Pilot testing of WHO child growth standards in Chandigarh: implications for India's child health programmes.
OBJECTIVE
To compare the prevalence of underweight as calculated from Indian Academy of Paediatrics (IAP) growth curves (based on the Harvard scale) and the new WHO Child Growth Standards.


METHODS
We randomly selected 806 children under 6 years of age from 45 primary anganwadi (childcare) centres in Chandigarh, Punjab, India, that were chosen through multistage stratified random sampling. Children were weighed, and their weight for age was calculated using IAP curves and WHO growth references. Nutritional status according to the WHO Child Growth Standards was analysed using WHO Anthro statistical software (beta version, 17 February 2006). The chi2 test was used to determine statistical significance at the 0.05 significance level.


RESULTS
The prevalence of underweight (Z score less than -2) in the first 6 months of life was nearly 1.6 times higher when calculated in accordance with the new WHO standards rather than IAP growth curves. For all ages combined, the estimated prevalence of underweight was 1.4 times higher when IAP standards instead of the new WHO standards were used. Similarly, the prevalence of underweight in both sexes combined was 14.5% higher when IAP standards rather than the new WHO growth standards were applied (P < 0.001). By contrast, severe malnutrition estimated for both sexes were 3.8 times higher when the new WHO standards were used in place of IAP standards (P < 0.001).


CONCLUSIONS
The new WHO growth standards will project a lower prevalence of overall underweight children and provide superior growth tracking than IAP standards, especially in the first 6 months of life and among severely malnourished children.
Prinja
Shankar
S
Postgraduate Institute of Medical Education and Research, School of Public Health, Chandigarh, India.
Thakur
Jarnail Singh
JS
Bhatia
Satpal Singh
SS
D001835:Body Weight; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009748:Nutrition Disorders / Q000453:epidemiology*; D009752:Nutritional Status; D010865:Pilot Projects; D015995:Prevalence; D014944:World Health Organization