [1.4-2.6] 0.4 [0.2-0.7] 5 0.0 [0.0-0.1] 5 3.7 [2.6-5.2] 5 5.2 [3.2-8.2] 5 World Bank Regions East Asia and Pacific 38.2 [30.2-46.2] 17.0 [10.6-23.3] 5.7 [3.4-8.0] 2.2 [0.5-3.8] 8.0 [6.5-9.5] 10.4 [6.3-14.6] Europe and Central Asia - - - - - - Latin America and Caribbean 9.5 [7.6-11.5] 4.7 [3.2-6.2] 0.7 [0.4-0.9] 0.1 [0.1-0.2] 3.8 [3.1-4.4] 3.9 [3.5-4.3] Middle East and North Africa 8.5 [6.5-11.0] 7.1 [4.5-10.9] 3.3 [2.1-5.4] 1.3 [0.7-2.5] 3.3 [2.5-4.5] 5.4 [3.3-8.8] North America4 0.7 0.6 0.1 0.0 1.4 [1.4-1.5] 1.9 [1.9-2.0] South Asia 90.1 [87.1-93.1] 56.1 [52.7-59.6] 25.1 [19.1-32.5] 7.7 [5.6-10.5] 4.2 [2.5-7.1] 4.2 [2.5-7.1] Sub-Saharan Africa 49.2 [45.4-53.1] 57.5 [53.6-61.5] 11.8 [9.8-14.2] 3.0 [2.3-4.0] 5.1 [4.2-6.1] 5.2 [4.2-6.5] 14 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition Strengths and weaknesses of malnutrition data Prevalence estimates for stunting and overweight are relatively stable over the course of a calendar year. It is therefore possible to track global and regional changes in these two conditions over time. Wasting and severe wasting are acute conditions that can change frequently and rapidly over the course of a calendar year. This makes it diffi cult to generate reliable trends over time with the input data available, and as such, this report provides only most recent global and regional estimates. The joint global and regional estimates that make up the UNICEF/ WHO/World Bank Group Joint Child Malnutrition Estimates have been generated using a country-level dataset which is mainly comprised of estimates from nationally representative household surveys. These data are collected infrequently (every 3 to 5 years in most countries) and measure malnutrition at one point in time (e.g. during one or several months of fi eld work), making it diffi cult to capture the rapid fl uctuations in wasting that can occur over the course of a given year. Incidence data (i.e. the number of new cases that occur during the calendar year) would allow for better tracking of changes over time; however, these data currently do not exist. The analysis methods and presentation have remained unchanged from the 2012 report1, except for minor refi nements detailed below: 1. Year assigned to each survey When data collection begins in one calendar year and continues into the next, the survey year assigned is the one in which most of the fi eldwork took place. For example, if a survey was conducted between 1 September 2009 and 28 February 2010, the year 2009 would be assigned, since the majority of data collection took place in that year (i.e., four months in 2009 versus two months in 2010). This method has been used since the 2013 edition (prior to that, the latter year was used by default – e.g., 2010 in the example above). 1 United Nations Children’s Fund, World Health Organization, The World Bank. UNICEF- WHO-World Bank Joint Child Malnutrition Estimates. (UNICEF, New York; WHO, Geneva; The World Bank, Washington, DC; 2012). 2. Final reports only As of the 2014 edition, the country-level dataset used to generate the global and regional joint malnutrition estimates is based only on fi nal survey results. Preliminary survey results are no longer included in the dataset since the data are sometimes retracted or change signifi cantly when the fi nal version is released. 3. Updated data sources i. The updated joint dataset includes: • 924 nationally representative surveys; • data from 152 countries and territories, representing more than 90 per cent of all children under 5 globally (population coverage varies by regions and periods). The majority of data available are from low- and middle-income countries – more efforts are needed to generate data from high-income countries. ii. The under 5 population estimates were based on The United Nations World Population Prospects, 2019 Revision. These were used as weighting factors for each country survey to derive the regional and global prevalence estimates and calculate the numbers affected. iii. Regional and country income classifi cations were based on FY2020 World Bank income classifi cation. 4. Footnotes on population coverage As started in the 2014 edition, a separate exercise was conducted to assess population coverage. This was important in order to alert the reader, via footnotes, to instances where the data should be interpreted with caution due to low population coverage (defi ned as less than 50 per cent). A conservative method was applied looking at available data within fi ve-year periods around the projected years. Population coverage was calculated as: the sum of country fi ve-year average populations for which surveys are available in the dataset the total of country fi ve-year average population for all countries in the region Population coverage 9/37 71/2023/51 Global More Developed Regions***Oceania** 25/47 Asia* 2/15 Latin America and Caribbean 32/54 Africa Number of countries with at least one recent (2015-2019) survey Number of countries with at least one recent (2015-2019) survey 64%34%69% 51% 7%72% Population coverage 9/37 71/20225/47 2/1531/54 65%69% 51% 7%71% Stunting Overweight 4/51 36% Note: * Asia excluding Japan; **Oceania excluding Australia and New Zealand. *** The More Developed Region malnutrition estimates are not displayed in the brochure due to lack of adequate population coverage (<50 per cent) in all year ranges since 1990. Also note that fi gures for wasting are the same as for stunting and therefore not presented. NOTES ON THE DATA AND METHODOLOGY Population coverage for the most recent period (2015-2019), by UN regions UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition 15 This key fi ndings report of the 2020 edition of the Joint Malnutrition Estimates summarizes the new regional and global numbers and main messages for offi cial United Nations data on child malnutrition. Additional information is available and the following materials can be downloaded from the links on the bottom right: • the latest country-level joint malnutrition dataset, a time series of all country estimates that were used to generate the joint child malnutrition global and regional estimates; • the joint malnutrition global and regional estimates database by various regional groupings (e.g. United Nations, UNICEF, WHO, etc., regional groupings) and for more years than presented in this brochure; • a reference document outlining the composition of the various regional groupings for which the joint estimates have been produced. • interactive dashboards, which allow users to visualize and export the global and regional estimates for a number of regional groupings. UNICEF: <https://data.unicef.org/resources/jme> WHO: <www.who.int/nutgrowthdb/estimates> World Bank Group: <data.worldbank.org/child-malnutrition> ONLINE MATERIALS INTERACTIVE DASHBOARD OVERVIEW 5. Prevalence thresholds for wasting, overweight and stunting in children under 5 years New thresholds, presented in Table 1, were established through the WHO-UNICEF Technical Advisory Group on Nutrition Monitoring (TEAM)2 and released in 2018. These new thresholds have been used for development of prevalence-based maps in this brochure. The thresholds were developed in relation to standard deviations (SD) of the normative WHO Child Growth Standards. The international defi nition of ‘normal’ (two SD from the WHO standards median) defi nes the fi rst threshold, which includes 2.3% of the area under the normalized distribution. Multipliers of this “very low” level (rounded to 2.5%) set the basis to establish subsequent thresholds. 2 de Onis, M., et al. (2018). Prevalence thresholds for wasting, overweight and stunting in children under 5 years. Public health nutrition, 22(1), 175–179. Table 1. Prevalence thresholds and corresponding labels for stunting, overweight and wasting Labels Prevalence thresholds (%) Stunting Overweight and Wasting Very low < 2.5 < 2.5 Low 2.5 – < 10 2.5 – < 5 Medium 10 – < 20 5 – < 10 High 20 – <30 10 – < 15 Very high ≥ 30 ≥ 15 Select your regional grouping (UNICEF, WHO, United Nations, World Bank Income) Select regions to view Select years to view Hover over data points for detailed information Options Tabs where you can select different visualizations for global and regional data With these links you can view the dashboard on the UNICEF, WHO or World Bank Group websites Download the graphics and data here 16 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2020 edition Acknowledgements This publication was prepared by: the Data, Analytics and Innovation Section of the Division of Data, Analytics, Planning and Monitoring, UNICEF New York together with the Department of Nutrition for Health and Development, WHO Geneva and the Development Data Group of the World Bank, Washington DC. March 2020. Organizations and individuals involved in generating this publication: UNICEF: Chika Hayashi, Julia Krasevec, Richard Kumapley, Juan Manuel Puyana, Vrinda Mehra WHO: Elaine Borghi, Elisa Dominguez, Jose Luis Alvarez Moran, Mercedes de Onis World Bank Group: Espen Beer Prydz, Umar Serajuddin, Emi Suzuki Design: Nona Reuter (UNICEF); Writing and editing: Julia D’Aloisio (UNICEF) Special thanks go to Victor Aguayo (UNICEF), Francesco Branca (WHO) and Mark Hereward (UNICEF) ISBN 978-92-4-000357-6 (electronic version) ISBN 978-92-4-000358-3 (print version) © United Nations Children’s Fund (UNICEF), the World Health Organization, and the International Bank for Reconstruction and Development/The World Bank, 2020. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence. Suggested citation: United Nations Children’s Fund (UNICEF), World Health Organization, International Bank for Reconstruction and Development/The World Bank. Levels and trends in child malnutrition: Key Findings of the 2020 Edition of the Joint Child Malnutrition Estimates. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO. <data.unicef.org/nutrition>; <www.who.int/nutgrowthdb>; <data.worldbank.org>. Email: data@unicef.org Email: nutrition@who.int Email: data@worldbank.org ISBN 978-92-4-000357-6