Online Reporter
Ray Bande
Senior Reporter
A RECENT report by the Zimbabwe Demographic and Health Survey (ZDHS) has revealed that Manicaland is among the provinces in the country with the highest prevalence of thinness among women aged 20 and 49.
The 2023/24 ZDHS, conducted by the Zimbabwe National Statistics Agency (ZIMSTAT), was funded by Government, United States Agency for International Development (USAID), United Nations Population Fund (UNFPA), and Global Fund to Fight AIDS, Tuberculosis and Malaria (GF).
Technical assistance was provided by ICF through The DHS Programme, a USAID-funded initiative that supports population and health surveys globally.
According to the report, wasting was assessed using the weight-for-height index – a measure of body mass relative to body height or length, indicating acute undernutrition.
Individuals with a weight-for-height score below the median of the reference population are classified as thin.
Chronic energy deficiency, a primary cause of thinness, results from inadequate food intake or an unbalanced diet lacking essential nutrients.
Women of reproductive age (15-49 years) are disproportionately susceptible to chronic energy deficiency and malnutrition.
This vulnerability stems from various factors, including inadequate dietary intake, unequal distribution of food within households, poor food storage and preparation methods, dietary taboos, infectious diseases, and suboptimal care practices.
Chronic energy deficiency has far-reaching consequences, including reduced productivity among adults and increased morbidity and mortality (WHO, 1995). Moreover, undernutrition in women significantly elevates the risk of adverse birth outcomes.
Conversely, overweight and obesity also have detrimental health implications, serving as major risk factors for chronic diseases such as diabetes, cardiovascular disorders, and cancer.
Body Mass Index (BMI) — the ratio of weight to height squared — is employed to assess nutritional status among adults aged 20-49.
Notably, BMI values are age- and sex-independent.
Adult women aged 20-49 with a height below 145 centimetres are classified as being of short stature.
A recent study on the nutritional status of women revealed provincial disparities.
The findings indicated that Masvingo had the lowest prevalence of thinness (three percent), while Harare had the highest prevalence of overweight and obesity (60 percent) among women aged 20-49.
“The nutritional status of women 20-49 years old varies by province, with Masvingo having the lowest prevalence of thinness (three percent) and Harare having the highest prevalence of overweight and obesity (60 percent).
“Matabeleland North, Matabeleland South, Mashonaland West, and Manicaland had the highest prevalence of thinness (six percent). Mashonaland Central had the lowest prevalence of overweight and obesity (41 percent),” reads the report in part.
When contacted for comment, local dietician, Mr Ephert Bhobho concurred that Manicaland has a high prevalence of thinness among women.
“Yes, Manicaland has a significantly high prevalence of thinness among women aged 20-49. There are several factors that could explain this phenomenon,” he said, adding that the data encompasses women from both rural and urban areas, with 58,3 percent of respondents residing in rural areas and 41,7 percent in urban areas.
“Generally, food security is a significant concern at the household level in rural areas, which may lead to inadequate food availability. Furthermore, the report reveals that 28 percent of women in Manicaland belong to the apostolic sect, specifically the Johane Marange Church, which permits polygamous marriages. This places a considerable burden on food production,” he said.
Given that Manicaland is the headquarters of these indigenous religious churches, Mr Bhobho believes this factor contributes significantly to the high prevalence of thinness among women in the province.
On a national scale, ZDHS further unearthed that overweight and obesity is highest in older women and more prevalent in urban areas than in rural settings.
“The prevalence of thinness is highest in younger women 20-29 years (seven percent) and lowest in older women 40-49 years (three percent), while overweight and obesity is highest in the older age group of 40-49 years (63 percent) and lowest in the younger age group of 20-29 years (36 percent).
“Prevalence of thinness is higher among women in rural areas (six percent) than in urban areas (four percent) whereas overweight and obesity is higher in urban areas (59 percent) than in rural areas (45 percent),” reads the report.
Being underweight, or having low weight-for-age, is a complex indicator that encompasses both weight-for-height and height-for-age. This metric reveals stunted growth, wasting, or a combination of both.
In contrast, being overweight, or having high weight-for-height, is often the result of an imbalance between energy intake (excessive) and energy expenditure (insufficient).
The study’s findings indicate that the trend of overweight and obesity among women in urban areas persists across various age groups.
Notably, the prevalence of overweight and obesity is higher among women with tertiary education compared to those with secondary education and primary education.
“The trend is similar among the adolescent women 15-19 years in which the prevalence of overweight/obesity in urban areas is 20 percent, while in rural areas it is 13 percent.
“Women 20-49 years old with primary or secondary education level (five percent) have higher prevalence of thinness as compared to those with above secondary level of education (3 percent).
“However, the prevalence of overweight and obesity is higher in women 20-49 years with more than secondary education (66 percent) than those with secondary (51 percent) and those with primary (45 percent). Data on height, weight, and age were used to calculate two measures of nutritional status — height-for-age and Body Mass Index-for-age. The report further reveals that, on a national scale, the prevalence of overweight and obesity among women aged 20-29 has doubled over the past 18 years, rising from 25 percent in 2005-06 to a staggering 51 percent in 2023-24.
“The prevalence of overweight and obesity in women 20-29 years has doubled over the past 18 years from 25 percent in 2005-06 to 51 percent in 2023-24, while the prevalence of thinness decreased by almost half from 9 percent in 2002-06 to 5 percent in 2023-24. Among women 15-19 years, obesity and overweight increased from 8 percent in 1994 through to 10 percent in 1999 and to 15 percent in 2005-6, then declined to 14 percent in 2010-11 through to six percent in 2015 and increased to 16 percent in 2023-24.
“Thinness in adolescents 15-19 increased from 10 percent in 1994 to 13 percent in 1999, and had slight decline to 11 percent in 2005-06, it plateaued to 13 percent in 2010-11, and 2015 before a slight decline to 12 percent in 2023-24.
“Among adolescents 15-19 years, the prevalence of overweight and obesity is higher in those with secondary education (17 percent) compared with those with primary education (five percent).
“Thinness prevalence is highest in women age 20-49 who are in the lowest quintile (nine percent) and lowest among those in the highest quintile (three percent), while overweight and obesity is highest among those in the 272 highest quintile (63 percent) and lowest in the lowest quintile (32 percent). The trend is similar in adolescents 15-19 years,” further notes the report.
