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A comparative analysis among three world health organization growth charts
Chaitali A Borgaonkar1, Chinmay N Gokhale2, Mridula J Solanki3, Sunita S Shanbhag3
1 Department of Community Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
2 Department of Community Medicine, HBTMC and RNCH, Mumbai, Maharashtra, India
3 Department of Community Medicine, GSMC and KEMH, Mumbai, Maharashtra, India
Correspondence Address:
Chinmay N Gokhale,
MHADA/20-B, Orchard Avenue Road, POWAI, Mumbai - 400 076, Maharashtra
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/mjdrdypu.mjdrdypu_519_21
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Background: India is in a phase of nutrition transition. Child nutrition and growth monitoring services are provided under the state-run Integrated Child Development Scheme program. Classically, only one kind of growth chart is used to quantify nutrition status and categorize the children. Materials and Methods: This cross-sectional study involving 222 children was done to compare the outcome of nutritional status evaluated using three World Health Organization growth charts: weight-for-age, height-for-age, and weight-for-height. The results obtained by the use of these three charts were further compared and analyzed for concordance. Results: The three growth charts showed that 58% of children were underweight, 53% had stunting, and 35% were wasted among the study population. The comparisons using sensitivity/specificity, Kappa statistics, and ANOVA showed bidirectional disagreements between the three charts. Similar results could be deduced from large surveys done previously in Iraq and Congo. Conclusion: Hence, simultaneous use of three growth charts to categorize nutrition status is essential. This will help in preventing missing out cases of malnutrition and perhaps may aid in detecting child malnutrition at a relatively earlier stage.
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