TY - JOUR T1 - ‘Severe malnutrition’: thinking deeply, communicating simply JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-003023 VL - 5 IS - 11 SP - e003023 AU - Marko Kerac AU - Marie McGrath AU - Nichola Connell AU - Chytanya Kompala AU - William H Moore AU - Jeanette Bailey AU - Robert Bandsma AU - James A Berkley AU - André Briend AU - Steve Collins AU - Tsinuel Girma AU - Jonathan C Wells Y1 - 2020/11/01 UR - http://gh.bmj.com/content/5/11/e003023.abstract N2 - Summary boxChild malnutrition is a major global public health problem which risks significant worsening with COVID-19.Current terminology is complex and limits effective communications and programme actions.‘Severe malnutrition’ is a simple, advocacy-focused term in which the ‘severe’ highlights high risk of mortality/morbidity and encompasses different manifestations of malnutrition, context-appropriate anthropometric cut-offs and underlying causes.Advantages include improved clarity and familiarity; a focus on clinically important severe outcomes and potential to increase interprogramme linkages and synergiesMalnutrition affects millions worldwide and underlies almost half of deaths in children aged <5 years.1 Progress towards Sustainable Development Goal 2 (End hunger) was already slow but coronavirus-related secondary impacts now threaten nutritional crises described as:Biblical, on steroids, across generations.2Towards effective actions, effective communication matters. Malnutrition involves a plethora of complex technical terminology. Sometimes it helps to go beyond details and consider problems at broader scale, especially when engaging with non-specialist stakeholders like policymakers, funders and the public. These may not wish to know full technical nuances, but they should:appreciate why malnutrition matters.hear clear, consistent messages: else they will turn to other global-health issues perceived as more straightforward.Focusing on undernutrition, we argue that a simple umbrella term, ‘Severe Malnutrition’ would benefit future communication and advocacy efforts.Defining a problem is vital for effective action/evaluation. Assessing both individual and population nutritional status typically involves anthropometry.3 Measurements (eg, weight) are interpreted through indices (eg, weight-for-age) in comparison with reference populations (eg, WHO Growth Standards, a ‘gold standard’ describing how healthy children should grow). Current terminology is summarised below.1Often neglected is the full definition of malnutrition: ‘Any condition in which deficiency, excess or imbalance of energy, protein or other nutrients…adversely affects body function and/or clinical outcome’.4 Problems consequently arise.Undue focus on body sizeBeing severely small (short or thin) alone … ER -