Chapter 2


(z-score) of the mean weight-for-height of children of the same age in a well-fed population,
the chances of this being the result of their genetic make-up is very slight indeed. The child
is almost certainly malnourished. Table 2.6 is an example of the kind of standard reference
table that would be used when assessing weight-for height. The child's weight would be
measured, and then the weight of the child assessed in relationship to this. Similar tables are
available for weight-for-age and height-for-age.

Table 2.6 Weight for Height for boys between 106 and 120 cms (in Kg)

 Height in cms -3S.D -2S.D -IS.D Median

 106.0 12.9 14.4 15.9 17.4
 106.5 13.0 14.5 16.1 17.6
 107.0 13.1 14.7 16.2 17.7
 107.5 13.2 14.8 16.3 17.9
 108.0 13.4 14.9 16.5 18.0
 108.5 13.5 15.0 16.6 18.2

 109.0 13.6 15.2 16.8 18.3
 109.5 13.7 15.3 16.9 18.5
 110.0 13.8 15.4 17.1 18.7
 110.5 14.0 15.6 17.2 18.8
 111.0 14.1 15.7 17.4 19.0
 111.5 14.2 15.9 17.5 19.1
 112.0 14.4 16.0 17.7 19.3

 Source: NCHS/CDC/WHO Reference Population, from WHO, 1983.

 Table 2.7 shows some of the characteristics of commonly used anthropometric indicators for
 children, with their respective cut-off points, and the terms normally used to refer to the
 different categories of malnutrition. They have different degrees of ease in use. The first two
 require knowledge of the child's age, which may be difficult to get accurately in some
 communities. However, weight-for-age is perhaps the most commonly used indicator, and
 reflects present and past history of malnutrition. Height-for-age is generally interpreted as
 reflecting the effects of chronic malnutrition, leading to growth retardation or stunting.
 Weight-for-height does not require knowledge of the child's age and is sensitive to recent
 episodes of malnutrition which have resulted in wasting. Thus a child who has suffered
 severe episodes of malnutrition in the past, but is now well-fed and healthy might be
 identified as malnourished by the first two indicators but not the third. Arm circumference
 measurements also reflect current episodes of malnutrition. This can be one of the cheapest
 methods of measuring children, though it does, like the other methods, require proper
 training of the investigators.