The 1977 International Growth Reference, formulated by the National Center for Health Statistics (NCHS) and endorsed by World Health Organization (WHO), has long been used to assess the nutritional status of children. In 2006, however, WHO introduced new Child Growth Standards to replace the 1977 NCHS Reference. The study reported here presents findings from 10 DHS surveys, representing countries in South Asia, Central Asia, sub-Saharan Africa, and South America to compare the prevalence of stunting, wasting, underweight, and overweight in children under age 5 years by these two international standards.
Using the 2006 WHO Standards increases the prevalence of stunting, wasting, and overweight among children, while the prevalence of underweight children is lower compared with using the 1977 NCHS Reference. After controlling for various background characteristics of children, the study finds that place of residence (rural versus urban) and birth order are the only two characteristics that seem not to be important predictors of differences in stunting and wasting, respectively, between the 1977 NCHS Reference and the 2006 WHO Standards. Most findings of our study agree with findings from other studies reported in the literature.
These findings have implications for evaluating children’s nutritional status and for analyzing trends. Our major conclusion is that malnutrition tabulations should be made using both the 1977 NCHS Reference and the 2006 WHO Standards during the transition between the former reference and the new standards.