A Cost–Benefit Approach
Chapter 12: Nutrition and HIV at the Country Level
HIV can reside in an individual and in a group of individuals, a country population. So interventions can be carried out targeting individuals or the whole nation. Similarly, malnutrition can be treated individually and at country levels. In this chapter we follow up the previous chapter with an analysis of the malnutrition/HIV link at the national and regional levels. UNDERSTANDING THE MALNUTRITION MEASURES The three measures of malnutrition we introduced in the last chapter for measuring malnutrition in children under 15 in South Africa (underweight, wasting and stunting) can also be used to establish the extent of malnutrition in a national population and region. Children’s weight or height by age and sex in a particular country can be compared with the weight or height by age and sex in a reference population, usually the United States. A child in the United States would be judged malnourished if the child was well below the weight for height that was typical in the United States. If the height and weight distributions were normally distributed (a symmetrical bell-shaped distribution), approximately 95 percent of the children would be within plus or minus 2 standard deviations (SDs) from the mean or median in the United States. This means that 5 percent of the children would not be typical. Since being way above what is typical is not a hunger problem, only those in the bottom tail of 2.5 percent would be considered malnourished. So –2 SDs from the United States mean or median is the...
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