Newly developed WHO growth standards: Implications for demographic surveys and child health programs

Abstract

To compare estimates of undernutrition based on the World Health Organization (WHO) Child Growth Standards ('WHO standards') and the National Center for Health Statistics NCHS/ WHO international growth reference ('NCHS reference') and discuss implications for child health programs and reporting of prevalence of underweight in demographic surveys. A cross-sectional study was carried out in 20 Anganwadi centers under Primary Health Centre, Anji. Total of 1491 under-six year children attending the Anganwadi centers were studied for nutritional status. Nutritional status was analyzed by NCHS standards by using EPI_INFO 6.04 software package and also by newly introduced WHO Child Growth Standards by Anthro 2005 software package. Chi-square test was used to compare the results. According to WHO standards, the prevalence of underweight and severe underweight for children 0-6 year was 47.4% and 16.9% respectively. By NCHS reference, the overall prevalence of underweight and severe underweight for children 0-6 years was 53% and 15% respectively. The prevalence of underweight as assessed by WHO standards was significantly lower when compared with the assessment based on NCHS reference (p< 0.01). But, WHO standards gave higher prevalence of severe underweight than NCHS reference though the difference was not statistically significant (p>0.05). In the light of newly developed WHO Child growth standards, all the nutrition-related indicators in demographic surveys like NFHS should now be derived using the WHO standards. There is need to reanalyze NFHS - I and NFHS - II data using WHO standards and findings should be made available so that it becomes comparable and trends over the years can be studied.