Malnutrition in all its forms and socioeconomic status in Bolivia

Objective: To estimate the prevalence of malnutrition (undernutrition and excess BMI) among children under the age of 5 years and women of reproductive age in Bolivia considering three socioeconomic indicators: wealth, education and ethnicity. Design: We used the 2008 nationally representative Bolivian Demographic and Health Survey (DHS). Malnutrition's prevalence was estimated by wealth, ethnicity and educational level. Wealth index was measured based on the DHS methodology and nutritional status by using WHO standards and indicators. Education level (EL) was categorized by years of formal education. Setting: Bolivia. Participants: In total, 5 center dot 903 children <5 years, 3 center dot 345 adolescent women (15-19 years) and 12 center dot 297 women (20-49 years) with available information on anthropometric measurements center dot Results: A disproportionate prevalence of malnutrition was observed among different wealth groups: lower wealth tertiles show the higher prevalence of stunting (>30 %) and anaemia (>40 %) in all ages center dot The prevalence of overweight and obesity tends to rise with age from childhood (10 center dot 02-11 center dot 60) to adolescence (27 center dot 9-31 center dot 03), reaching highest levels in women of reproductive age (56 center dot 02-57 center dot 76). According to wealth tertiles, higher prevalence of overweight and obesity was found in children of high tertile (12 center dot 23), adolescent women of low (32 center dot 56) and adult women of medium tertile (63 center dot 08). Conclusions: The present study shows that currently Bolivia is in a transitional stage, faces not only the problem of undernutrition but also those of overnutrition, showing strong inequalities according to socioeconomic and education status. This study calls for state-specific policies keeping in view of the nature of inequality in malnutrition in the country and its differential characteristics across wealth status.