This document discusses the growth chart, which is used to monitor children's growth and development over time. The growth chart displays weight-for-age as the primary growth parameter. It helps identify at-risk children and inform policy and educational efforts. The World Health Organization developed a new international growth standard based on data from healthy breastfed children in multiple countries. India has adopted the WHO growth standard to monitor childhood nutrition under the National Rural Health Mission.

1. THE GROWTH CHART

2. INTRODUCTION
• Called as the road-to-health
• Developed by David Morley and later modified by WHO
• Displays child’s growth and development
• Primarily for longitudinal follow up ( growth monitoring)
• Helps to identify changes over time
• The mostly used parameter in growth is weight for age.
• Because weight is the most sensitive measure and it’s deviation from normal can be
easily detected
• Height not considered-Cos a child cannot lose height
• Growth cart is a simple and inexpensive tool

3. WHO CHILD GROWTH STANDARD
• Developed by multicentre growth reference study(MGRS)
• Conducted from 1997-2003 in Brazil Ghana India Oman and USA
• Data collected from 9440 healthy breast feed infants and young children (0-
60months)
• The new WHO standard adopted in 2006
• It can be used to assess children everywhere regardless of ethnicity socioeconomic
status and type of feeding.
• Formerly used Charts were NCHS growth chart which had notable difference from
the new WHO groth chart.

4. USES
• Growth monitoring :
• Diagnostic tool : to identify high risk children
• Planning and policy making : for child health care at local and central level
• Educational tool: for mother to monitor
• Tool for action: for health worker to intervene
• Evaluation : effectiveness of corrective measures
• Tool for teaching : advantage of breast feeding , effect of diarrhoea

5. GROWTH CHART USED IN INDIA
• India adopted the new WHO child growth standard in February 2009
• Under NATIONAL RURAL HEALTH MISSION and the ICDS

8. • The chart show Normal zone Of weight for age, undernutrition( 2SD) and severely
underweight zone (below 3SD)
• It is the direction of growth more important than the position of dots on the line.
• flattening or falling of the child’s weight curve signal growth failure which is the
earliest sign of PEM and may precede clinical signs

9. The objective is to keep the child in normal zone by giving special care to
high risk children