title: Referral of children for nutritional interventions in an under-fives clinic: would weight-for-height assessment help?
abstract: This study investigates decision making in an under-fives clinic by examining the referral of children for nutritional help on the basis of weight-for-age assessments ('Road to Health Card'). The weight-for-age status of each child is compared with his weight-for-height status. Children with a weight-for-height status of less than 89% and who were still failing to gain weight were considered 'at risk' and in need of referral. Of 28 such children, only four were referred. The growth curves of five wasted children who were not referred showed acute weight loss. It is suggested that community health nurses may experience problems in interpreting the trend of a child's growth curve, possibly because the information is inadequate or because they fail to interpret the given information correctly. Alternatively, community health nurses may have other reasons for nonreferral and these are also discussed. The study also considers whether incorporating a weight-for-height assessment into the clinic routine would increase the efficiency of nutritional intervention. However, there appears to be no obvious advantage if children's ages are known and the majority of children are not severely malnourished. The emphasis should be on training, not on new techniques.
mesh_terms: D001827:Body Height; D001835:Body Weight; D002662:Child Health Services; D002675:Child, Preschool; D003152:Community Health Nursing; D004045:Dietary Services; D006801:Humans; D007630:Kenya; D008499:Medical Records; D008722:Methods; D009748:Nutrition Disorders / Q000175:diagnosis*; D012017:Referral and Consultation; D012306:Risk; D012423:Rural Health