Growth status of children in rural Mali: Implications for nutrition education programs

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Abstract
In conjunction with a rural development project, a cross-sectional anthropometric survey and ethnographic research were conducted in six rural villages in southern Mali where food is generally sufficient. A total of 1,132 individuals were measured, and individual and group interviews concerning dietary habits and intra-familial food distribution patterns were conducted. In this paper, data on the growth status of children under 12 years of age (N=575) are reported and analyzed. As defined by inadequate growth, rates of malnutrition are extremely high in this population. Deficits in growth peak among the 2 year olds, with 67% falling more than 2 SD below the NCHS/WHO standard for weight-for-age, and 53% falling more than 2SD below the standard for height-for-age. Deficits in weight-for-height are highest among the 1 year olds, with 32% falling more than 2 SD below the NCHS/WHO standards. From birth to 23 months, the correlation between age (in months) and weight-for-age z-scores is −.63 (P=.0001). Between 24 and 47 months, the correlation improves, to +.36 (P=.0004), indicating that children experience some catch-up growth. By the age of 11 years, they still have not recovered fully from the combination of poor nutrition and infections in early childhood, however, and malnutrition continues to be a problem throughout childhood. Iodine deficiency is also a problem in two of the six villages. Interview data confirm earlier findings in Mali regarding child feeding practices, specifically, that infants and young children are expected to feed themselves, and that the best foods are reserved for adults. These findings have important implications for the design and implementation of nutrition education programs in southern Mali.