The asset index is the best socioeconomic indicator to identify children at risk of presenting stunting in families in low and middle-income countries.

This is what the research developed in a Master's thesis of the Post-Graduation in Epidemiology of the Federal University of Pelotas, authored by Luís Paulo Vidaletti, under the guidance of Professor Aluísio Jardim Dornellas de Barros indicates.

The study analyzed the ability of two wealth indices to distinguish the socioeconomic status of families and their relationship with stunting deficit among children in low- and middle-income countries: the asset index and the consumption expenditure index. Information on household ownership and living conditions, consumption expenditures, and anthropometric measurements of children up to five years of age were obtained from national surveys of the Living Standards Measurement Study in ten countries: Panama, Tanzania, Uganda, East Timor, Ghana , Nigeria, Tajikistan, Burkina Faso, Iraq and Malawi in six separate regions - Latin America and the Caribbean, Central and Eastern Europe, Pacific and East Asia, Central and West Africa, Eastern and Southern Africa, the Middle East and North Africa.

The researchers divided the population of each country into five economic groups, according to the asset index and the consumption expenditures index, singly, and evaluated the agreement between the economic levels generated by each index.

At the same time, the research group verified whether there was an association between the poorest quintile and higher means of stunting deficit. Because of the strong association with the poverty situation, the United Nations Children's Fund (UNICEF) recommends the stunting indicator as a parameter for the validation of socioeconomic indicators.

The results indicate that the asset index is a better predictor of height deficit than the consumption expenditure index. Eight countries (80%) had an association between averages of stunting and socioeconomic level in both indices, except for Malawi and Nigeria. The asset index discriminated better the families’ wealth and the association with measures of the child height in seven countries, only in Tanzania the consumption expenditure index had superior performance.

"In low- and middle income countries, a higher percentage of the population lives in rural areas, where consumption expenditures lose the power to discriminate households against their wealth, as opposed to possessing goods and living conditions. Part of the family's consumption needs can be solved in direct exchanges of agricultural products”, explains the author of the paper.

The research shows that there is a low agreement between the indexes tested in Tajikistan and Ghana, high agreement only in Panama and intermediate agreement in seven countries.

According to the researcher, despite the intermediate agreement, the asset index has superior performance in the validation process in relation to the height deficit, which justifies its use in the analysis of home health surveys. "That's why health’s researches includes questions about having stove, refrigerator, television, radio, telephone, car, for instance. Who is participating may be surprised, think 'what does this have to do with health?' Our study helps explain this relationship", comments the author.

"One of the main focuses of working with health indicators is to ensure that interventions are reaching all people who need them regardless of gender, age, ethnicity, geographic location or socioeconomic status. The correct identification of poorer groups is fundamental to minimize the impact of economic inequalities on the coverage of health interventions for the population," he concludes.