Worldwide implementation of the WHO Child Growth Standards.
OBJECTIVE
To describe the worldwide implementation of the WHO Child Growth Standards ('WHO standards').


METHODS
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.


METHODS
Worldwide.


METHODS
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-for-age 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.
Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. deonism@who.int
Mercedes
M
de Onis
Adelheid
A
Onyango
Elaine
E
Borghi
Amani
A
Siyam
Monika
M
Blössner
Chessa
C
Lutter
D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D001942:Breast Feeding; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D057238:Growth Charts; D006801:Humans; D007223:Infant; D008297:Male; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014944:World Health Organization