sex specific W/H charts in WHO2006 growth standards
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Normal user
16 Jun 2010, 15:23
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We are planning to shift from NCHS to WHO 2006 growth standards for admissions to our CTC programmes. As you know sex specific standards were issued for W/H. As expected girls have lower average weight than boys of the same height. I have read here: http://www.en-net.org.uk/question/40.aspx a comment from Michael Golden about the new sex specific W/H charts. If I understand well, he affirms that due to lack of data on the correlation between the W/H sex specific standards and mortality due to wasting, boy charts should be used for both sexes. In fact a girl having the same weight and height of a boy may be excluded from treatment (due to better W/H ratio) while she may have the same mortality risk of the boy. Therefore he proposes to adopt the boys standards for both sexes so to be sure that we are not discriminating girls. I agree that mortality risk is what we should care most of when choosing admission criteria to nutrition centers, yet I am wondering whether it is the right choice to adopt the boy W/H tables for both sexes, since if we do so we may discriminate boys (if sex specific W/H is associated with mortality). Although not proved, it seems more logical that sex specific mortality and W/H are associated rather the opposite. Moreover changing standards at programme (and much more at country level) is a quite slow process which needs specific training, protocols and materials. A proof is the fact that many countries are still using the NCHS standards, almost 5 years after the introduction of the new OMS standards. What is your opinion on the subject? Would you recommend the boys W/H tables to be temporarily used for both sexes to be on the cautious side, or rather adopt the sex specific tables because they are more accurate from an anthropometric perspective? Thank you.
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Technical expert
18 Jun 2010, 15:06
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I would not recommend using W/H as the primary admission criteria for a CTC program due to its problems of low coverage. You might want to create a sex-combined table using the mean for the male and female values. |
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