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Objective: This paper explores the global prevalence of an emerging phenomenon-the coexistence of a stunted child and an overweight mother in the same household. It also tests whether this phenomenon is associated with a country's level of economic development and urbanization. Policy directions for public nutrition are highlighted. Design: Data from 36 Demographic and Health Surveys (DHS) were used (23 in Africa, 8 in Latin America, and 5 in Asia). Stunting was defined as height-for-age < - 2 SD of the reference population and maternal overweight as a body mass index (BMI) of > 25 kg/m2. World Bank and United Nations figures were used for GNP per capita (our indicator of economic development) and for level of urbanization, respectively. Descriptive statistics were derived, and regression analysis was used to model the association between economic development, urbanization, and the prevalence of stunted children and overweight women (SCOWT). Results and conclusions: The prevalence of SCOWT is generally below 10 percent, except in four countries, of which three are in Latin America. Among our sample of countries, SCOWT is generally more prevalent in Latin America than in Africa, and is below 5 percent in all five Asian countries. Contrary to our expectations, SCOWT is not necessarily more prevalent in urban than rural areas. In fact, when economic development is controlled for, SCOWT is associated with urbanization only in Latin America. In Africa and Asia, SCOWT is associated with economic development, but not urbanization, which suggests that SCOWT may emerge only at levels of economic development and urbanization higher than currently seen in most of the Asian and African countries studied. The concrete recognition of the SCOWT phenomenon is an important step to delineating more effective and integrated strategies to address problems of over- and undernutrition and dietary quality within countries, regions, and households. This gives special importance to designing programs and policies that will address the food and nutrition needs of each individual, rather than assuming that those needs are addressed by targeting programs or policies to the household as a whole.


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