Comparison of a possession score and a poverty index in predicting anaemia and undernutrition in pre-school children and women of reproductive age in rural and urban Cote d'Ivoire

Objective: To determine whether a possession score or a poverty index best predicts undernutrition and anaemia in women of reproductive age (15-49 years; WRA) and children aged 6-59 months living in Cote d'Ivoire. Design: Anthropometric measurements were converted to Z-scores to assess stunting, wasting and underweight in children, and converted to BMI in WRA. A venous blood sample was drawn, and Hb concentration and Plasmodium spp. infection were determined. A possession score was generated with categories of zero to four possessions. A five-point (quintile) poverty index using household assets was created using principal component analysis. These socio-economic measures were compared for their ability to predict anaemia and malnutrition. Setting: Data were from a nationally representative survey conducted in Cote d'Ivoire in 2007. Subjects: A sample of 768 WRA and 717 children aged 6-59 months was analysed. Results: Overall, 74.9% of children and 50.2% of WRA were anaemic; 39.5% of the children were stunted, 28.1% underweight and 12.8% wasted, while 7.4% of WRA had BMI, 18.5 kg/m(2). In general, there were more stunted and underweight children and thin WRA in rural areas. The poverty index showed a stronger relationship with nutritional status than the possession score; mean Hb difference between the poorest and wealthiest quintiles in children and WRA was 8.2 g/l and 6.5 g/l, respectively (13.9% and 19.8% difference in anaemia, respectively; P<0.001), and Z-scores and BMI were significantly better in the wealthiest quintile (P<0.001). Conclusions: The poverty index was generally a better predictor of undernutrition in WRA and pre-school children than the possession score.