Abstract
Child malnutrition is an important cause of under‐5 mortality and morbidity around the globe. Despite the partial success of (inter)national efforts to reduce child mortality, under‐5 mortality rates continue to be high. The multidimensional approaches of the Sustainable Development Goals may suggest new directions for rethinking strategies for reducing child mortality and malnutrition. We propose a theoretical framework for developing a “capability” approach to child growth. The current child growth monitoring practices are based on 2 assumptions: (a) that anthropometric and motor development measures are the appropriate indicators; and (b) that child growth can be assessed using a single universal standard that is applicable around the world. These practices may be further advanced by applying a capability approach to child growth, whereby growth is redefined as the achievement of certain capabilities (of society, parents, and children). This framework is similar to the multidimensional approach to societal development presented in the seminal work of Amartya Sen. To identify the dimensions of healthy child growth, we draw upon theories from the social sciences and evolutionary biology. Conceptually, we consider growth as a plural space and propose assessing growth by means of a child growth matrix in which the context is embedded in the assessment. This approach will better address the diversities and the inequalities in child growth. Such a multidimensional measure will have implications for interventions and policy, including prevention and counselling, and could have an impact on child malnutrition and mortality.
Highlights
Child malnutrition is an important underlying cause of child morbidity and mortality (Black et al, 2013)
We suggest adopting a multidimensional approach to child growth that uses Sen's capability approach as a conceptual framework; this entails the construction of a growth matrix in which context will be embedded in the actual growth assessment
This paper aims to open the debate on a multidimensional approach for measuring child growth, while at the same time suggesting elements bs_bs_banner for the construction of a conceptual framework for its further development
Summary
Child malnutrition is an important underlying cause of child morbidity and mortality (Black et al, 2013). The Sustainable Development Goals (SDGs) have suggested developing a multisectoral, multidimensional approach to achieving the 2030 targets (UN Department of Economic and Social Affairs, 2015). This may open the way for a multidimensional approach to child growth, with implications for its measurement. Malnutrition is an important factor underlying child mortality (Black et al, 2013). In the 1970s, charts for growth monitoring were introduced as a tool to identify children at risk of malnutrition and to improve efforts to reduce child morbidity and mortality.
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