| Documentation on nutritional 'score' variable [message #2212] | 
			Tue, 27 May 2014 14:48   | 
		 
		
			
				
				
				
					
						  
						jafishm2
						 Messages: 3 Registered: May 2014 
						
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					Member  | 
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		I am yet to find any documentation on the 'score' variable aside from the codebook in my statistical software. According to the codebook the 'score' variable is an indicator of nutritional score, ranging from 0 to 15. Has anybody seen DHS-published documentation for this variable which could explain how it is derived and what the  high/low values in the score refer to?  
 
Thanks, 
 
Jamie
		
		
		
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			| Re: Documentation on nutritional 'score' variable [message #2228 is a reply to message #2212] | 
			Fri, 30 May 2014 10:23    | 
		 
		
			
				
				
				
					
						
						Liz-DHS
						 Messages: 1516 Registered: February 2013 
						
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		Dear User, 
The Guide to DHS Statistics  http://dhsprogram.com/publications/publication-dhsg1-dhs-que stionnaires-and-manuals.cfmcontains the following: 
 
CHILDREN'S AND WOMEN'S NUTRITIONAL STATUS 
CHILDREN'S NUTRITIONAL STATUS 
Statistics: Percentages of Children Under 5 Years of Age, by Stunted, Wasted, 
and Underweight 
Definition 
A. Coverage: 
1. Population base: Living children born 0 to 59 months before the survey. 
2. Time period: Current status at the time of the survey. 
B. Numerators: 
1. Severely stunted: Number of children whose height for age z-score is less than -3.0 standard 
deviations (SD) below the mean on the NCHS/CDC/WHO international references standard. 
2. Moderately stunted: Number of children whose height for age z-score is between 2.0 and 
-2.99 standard deviations (SD) below the mean on the NCHS/CDC/WHO international 
references standard. 
3. Severely wasted: Number of children whose weight for height z-score is less than 3.0 
standard deviations (SD) below the mean on the NCHS/CDC/WHO international references 
standard. 
4. Moderately wasted: Number of children whose weight for height z-score is between 2.0 and 
2.99 standard deviations (SD) below the mean on the NCHS/CDC/WHO international 
references standard. 
5. Severely underweight: Number of children whose weight for age z-score is less than 2.0 
standard deviations (SD) below the mean on the NCHS/CDC/WHO international references 
standard. 
6. Moderately underweight: Number of children whose weight for age z-score is between 2.0 
and 2.99 standard deviations (SD) below the mean on the NCHS/CDC/WHO international 
references standard. 
C. Denominator: Number of living children between ages 0 and 59 months before the survey. 
 
Calculation 
A. The assignment of anthropmetric z-scores based on the NCHS/CDC/WHO International 
Reference Standard is done through a complicated interpolation function that takes into account 
sex, age (measured by difference in date of birth and date of interview, both precise to day of 
month), height in centimeters, and weight in kilograms (precise to 100 grams). As part of a 
creation of a recode file variables with the z-scores are calculated and included in that file. In the 
process of assigning the z-scores, checks are made on their plausibility. Z-scores are assigned 
missing to children with incomplete date of birth (month or year missing or "don't know"). The 
reason is because z-scores are very sensitive to changes in age. Children with height for age 
z-scores below 6 SD or above +6 SD, with weight for age z-scores below 6 SD or above +6 
SD, or with weight for height z-scores below 4 SD or above +6 SD are flagged as having invalid 
data. Also invalid are combinations of z-scores where height for age is less than 3.09 SD and 
weight for age is more than +3.09 SD, or where height for age is more than +3.09 SD and weight 
for age is less than 3.09 SD. 
B. The percentages of children stunted, wasted, and underweight are equal to the specific numerators 
divided by the denominators and multiplied by 100. 
Handling of Missing Values 
Children who were not weighed and measured and children whose values for weight and height were not 
recorded are excluded from both the denominator and the numerators. Children whose day of month of 
birth is missing or unknown are assigned day 15. Children who are flagged for out-of-range z-scores or 
invalid z-scores are excluded from both the denominator and the numerators. Children with missing data 
in the z-scores (date of birth incomplete or missing) are excluded from both the denominator and the 
numerators. 
Notes and Considerations 
Stunting, based on a child's height and age, is a measure of chronic nutritional deficiency. Wasting, based 
on a child's weight and height, is a measure of acute nutritional deficiency. Underweight, based on weight 
and age, is a composite measure of both acute and chronic statuses. The NCHS/CDC/WHO standard is 
based on well-nourished children in the United States. Due to natural variations in a well nourished 
population, 2.2 percent of children will be between 2.0 and 2.99 SD below the mean, and 0.1 percent 
will be 3.0 or more SD below the mean. The extent of malnutrition in a population should be taken by 
the extent the proportions moderate and severe exceed these percentages that occur in a well-fed 
population of children. 
The NCHS/CDC/WHO international reference standard is a combination of two reference standards: one 
for children under 24 months and the other for children 24216 months. The first standard, called the Fels 
standard, is based on children whose height was taken while prone. The other standard, based on 
NHANES data, is derived from children 24 months and older whose height was measured while they 
were standing. For children 24 months of age or over, whose height was measured while lying down, one 
centimeter should be subtracted from their measured height before calculating the z-scores. 
 
Changes over Time 
In phases of the DHS survey before phase IV (DHS+), only children of interviewed women and who 
were under five years old (or the cutoff for the health section of the individual questionnaire) were 
weighed and measured. In many surveys, only a subsample of these children were selected for 
anthropometry. All comparisons between surveys, either over time or between countries, should take into 
account the possible differences in the defined population base.
		
		
		
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			| Re: Documentation on nutritional 'score' variable [message #4128 is a reply to message #4126] | 
			Thu, 02 April 2015 14:57   | 
		 
		
			
				
				
				
					
						  
						Trevor-DHS
						 Messages: 808 Registered: January 2013 
						
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					Senior Member  | 
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		The score variable in this dataset is a food security score, based on questions 1001-1005.  It is calculated as follows: 
 
gen score = 0
replace score = score + s1001-1 if s1001 < 9
replace score = score + s1002-1 if s1002 < 9
replace score = score + s1003-1 if s1003 < 9
replace score = score + s1004-1 if s1004 < 9
replace score = score + s1005-1 if s1005 < 9
replace score = . if s1001 == 9 | s1002 == 9 | s1003 == 9 | s1004 == 9 | s1005 == 9  
with 0 being most secure and 15 being the least secure.
		
		
		
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