Child Growth Standards in India

The issue of child under nutrition persists in India, with multiple determinants such as food intake, dietary diversity, health, sanitation, and poverty.

The measurement of childhood under nutrition relies on anthropometric standards, and India currently uses the World Health Organization (WHO) Growth Standards. However, there is an on-going debate regarding the appropriateness of these standards for the Indian context.

• The WHO standards are derived from the Multicentre Growth Reference Study (MGRS), conducted in six countries between 1997 and 2003.
• Critics argue that the MGRS sample, particularly in India, was drawn from privileged households in South Delhi, potentially skewing the standards.

Need:

• Monitoring child growth is essential for tracking progress, but concerns have been raised about the suitability of the WHO standards in the Indian context.
• The determinants of under nutrition are multifaceted, and a nuanced approach is required.

Comparison of Two Standards:

• Critics contend that the WHO standards overestimate under nutrition in India.
• However, comparing these standards with other datasets is challenging due to issues of inequality and sample representation.
• The MGRS included counselling, absent in national surveys, influencing the comparability of results.

Analysis:

• Genetic growth potential and maternal height significantly influence child growth.
• Questions arise about the adaptability of the standards to diverse genetic profiles and whether improvement is achievable in one generation.
• Regional variations within India and the shifting gene pools with socio-economic development further complicate the analysis.

Issues/Challenges:

• Concerns exist regarding the potential misdiagnosis of under nutrition, leading to overfeeding and an increase in non-communicable diseases.
• However, addressing dietary gaps, improving meal quality in government programs, and enhancing overall healthcare access are crucial to effective nutritional interventions.

Possible Suggestions:

• The Indian Council of Medical Research (ICMR) has formed a committee to revisit growth references for India.
• The committee recommends a thorough nationwide study to formulate national growth charts, if necessary.
• While acquiring precise information is valuable, maintaining comparability with international standards, as suggested by the WHO-MGRS, remains essential.

Conclusion

As India aspires for comprehensive development by 2047, the focus on child growth standards gains significance. Striking a balance between aspirational goals and achievable standards is crucial. The on-going discussions about revising growth references underscore the need for a nuanced approach that considers regional variations, socio-economic factors, and international benchmarks to ensure effective child nutrition strategies in India.