Worldwide implementation of the WHO Child Growth Standards

Abstract

Objective: To describe the worldwide implementation of the WHO Child Growth Standards ('WHO standards'). Design: A questionnaire on the adoption of the WHO standards was sent to health authorities. The questions concerned anthropometric indicators adopted, newly introduced indicators, age range, use of sex-specific charts, previously used references, classification system, activities undertaken to roll out the standards and reasons for non-adoption. Setting: Worldwide. Subjects: Two hundred and nineteen countries and territories. Results: By April 2011, 125 countries had adopted the WHO standards, another twenty-five were considering their adoption and thirty had not adopted them. Preference for local references was the main reason for non-adoption. Weight-forage was adopted almost universally, followed by length/height-for-age (104 countries) and weight-for-length/height (eighty-eight countries). Several countries (thirty-six) reported newly introducing BMI-for-age. Most countries opted for sex-specific charts and the Z-score classification. Many redesigned their child health records and updated recommendations on infant feeding, immunization and other health messages. About two-thirds reported incorporating the standards into pre-service training. Other activities ranged from incorporating the standards into computerized information systems, to providing supplies of anthropometric equipment and mobilizing resources for the standards' roll-out. Conclusions: Five years after their release, the WHO standards have been widely scrutinized and implemented. Countries have adopted and harmonized best practices in child growth assessment and established the breast-fed infant as the norm against which to assess compliance with children's right to achieve their full genetic growth potential.

Is the economic crisis affecting birth outcome in Spain? Evaluation of temporal trend in underweight at birth (2003–2012)

“…As growth is a progressive process, an infant may weigh less than 2 500 g at birth either because he/she is born too early (preterm birth) or because he/she was small for his/her gestational age, which is used as a proxy for intrauterine growth restriction. As Kramer Reference Study Group have been adopted by Spain, among more than one hundred countries (de Onís et al, 2012). The WHO Standards consider underweight at birth those neonates whose weight is -2 SD from the median weight at birth for each sex, in single births with a gestational age from 37 to 41 complete weeks.…”

Assessment of Anemia Levels in Infants and Children in High Altitude Peru

“…Below -2 SD is a commonly recognized cut-off score to indicate stunting or underweight and was used in this study to identify children with growth risks. Z-scores are preferred to track the clinical nutrition status because severely malnourished children may fall outside the standard percentile ranges for anthropometric measurements (de Onis et al, 2012 analysis based on a 90% confidence level and a margin error of 5%. Specimens were collected from 166 infants and children.…”

Prevalencia de sobrepeso y obesidad en escolares jujeños de diferente nivel altitudinal según las referencias IOTF, CDC y OMS

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