Figure 1
Flowchart summarizing the inclusion and exclusion criteria for participation.
Table 1
Selected baseline characteristics of the children under age five at the national level and by living area, Panama, 2019.
| SELECTED BASELINE CHARACTERISTICS | LIVING AREA | |||||||
|---|---|---|---|---|---|---|---|---|
| NATIONAL | URBAN AREA | RURAL AREA | INDIGENOUS AREA | |||||
| N | WEIGHTED PREVALENCE % (95% CI) | N | WEIGHTED PREVALENCE % (95% CI) | N | WEIGHTED PREVALENCE % (95% CI) | N | WEIGHTED PREVALENCE % (95% CI) | |
| Total | 370,408 | 100.0 | 184,798 | 49.9 (46.7–53.0) | 124,196 | 33.5 (30.8–36.3) | 61,414 | 16.6 (14.4–19.0) |
| Sociodemographic characteristics | ||||||||
| Age (months) | ||||||||
| 0–11 | 50,317 | 13.6 (11.7–15.7) | 24,303 | 13.2 (10.3–16.7) | 17,228 | 13.9 (11.3–16.9) | 8,786 | 14.3 (10.2–19.7) |
| 12–23 | 75,137 | 20.3 (17.9–23.0) | 36,031 | 19.5 (15.8–23.8) | 25,582 | 20.6 (17.5–24.1) | 13,524 | 22.0 (15.8–29.9) |
| 24–35 | 85,444 | 23.1 (20.5–25.9) | 38,879 | 21.0 (17.1–25.6) | 28,759 | 23.2 (19.6–27.1) | 17,805 | 29.0 (22.8–36.1) |
| 36–47 | 80,472 | 21.7 (19.4–24.2) | 46,949 | 25.4 (21.6–29.7) | 24,490 | 19.7 (16.7–23.1) | 9,033 | 14.7 (10.9–19.5) |
| 48–59 | 79,038 | 21.3 (18.7–24.3) | 38,635 | 20.9 (17.3–25.1) | 28,136 | 22.7 (18.1–27.9) | 12,266 | 20.0 (13.8–27.9) |
| Female sex | 169,158 | 45.7 (42.5–48.8) | 76,020 | 41.1 (36.5–45.9) | 62,110 | 50.0 (45.4–54.6) | 31,027 | 50.5 (42.9–58.1) |
| Overcrowding | 53,454 | 14.4 (12.7–16.3) | 15,436 | 8.4 (6.3–11.0) | 12,737 | 10.3 (8.2–12.8) | 25,281 | 41.2 (34.4–48.3) |
| Household monthly income quartile (USD; $) | ||||||||
| First quartile (≤124) | 101,824 | 29.2 (26.6–32.0) | 18,679 | 10.8 (8.4–16.6) | 37,233 | 32.0 (28.1–36.3) | 45,911 | 77.6 (69.5–84.1) |
| Second quartile (125–399) | 94,054 | 27.0 (24.2–30.0) | 45,205 | 26.1 (21.8–30.9) | 37,469 | 32.2 (28.2–36.5) | 11,380 | 19.2 (13.0–27.6) |
| Third quartile (400–699) | 83,150 | 23.8 (21.1–26.8) | 54,117 | 31.2 (27.1–35.6) | 27,478 | 23.6 (18.8–29.3) | 1,555 | 2.6 (1.5–4.4) |
| Fourth quartile (≥700) | 69,765 | 20.0 (17.3–23.0) | 55,405 | 32.0 (27.3–37.0) | 14,064 | 12.1 (9.5–15.3) | 296 | 0.5 (0.2–1.1) |
| Household dietary diversity | ||||||||
| Low (0–3) | 28,576 | 7.7 (6.1–9.7) | 7,653 | 4.1 (2.2–7.8) | 6,182 | 5.0 (3.6–6.8) | 14,740 | 24.0 (18.5–30.6) |
| Medium (4–6) | 63,164 | 17.1 (14.9–19.4) | 21,696 | 11.7 (9.1–15.0) | 19,627 | 15.8 (13.0–19.0) | 21,840 | 35.6 (28.5–43.3) |
| High (7–12) | 278,668 | 75.2 (72.5–77.8) | 155,449 | 84.1 (80.0–87.5) | 98,386 | 79.2 (75.7–82.3) | 24,833 | 40.4 (33.0–48.3) |
| WASH characteristics | ||||||||
| Unimproved drinking water source status | 47,651 | 12.9 (11.0–15.0) | 8,206 | 4.4 (3.0–6.5) | 16,649 | 13.4 (10.9–16.4) | 22,797 | 37.1 (29.8–45.1) |
| Unimproved sanitation system | 127,008 | 34.3 (31.5–37.2) | 22,327 | 12.1 (9.5–15.2) | 47,197 | 38.0 (33.8–42.4) | 57,484 | 93.6 (88.3–96.6) |
| Inadequate hygiene | 153,547 | 53.5 (49.8–57.2) | 75,800 | 51.1 (45.9–57.1) | 46,406 | 49.0 (43.6–54.6) | 31,340 | 69.1 (60.9–76.3) |
| Access to health care | ||||||||
| Inadequate growth checkups | 84,670 | 22.9 (20.4–25.6) | 41,737 | 22.6 (18.7–27.0) | 27,143 | 21.9 (18.7–25.4) | 15,790 | 25.7 (19.7–32.8) |
| Comorbidities | ||||||||
| Diarrhoea | 37,347 | 10.3 (8.7–12.1) | 14,129 | 7.8 (5.6–10.7) | 11,123 | 9.2 (7.2–11.6) | 12,095 | 20.1 (15.5–25.6) |
| Acute respiratory infections | 107,648 | 29.1 (26.1–32.2) | 55,642 | 30.1 (25.5–35.1) | 35,974 | 29.0 (24.4–34.0) | 16,032 | 26.1 (21.0–31.9) |
[i] Source: National Health Survey of Panama (ENSPA) 2019; CI: confidence interval; Twenty-one thousand six hundred fourteen (21,614) participants had missing values or did not know their household monthly income. Ninety-six (96) participants had missing values for sanitation system variable. Eighty-three thousand three hundred forty-seven (83,347) participants had missing values for adequate hygiene variable. Seven thousand nine hundred six (7,906) participants had missing values for the diarrhoea in the last two weeks’ variable.
Table 2
Weighted prevalence of undernutrition among children under age five by baseline characteristics at the national level and by living area, Panama, 2019.
| SELECTED BASELINE CHARACTERISTICS | LIVING AREA | |||||||
|---|---|---|---|---|---|---|---|---|
| NATIONAL | URBAN AREA | RURAL AREA | INDIGENOUS AREA | |||||
| N | % (95% CI) | N | % (95% CI) | N | % (95% CI) | N | % (95% CI) | |
| Total | 370,408 | 15.3 (13.4–17.3) | 184,798 | 10.5 (8.2–13.4) | 124,196 | 11.8 (9.5–14.7) | 61,414 | 36.6 (30.1–43.5) |
| Sociodemographic characteristics | ||||||||
| Age (months) | ||||||||
| 0–11 | 50,317 | 9.6 (6.4–14.1) | 24,303 | 8.6 (4.4–16.3) | 17,228 | 9.9 (5.1–18.4) | 8,786 | 11.5 (5.6–22.3) |
| 12–23 | 75,137 | 18.6 (14.5–23.6) | 36,031 | 17.2 (11.0–25.9) | 25,582 | 10.5 (6.8–15.9) | 13,524 | 26.8 (16.5–40.3) |
| 24–35 | 85,444 | 17.5 (13.6–22.3) | 38,879 | 9.3 (5.5–15.4) | 28,759 | 11.6 (7.6–17.3) | 17,805 | 46.8 (34.1–60.0) |
| 36–47 | 80,472 | 14.2 (10.6–18.8) | 46,949 | 9.7 (5.4–16.7) | 24,490 | 11.6 (7.6–17.3) | 9,033 | 44.9 (31.0–59.6) |
| 48–59 | 79,038 | 14.3 (10.6–18.9) | 38,635 | 7.5 (3.9–14.0) | 28,136 | 10.5 (5.3–19.7) | 12,266 | 44.2 (27.1–62.9) |
| Sex | ||||||||
| Male | 201,250 | 16.5 (13.9–19.5) | 108,778 | 11.3 (8.0–15.7) | 62,085 | 13.1 (10.1–16.8) | 30,386 | 42.3 (33.8–51.4) |
| Female | 169,158 | 13.8 (11.5–16.4) | 76,020 | 9.4 (6.7–13.0) | 62,110 | 10.5 (7.2–15.2) | 31,027 | 30.9 (22.7–40.5) |
| Overcrowding | ||||||||
| Yes | 53,454 | 29.8 (24.7–35.4) | 15,436 | 17.4 (9.3–30.1) | 12,737 | 14.0 (8.7–21.9) | 25,281 | 45.3 (37.0–53.8) |
| No | 316,953 | 12.8 (10.9–15.0) | 169,362 | 9.9 (7.5–12.9) | 111,458 | 11.6 (9.1–14.7) | 36,133 | 30.5 (22.0–40.5) |
| Household monthly income quartile (USD; $) | ||||||||
| First quartile (≤124) | 101,824 | 25.2 (21.2–29.6) | 18,679 | 8.6 (4.2–16.8) | 37,233 | 17.0 (12.0–23.6) | 45,911 | 38.5 (31.0–46.6) |
| Second quartile (125–399) | 94,054 | 14.2 (11.2–18.0) | 45,205 | 11.5 (7.4–17.5) | 37,469 | 13.3 (9.2–18.7) | 11,380 | 28.1 (16.0–44.5) |
| Third quartile (400–699) | 83,150 | 11.5 (7.9–16.3) | 54,117 | 13.4 (8.5–20.5) | 27,478 | 6.4 (3.5–11.4) | 1,555 | 32.6 (15.7–55.7) |
| Fourth quartile (≥700) | 69,765 | 6.9 (4.3–10.8) | 55,405 | 6.9 (4.0–11.9) | 14,064 | 5.4 (2.2–12.9) | 296 | 60.0 (24.2–87.6) |
| Household dietary diversity | ||||||||
| Low (0–3) | 28,576 | 25.1 (17.7–34.2) | 7,653 | 1.1 (0.1–7.9) | 6,182 | 19.4 (10.9–32.3) | 14,740 | 39.8 (27.8–53.2) |
| Medium (4–6) | 63,164 | 23.7 (18.8–29.5) | 21,696 | 16.2 (9.3–26.6) | 19,627 | 17.6 (10.0–29.0) | 21,840 | 36.7 (26.5–48.2) |
| High (7–12) | 278,668 | 12.3 (10.4–14.6) | 155,449 | 10.2 (7.7–13.3) | 98,386 | 10.2 (8.0–13.0) | 24,833 | 34.5 (24.5–46.2) |
| WASH characteristics | ||||||||
| Drinking water source status | ||||||||
| Unimproved | 47,651 | 25.3 (19.8–31.8) | 8,206 | 15.9 (6.7–33.4) | 16,649 | 12.2 (6.7–21.4) | 22,797 | 38.3 (27.5–50.4) |
| Improved | 322,756 | 13.8 (11.9–15.9) | 176,592 | 10.2 (7.9–13.2) | 107,548 | 11.8 (9.3–14.8) | 38,617 | 35.5 (27.8–44.1) |
| Sanitation system | ||||||||
| Unimproved | 127,008 | 25.3 (21.8–29.2) | 22,327 | 14.6 (7.8–25.7) | 47,197 | 17.1 (12.5–23.0) | 57,484 | 36.2 (29.8–43.1) |
| Improved | 243,303 | 10.0 (8.1–12.3) | 162,375 | 9.9 (7.6–12.9) | 76,999 | 8.6 (6.4–11.4) | 3,929 | 41.7 (14.3–75.4) |
| Adequate Hygiene | ||||||||
| Yes | 133,514 | 12.3 (9.7–15.6) | 71,314 | 11.4 (7.8–16.4) | 48,206 | 7.7 (4.9–11.7) | 13,994 | 33.2 (22.4–46.1) |
| No | 153,547 | 16.7 (13.8–20.0) | 75,800 | 9.5 (6.1–14.6) | 46,406 | 13.7 (9.6–19.2) | 31,340 | 38.2 (28.8–48.6) |
| Access to health care | ||||||||
| Adequate growth checkups | ||||||||
| Yes | 285,738 | 15.3 (13.2–17.6) | 143,061 | 10.9 (8.2–14.3) | 97,052 | 11.4 (8.8–14.7) | 45,624 | 37.0 (29.5–45.2) |
| No | 84,670 | 15.3 (11.9–19.5) | 41,737 | 9.1 (5.4–15.0) | 27,143 | 13.2 (8.7–19.6) | 15,790 | 35.2 (23.7–48.7) |
| Comorbidities | ||||||||
| Diarrhoea | ||||||||
| Yes | 37,347 | 27.3 (20.0–36.0) | 14,129 | 25.8 (13.0–44.9) | 11,123 | 6.2 (3.0–12.4) | 12,095 | 48.4 (36.1–61.0) |
| No | 325,154 | 13.8 (12.0–15.8) | 166,754 | 9.3 (7.2–12.0) | 110,387 | 12.5 (9.9–15.7) | 48,013 | 32.3 (25.4–40.2) |
| Acute respiratory infections | ||||||||
| Yes | 107,648 | 16.3 (13.0–20.1) | 55,642 | 9.5 (5.8–15.2) | 35,974 | 15.4 (10.9–21.4) | 16,032 | 41.4 (31.9–51.6) |
| No | 262,759 | 14.9 (12.7–17.3) | 129,156 | 10.9 (8.2–14.4) | 88,221 | 10.4 (7.7–13.8) | 45,382 | 34.8 (27.1–43.5) |
[i] Source: National Health Survey of Panama (ENSPA) 2019; CI: confidence interval; “stunting” and “wasting” were defined according to the cut-off points of the World Health Organization Growth Standards; Undernutrition: wasting only, stunting only, or wasting and stunting.
Table 3
Weighted prevalence of overnutrition among children under five by baseline characteristics at the national level and by living area, Panama, 2019.
| SELECTED BASELINE CHARACTERISTICS | LIVING AREA | |||||||
|---|---|---|---|---|---|---|---|---|
| NATIONAL | URBAN AREA | RURAL AREA | INDIGENOUS AREA | |||||
| N | % (95% CI) | N | % (95% CI) | N | % (95% CI) | N | % (95% CI) | |
| Total | 370,408 | 10.2 (8.2–12.6) | 184,798 | 11.9 (8.5–16.3) | 124,196 | 8.4 (6.5–10.7) | 61,414 | 8.7 (5.2–14.3) |
| Sociodemographic characteristics | ||||||||
| Age (months) | ||||||||
| 0–11 | 50,317 | 21.1 (13.9–30.6) | 24,303 | 27.5 (15.8–43.5) | 17,228 | 8.1 (4.2–14.8) | 8,786 | 28.9 (13.1–52.2) |
| 12–23 | 75,137 | 10.1 (5.1–18.8) | 36,031 | 11.7 (3.7–31.6) | 25,582 | 11.6 (7.1–18.2) | 13,524 | 3.0 (0.8–10.5) |
| 24–35 | 85,444 | 5.7 (3.9–8.2) | 38,879 | 5.9 (3.3–10.4) | 28,759 | 6.1 (3.5–10.3) | 17,805 | 4.4 (1.6–11.4) |
| 36–47 | 80,472 | 12.3 (8.8–16.9) | 46,949 | 12.4 (7.6–19.6) | 24,490 | 12.0 (7.4–18.8) | 9,033 | 12.4 (4.8–28.3) |
| 48–59 | 79,038 | 6.1 (4.0–9.1) | 38,635 | 7.6 (4.3–13.0) | 28,136 | 4.8 (2.5–9.1) | 12,266 | 4.2 (1.2–14.2) |
| Sex | ||||||||
| Male | 201,250 | 10.0 (7.5–13.0) | 108,778 | 10.3 (6.8–15.3) | 62,085 | 8.0 (5.6–11.3) | 30,386 | 12.9 (6.8–23.1) |
| Female | 169,158 | 10.4 (7.4–14.5) | 76,020 | 14.2 (8.5–22.6) | 62,110 | 8.7 (6.2–12.3) | 31,027 | 4.6 (2.3–9.1) |
| Overcrowding | ||||||||
| Yes | 53,454 | 10.9 (6.5–17.6) | 15,436 | 13.2 (5.7–27.8) | 12,737 | 9.0 (3.9–19.6) | 25,281 | 10.4 (4.4–22.9) |
| No | 316,953 | 10.0 (7.9–12.7) | 169,362 | 11.8 (8.3–16.5) | 111,458 | 8.3 (6.4–10.7 | 36,133 | 7.5 (4.2–13.0) |
| Household monthly income quartile (USD; $) | ||||||||
| First quartile (≤124) | 101,824 | 10.1 (7.1–14.1) | 18,679 | 14.3 (6.4–29.2) | 37,233 | 9.5 (6.5–13.8) | 45,911 | 8.8 (4.7–15.9) |
| Second quartile (125–399) | 94,054 | 12.6 (7.6–20.3) | 45,205 | 18.2 (9.1–33.2) | 37,469 | 7.3 (4.7–11.1) | 11,380 | 8.0 (2.5–22.7) |
| Third quartile (400–699) | 83,150 | 9.6 (6.7–13.6) | 54,117 | 9.6 (6.1–14.9) | 27,478 | 9.6 (5.1–17.3) | 1,555 | 10.9 (1.6–48.5) |
| Fourth quartile (≥700) | 69,765 | 9.1 (6.0–13.6) | 55,405 | 9.6 (5.9–15.3) | 14,064 | 7.2 (3.8–13.3) | 296 | 5.3 (0.7–32.1) |
| Household dietary diversity | ||||||||
| Low (0–3) | 28,576 | 11.1 (5.9–19.7) | 7,653 | 16.1 (4.2–45.9) | 6,182 | 13.5 (5.6–29.1) | 14,740 | 7.5 (3.1–16.8) |
| Medium (4–6) | 63,164 | 7.7 (5.2–11.4) | 21,696 | 8.6 (4.4–16.2) | 19,627 | 6.2 (3.3–11.4) | 21,840 | 8.1 (3.8–16.4) |
| High (7–12) | 278,668 | 10.6 (8.2–13.7) | 155,449 | 12.1 (8.4–17.2) | 98,386 | 8.5 (6.4–11.2) | 24,833 | 10.0 (4.0–22.9) |
| WASH characteristics | ||||||||
| Drinking water source status | ||||||||
| Unimproved | 47,651 | 6.0 (3.8–9.4) | 8,206 | 8.2 (3.1–20.1) | 16,649 | 5.1 (2.4–10.5) | 22,797 | 5.8 (2.8–11.6) |
| Improved | 322,756 | 10.8 (8.6–13.5) | 176,592 | 12.0 (8.6–16.6) | 107,548 | 8.9 (6.8–11.5) | 38,617 | 10.4 (5.5–19.0) |
| Sanitation system | ||||||||
| Unimproved | 127,008 | 8.9 (6.6–11.9) | 22,327 | 11.4 (6.5–19.3) | 47,197 | 8.4 (5.8–12.0) | 57,484 | 8.4 (4.8–14.3) |
| Improved | 243,303 | 10.8 (8.2–14.2) | 162,375 | 11.9 (8.3–16.9) | 76,999 | 8.3 (6.0–11.5) | 3,929 | 13.6 (4.0–37.2) |
| Adequate Hygiene | ||||||||
| Yes | 133,514 | 10.9 (7.3–16.0) | 71,314 | 11.0 (5.7–20.3) | 48,206 | 9.5 (6.5–13.6) | 13,994 | 14.9 (5.1–36.4) |
| No | 153,547 | 7.9 (5.8–10.6) | 75,800 | 10.0 (6.4–15.1) | 46,406 | 5.8 (3.9–8.7) | 31,340 | 6.0 (3.1–11.4) |
| Access to health care | ||||||||
| Adequate growth checkups | ||||||||
| Yes | 285,738 | 9.8 (7.6–12.5) | 143,061 | 11.7 (8.0–16.7) | 97,052 | 8.6 (6.5–11.5) | 45,624 | 6.4 (3.7–10.9) |
| No | 84,670 | 11.4 (7.3–17.5) | 41,737 | 12.6 (6.3–23.6) | 27,143 | 7.3 (4.7–11.3) | 15,790 | 15.5 (6.2–33.6) |
| Comorbidities | ||||||||
| Diarrhoea | ||||||||
| Yes | 37,347 | 5.8 (3.3–9.9) | 14,129 | 5.5 (1.9–15.0) | 11,123 | 2.7 (0.9–8.0) | 12,095 | 8.8 (4.1–18.1) |
| No | 325,154 | 10.5 (8.4–13.2) | 166,754 | 12.4 (8.8–17.2) | 110,387 | 8.5 (6.5–10.9) | 48,013 | 8.9 (4.8–16.0) |
| Acute respiratory infections | ||||||||
| Yes | 107,648 | 10.8 (6.3–17.8) | 55,642 | 14.9 (7.2–28.1) | 35,974 | 6.3 (3.9–10.3) | 16,032 | 6.4 (2.8–13.8) |
| No | 262,759 | 9.9 (8.1–12.1) | 129,156 | 10.6 (7.9–14.1) | 88,221 | 9.2 (6.9–12.1) | 45,382 | 9.5 (5.1–17.0) |
[i] Source: National Health Survey of Panama (ENSPA) 2019; CI: confidence interval; “overweight” and “obesity” were defined according to the cut-off points of the World Health Organization Growth Standards; “overnutrition”: overweight only or obesity only.
Table 4
Weighted prevalence of the double burden of malnutrition among children under age five by baseline characteristics at the national level and by living area, Panama, 2019.
| SELECTED BASELINE CHARACTERISTICS | LIVING AREA | |||||||
|---|---|---|---|---|---|---|---|---|
| NATIONAL | URBAN AREA | RURAL AREA | INDIGENOUS AREA | |||||
| N | % (95% CI) | N | % (95% CI) | N | % (95% CI) | N | % (95% CI) | |
| Total | 370,408 | 1.4 (1.0–2.1) | 184,798 | 0.9 (0.5–1.8) | 124,196 | 1.6 (0.8–2.9) | 61,414 | 2.7 (1.4–5.1) |
| Sociodemographic characteristics | ||||||||
| Age (months) | ||||||||
| 0–11 | 50,317 | 3.2 (1.7–5.9) | 24,303 | 3.3 (1.3–8.1) | 17,228 | 4.4 (1.8–10.2) | 8,786 | 0.4 (0.1–1.8) |
| 12–23 | 75,137 | 2.1 (1.0–4.1) | 36,031 | 2.1 (0.7–6.0) | 25,582 | 1.5 (0.5–3.9) | 13,524 | 3.1 (0.7–12.0) |
| 24–35 | 85,444 | 1.2 (0.5–3.1) | 38,879 | 0.0 | 28,759 | 1.8 (0.4–7.8) | 17,805 | 2.9 (0.9–8.8) |
| 36–47 | 80,472 | 0.7 (0.2–1.9) | 46,949 | 0.0 | 24,490 | 0.1 (0.0–0.7) | 9,033 | 5.6 (1.9–15.8) |
| 48–59 | 79,038 | 0.8 (0.2–2.4) | 38,635 | 0.4 (0.1–1.7) | 28,136 | 1.1 (0.1–7.2) | 12,266 | 1.4 (0.2–9.5) |
| Sex | ||||||||
| Male | 201,250 | 1.8 (1.2–2.7) | 108,778 | 1.3 (0.6–2.6) | 62,085 | 1.7 (0.8–3.3) | 30,386 | 4.0 (1.9–8.1) |
| Female | 169,158 | 1.0 (0.5–2.1) | 76,020 | 0.4 (0.1–1.8) | 62,110 | 1.5 (0.5–4.3) | 31,027 | 1.4 (0.3–5.3) |
| Overcrowding | ||||||||
| Yes | 53,454 | 2.4 (1.0–5.4) | 15,436 | 1.3 (0.2–6.5) | 12,737 | 6.7 (2.2–18.7) | 25,281 | 0.9 (0.2–4.0) |
| No | 316,953 | 1.3 (0.8–1.9) | 169,362 | 0.9 (0.4–1.8) | 111,458 | 1.0 (0.5–2.0) | 36,133 | 3.9 (1.9–8.0) |
| Household monthly income quartile (USD; $) | ||||||||
| First quartile (≤124) | 101,824 | 2.3 (1.4–4.0) | 18,679 | 0.6 (0.1–3.8) | 37,233 | 2.6 (1.1–6.0) | 45,911 | 2.8 (1.4–5.8) |
| Second quartile (125–399) | 94,054 | 1.2 (0.6–2.5) | 45,205 | 1.1 (0.3–3.4) | 37,469 | 0.8 (0.2–3.0) | 11,380 | 3.1 (2.1–11.5) |
| Third quartile (400–699) | 83,150 | 0.7 (0.2–2.2) | 54,117 | 1.1 (0.3–3.3) | 27,478 | 0.0 | 1,555 | 0.0 |
| Fourth quartile (≥700) | 69,765 | 1.4 (0.5–3.9) | 55,405 | 0.8 (0.2–3.4) | 14,064 | 3.7 (0.8–15.3) | 296 | 0.0 |
| Household dietary diversity | ||||||||
| Low (0–3) | 28,576 | 2.9 (1.2–7.0) | 7,653 | 2.1 (0.3–14.7) | 6,182 | 2.9 (0.4–17.9) | 14,740 | 3.4 (1.1–10.1) |
| Medium (4–6) | 63,164 | 1.9 (0.9–3.9) | 21,696 | 0.5 (0.1–3.3) | 19,627 | 1.6 (0.5–5.1) | 21,840 | 3.6 (1.3–9.3) |
| High (7–12) | 278,668 | 1.2 (0.7–1.9) | 155,449 | 0.9 (0.4–1.9) | 98,386 | 1.5 (0.7–3.2) | 24,833 | 1.5 (0.4–5.3) |
| WASH characteristics | ||||||||
| Drinking water source status | ||||||||
| Unimproved | 47,651 | 1.2 (0.4–3.0) | 8,206 | 0.0 | 16,649 | 1.2 (0.3–4.2) | 22,797 | 1.5 (0.4–5.8) |
| Improved | 322,756 | 1.5 (1.0–2.2) | 176,592 | 1.0 (0.5–1.8) | 107,548 | 1.6 (0.8–3.2) | 38,617 | 3.4 (1.6–6.9) |
| Sanitation system | ||||||||
| Unimproved | 127,008 | 2.6 (1.6–4.0) | 22,327 | 2.0 (0.5–7.0) | 47,197 | 2.5 (1.2–5.2) | 57,484 | 2.8 (1.5–5.4) |
| Improved | 243,303 | 0.8 (0.4–1.6) | 162,375 | 0.8 (0.4–1.7) | 76,999 | 1.0 (0.3–3.1) | 3,929 | 0.3 (0.0–2.6) |
| Adequate Hygiene | ||||||||
| Yes | 133,514 | 0.7 (0.3–1.5) | 71,314 | 0.6 (0.2–2.0) | 48,206 | 0.6 (0.2–2.4) | 13,994 | 1.1 (0.2–7.7) |
| No | 153,547 | 1.5 (0.8–2.8) | 75,800 | 0.3 (0.1–1.8) | 46,406 | 1.7 (0.5–5.6) | 31,340 | 4.2 (2.0–8.6) |
| Access to health care | ||||||||
| Adequate growth checkups | ||||||||
| Yes | 285,738 | 1.2 (0.8–1.9) | 143,061 | 0.6 (0.3–1.6) | 97,052 | 1.3 (0.5–2.9) | 45,624 | 3.0 (1.5–5.9) |
| No | 84,670 | 2.2 (1.2–3.9) | 41,737 | 1.9 (0.8–4.8) | 27,143 | 2.7 (1.1–6.6) | 15,790 | 1.8 (0.3–9.4) |
| Comorbidities | ||||||||
| Diarrhoea | ||||||||
| Yes | 37,347 | 1.7 (0.6–4.5) | 14,129 | 0.0 | 11,123 | 1.0 (0.1–6.5) | 12,095 | 4.4 (1.4–12.8) |
| No | 325,154 | 1.4 (1.0–2.1) | 166,754 | 1.0 (0.5–2.0) | 110,387 | 1.7 (0.9–3.2) | 48,013 | 2.3 (1.1–5.1) |
| Acute respiratory infections | ||||||||
| Yes | 107,648 | 1.0 (0.4–2.3) | 55,642 | 0.3 (0.1–1.3) | 35,974 | 1.3 (0.3–5.3) | 16,032 | 2.6 (0.6–10.0) |
| No | 262,759 | 1.6 (1.1–2.4) | 129,156 | 1.2 (0.6–2.4) | 88,221 | 1.7 (0.8–3.4) | 45,382 | 2.7 (1.3–5.5) |
[i] Source: National Health Survey of Panama (ENSPA) 2019; CI: confidence interval; “stunting,” “overweight,” and “obesity” were defined according to the cut-off points of the World Health Organization Growth Standards; “double burden”: stunting and overweight/obesity.