WHO Growth Standards to assess Indonesian children < 2 years
Summary of published research1
A recent study set out to assess the implications of adopting the WHO Child Growth Standards to classify Indonesian children according to nutrition status. Data were obtained from two cross-sectional surveys in two districts in Indonesia in 1998. Children under two years of age were randomly selected using a two-stage cluster sampling. Z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ) were calculated based on both the NCHS/WHO references and the WHO Child Growth Standards. Wasting, stunting, and underweight were defined as z-scores less than -2.
Drawing on a sample from a study on complementary feeding in two districts in Indonesia (Belu and Purworejo), 1,374 children under 2 years (including infants under 6 months of age) were included in the analysis. Of these, 693 (50.4%) were male and 681 (49.6%) were female. Almost all of the children had initiated breastfeeding and were still being breastfed when the data were collected. According to the WHO Child Growth Standards, the prevalence of wasting did not change with age, but the prevalence rates of stunting and underweight rose steadily with age. Although the contribution of wasting to the classification of underweight was relatively constant, the contribution of stunting increased as the children grew. The reason for the decline in LAZ is not easy to explain. Most of the children in the study lived under socioeconomic conditions unfavourable for optimal growth.
The authors concluded that the WHO Child Growth Standards are a better tool for assessing the nutritional status of Indonesian children than the NCHS/WHO references. However, low WAZ is not a suitable indicator for commencing an extra feeding programme, because it reflects stunting instead of wasting. The high prevalence of stunting indicates the need to perform preventive nutritional intervention beginning earlier in life, i.e. in utero.
1Julia. M (2009). Adoption of the WHO Child Growth Standards to classify Indonesian children under 2 years of age according to nutrition status: Stronger indication for nutritional intervention. Food and Nutrition Bulletin, vol 30, no 3, pp 254-259
More like this
FEX: Malnutrition in infants under six months attending community health centres in Ethiopia
View this article as a pdf This is a summary of the following paper: Grijalva-Eternod, C.S., Beaumont, E., Rana, R., Abate, N., Barthorp, H., McGrath, M., et al. (2021)....
FEX: Growth faltering in rural Gambian children after four decades of interventions: a retrospective cohort study
Summary of Research1 Nabwera HM, Fulford AJ, Moore SE and Prentice AM. (2017). Growth faltering in rural Gambian children after four decades of interventions: a retrospective...
FEX: Severe malnutrition in infants under six months old: outcomes and risk factors in Bangladesh
Summary of research1 Location: Bangladesh What we know: The World Health Organization (WHO) recommends that infants under six months with uncomplicated severe acute...
FEX: Supporting healthy growth in infants in low-resource settings in Mumbai, India
View this article as a pdf Lisez cet article en français ici By Rupal Dalal, Shruthi Iyer, Marian Abraham and Lahari Yaddanapudi Rupal Dalal MD FAAP IBCLC is a...
FEX: Algorithms for converting NCHS references
Summary of published research1 One of the challenges thrown up by the development and introduction of the new WHO growth standards is that surveys using the new growth...
FEX: Diagnostic criteria for severe acute malnutrition among infants under six months of age
Summary of research1 Location: Kenya What we know: Diagnosis of acute malnutrition in infants under six months old (U6M) is currently based on weight-for-length z score...
FEX: Effect of nutrition survey ‘cleaning criteria’ on estimates of malnutrition prevalence and disease burden: secondary data analysis
Summary of research1 Location: Global What we know: Standardised methods for collection and reporting malnutrition prevalence data in nutrition surveys are used. What this...
FEX: Wasting is associated with stunting in early childhood
Summary of published research1 Location: Africa, Asia, Latin America What we know already: Wasting and stunting are respectively short term and longer term conditions of...
FEX: Making connections: Joint meeting of WaSt Technical Interest Group and MAMI Special Interest Group
ENN coordinates two international technical groups, the Management of at-risk Mothers and Infants under six months Special Interest Group (MAMI SIG) and the Wasting and...
FEX: The effect of age rounding on weight-for-age z-scores: Evidence from Sub-Saharan Africa
View this article as a pdf Ifrah Fayyaz is a Healthcare Data Analyst at Milliman. Zachary Tausanovitch is a Data Science Lead (Nutrition) at International Rescue Committee...
Resource: Children who are both wasted and stunted are also underweight and have a high risk of death: a descriptive epidemiology of multiple anthropometric deficits using data from 51 countries
Abstract Background: Wasting and stunting are common. They are implicated in the deaths of almost two million children each year and account for over 12% of...
FEX: A reflection on the 2021 Lancet Maternal & Child Nutrition Series through a WaSt lens
View this article as a pdf This article provides a summary of the Lancet Maternal & Child Nutrition Series to date, reflecting upon the 2021 series from the perspective of the...
FEX: Adapting the MAMI Care Pathway Package in India: Progress and direction
View this article as a pdf Praveen Kumar is Director Professor at Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India, and Deputy...
en-net: indicator for measuring wasting and stunting in Adults
If the BMI is indicator that measures underweight in adults, what are the indicators that conventient for measuring wasting and stunting in adults? BMI is not a good indicator...
FEX: Evaluation of an integrated health-nutrition-WASH project to reduce malnutrition prevalence in children under two in Bangladesh
By Monsurul Hoq and John Brogan Monsurul Hoq was working as a Statistician Epidemiologist during the study. He has experience in monitoring and evaluation of community-based...
FEX: How do children with severe underweight and wasting respond to treatment?
View this article as a pdf This is a summary of the following paper: Odei Obeng-Amoako G, Stobaugh H, Wrottesley S et al (2023) How do children with severe underweight and...
FEX: Survey data exploring the prevalence of concurrent wasting and stunting in Southern Angola, Huila and Cunene
View this article as a pdf This article features a snapshot of the burden of concurrent wasting and stunting in Angola using prevalence data from survey data in two...
Resource: Changing sex differences in undernutrition of African children: findings from Demographic and Health Surveys
Abstract The study investigates sex differences in the prevalence of undernutrition in sub-Saharan Africa. Undernutrition was defined by Z-scores using the CDC-2000 growth...
en-net: Emergency standards for SAM/MAM when using MUAC
Can one use the same thresholds for SAM/MAM prevalence when using MUAC as the basis for measurement? For example can one equally use less than 15% GAM prevalence to classify...
FEX: Risk factors associated with severe acute malnutrition in infants under six months in India: a cross sectional analysis
By Susan Thurstans Susan is a registered nurse and midwife with over 12 years' experience in maternal and child health and nutrition programmes in both development and...
Reference this page
WHO Growth Standards to assess Indonesian children < 2 years. Field Exchange 38, April 2010. p14. www.ennonline.net/fex/38/who
(ENN_4004)