Bhor, Nilanjan
(2017)
A call for development of a
growth standard to measure
malnutrition of school-age children.
Working Paper.
Azim Premji University.
Abstract
There is no globally established standard for measuring malnutrition among children aged 5-18
years. Growth references are used as a standard but there are many limitations to using such references
to assess nutritional status of Indian children. As per the World Health Organization, standards and
references both serve as a basis for comparison, but each enables a different interpretation. A standard
defines how children should grow; and deviations from the pattern it prescribes are evidence of abnormal
growth. A reference, on the other hand, does not provide a basis for such value judgments, although in
practice, references often are mistakenly used as standards.
This paper has conducted a methodological review of prevalence of malnutrition from openly accessible
literature pertaining to assessment of nutritional status of school-going children in India from the
year 2000 to 2016. The methodological review reveals that a combination of different national and
international references have been used in assessing nutritional status of Indian children. International
references includes NCHS 1977, CDC 2000, WHO 2007, IOTF 2012 extended Body Mass Index (BMI) cutoffs,
Gomez classification, Waterlow’s classification and national references such as - Agarwal standards,
ICMR reference values, IAP reference and BMI cut-off for overweight & obesity of Indian children. A new
national growth reference has been recently developed by Marwaha and others (2011) for BMI, but no
assessment of nutritional status using this reference was found. Each of these methods was then applied
to a database containing height, weight, age and sex of 5340 school-going children.
Though there are three nutritional indicators for school-age children, majority of the study conducted
used only BMI chart to assess nutritional status. Therefore BMI-for-age is considered for the analysis to i)
understand the methodological application of the above growth references ii) compare the differences in
nutritional status and iii) recommend an appropriate growth reference (from those available) to assess
the nutritional status of Indian school-age children. The literature review also reveals that malnutrition
among school-age children is prevalent in India. There is no national level data available to support this
judgement across regions, gender and caste. Given a likely high prevalence of malnutrition, this paper
calls for the development of a growth standard to measure malnutrition among school-age children in
India. Though this paper is focused on malnutrition, it simultaneously provides similar importance to
over growth. A growth Standard therefore fills up such gaps in measuring double burden of malnutrition
i.e. under-nutrition and over-nutrition.
| Item Type: |
Monograph
(Working Paper)
|
| Authors: |
Bhor, Nilanjan |
| Document Language: |
|
| Uncontrolled Keywords: |
Anthropometry, Growth charts, Malnutrition, School-age children |
| Subjects: |
Technology > Medicine & health |
| Divisions: |
Azim Premji University > University Publications > Working Paper |
| Full Text Status: |
Public |
| Note: |
The working paper series aims at reflecting the range of work done across the Azim Premji
Foundation, including the Field Institutes and the University, and disseminating this work to
a broader audience. University faculty, members of Field Institutes of the Foundation as well as
students graduating from the University may contribute to the series.
The findings, interpretations and conclusions expressed in these papers are entirely those of the
authors and do not necessarily represent the views of Azim Premji University. |
| URI: |
http://publications.azimpremjiuniversity.edu.in/id/eprint/383 |
| Publisher URL: |
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