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Worldwide implementation of the WHO Child Growth Standards

2012; Cambridge University Press; Volume: 15; Issue: 9 Linguagem: Inglês

10.1017/s136898001200105x

1475-2727

Mercedes de Onís, Adelheid W. Onyango, Elaine Borghi, Amani Siyam, Monika Blössner, Chessa Lutter,

Birth, Development, and Health

Abstract Objective To describe the worldwide implementation of the WHO Child Growth Standards (‘WHO standards’). Design 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. Setting Worldwide. Subjects 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.