WHO GROWRTH CHART, ROAD TO HEALTH CHART, DR ATHAR KHAN, LCMD

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Prof. Dr. Athar Khan
Department of Community Medicine
Liaquat College of Medicine & Dentistry
Karachi
matharm@yahoo.com

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 Describe the importance of Growth Chart
 List the tools for assessing nutritional status
 Interpret Growth Charts
 Describe their uses
LEARNING OBJECTIVES
Assessment of Nutritional Status- Growth Chart

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INTRODUCTION
Growth monitoring is the continuous monitoring of growth in children.

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Growth Monitoring & Promotion (GMP)
 Regular measurement, recording, and
interpretation of a child’s growth change in order
to counsel, act and followup results.
Growth Monitoring:
 Passive: No interpretation
 Active: Interpretation by workers but not
understood by mothers.
 Interactive: Interpretation understood by mothers
INTRODUCTION

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INTRODUCTION

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INTRODUCTION

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INTRODUCTION
Anthropometry is the most frequently used method to assess nutritional status.

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INTRODUCTION

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INTRODUCTION
Indicators for Growth
 Weight for Age: Underweight (Acute & Chronic
Malnutrition)
 Height for Age: Stunting (Past Nutrition
Problems)
 Weight for height: Wasting

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INTRODUCTION
Infantometer
Mid-Upper Arm Circumference
Occipito-Frontal
Circumference
Skinfold
Thickness
Salter Weighing
Scales

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Growth Chart
WHO Multicentre Growth Reference Study.

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Growth Chart
Standard deviation score (SD) or z-score.
Median
z-score lines, which indicate distance from
the average/MEDIAN.

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Growth Chart
2. A child whose weight-for-age falls in this range may have a growth problem, but this is
better assessed from weight-for-length/height or BMI-for-age.
normal range
normal range

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Growth Chart

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Growth Chart

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Growth Chart
Percentiles refer to the percentage of individuals falling below a particular level. By
definition 3 per cent of children are below the 3rd percentile, and a further 3 percent
are above the 97th percentile.

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Growth Chart

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Growth Chart

19. Moving upward:
Satisfactory
Static:
Dangerous
Moving downward;
Very dangerous
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Growth Chart

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LO 1:Describe The Importance of Growth Chart

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Growth Chart
1. A child in this range is very tall. 4. It is possible for a stunted or severely stunted
child to become overweight.

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Growth Chart

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Growth Chart

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Road To Health Chart

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LO Uses of Growth Chart
50th
Centile
3rd Centile
Used in LHW programs

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Growth Chart
Used in LHW programs
• It has two reference curves.
• Upper reference curve -the median (50th percentile) for
boys.
• Lower reference curve – 3rd percentile for girls
• Space between two growth curves called weight channel
or road to health – zone of normality for most
population.

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Growth Chart
50th Centile
- 2SD
3rd Centile
-3SD
97thCentile
Used in LHW programs

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Growth Chart
 N This range is normal between 50th -97th centile
 M Medium between 50th and 3rd centile
 S Severe < 3rd centile – needs immediate action.
In statistics, a percentile (or centile) is the value of a
variable below which a certain percent of observations fall.
For example, the 20th percentile is the value (or score)
below which 20 percent of the observations may be found.

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LO Uses of Growth Chart

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GOLDEN POINTS

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 Growth charts are the standard tool for
interpreting growth.
 A variation of 2 standard deviations from either
side of the mean (or median) is considered as
within normal limits.
 Individuals who fall between 3rd and 97th
percentiles) regarded as "normal.“
 The WHO growth chart are used for children upto
5 years of age
GOLDEN POINTS

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 The growth or "road-to-health" chart (first
designed by David Morley and later modified by
WHO) is a visible display of the child's physical
growth and development.
 It is designed primarily for the longitudinal follow-
up (growth monitoring) of a child.
GOLDEN POINTS

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 The growth chart shows normal zone of weight
for age, undernutrition (below - 2 SD) and
severely underweight zone (below - 3 SD).
 BMI = Weight in Kg/Height in meter square
GOLDEN POINTS

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Thank
You