According to surveys over the last 15 years, the nutritional status of children under five years in Papua New Guinea has not improved (Smith, 1992; Gibson and Rozelle, 1998). In rural areas there is a high prevalence of underweight, a very high prevalence of stunting and a medium prevalence of wasting in children under five years (Monsef, 1998). The prevalence of underweight and wasting was highest among infants at one year, while stunting affected more than half of the children at four years. A sub-national survey carried out among children under five years reported a lower prevalence of underweight, stunting and wasting in urban areas. Children under five years living in the Highlands have a greater risk of stunting than their coastal counterparts. However, children living in the coastal regions are more likely to be wasted (Gibson and Rozelle, 1998).
The prevalence of chronic energy deficiency in adults (greater than 18 years) in 1996 was 12% for women and 5% for men. Although there are no nationally representative data available, adults seem to be affected by overweight and obesity. According to a small scale survey, obesity is most prevalent in the urban coastal areas, and least prevalent in rural Highlands. This increase in the prevalence of overweight and obesity is partly attributable to the adoption of a modern life-style (Gibson & Rozelle, 1998).
Non-communicable diseases are of concern with increasing age, while communicable diseases still account for a majority of deaths, especially at an early age. Maternal and infant mortality rates are still high. There is insufficient routine immunisation coverage (UNICEF, 2002).
Food consumption patterns have changed in the last four decades in Papua New Guinea: from starchy roots to cereals as the main source of energy. There is a steady decrease in the availability of starchy roots. During the same period consumption of rice nearly tripled.
Iron deficiency anaemia is known to be widespread in Papua New Guinea, although no national representative survey has been carried out. Women of child-bearing age and young children are considered to be especially vulnerable. A survey carried out in 1998 identified a high prevalence of anaemia in children under five years. The highest prevalence was observed in the province of Sepik, indicating almost all children less than 5 years as anaemic.
Though there are no national representative data available, results from small scale surveys suggest that there is a problem of clinical vitamin A deficiency in some provinces. Prevalence of night blindness and xerophthalmia in Madang is a public health problem (Friesen et al., 1998a).
Data from different provinces of Papua New Guinea suggests that iodine deficiency disorders (IDD) are a national public health problem. In one district in Morobe, mild IDD was reported in children between 8 and 10 years in 1997. Earlier studies identified a much higher prevalence in several provinces and a vast gender difference in the prevalence of IDD, suggesting that women, especially pregnant and lactating, were twice as likely to suffer from iodine deficiency as men (Amoa et al., 1997).