Worldwide implementation of the WHO Child Growth Standards

Public Health Nutr. 2012 Sep;15(9):1603-10. doi: 10.1017/S136898001200105X. Epub 2012 Apr 12.


Objective: To describe the worldwide implementation of the WHO Child Growth Standards ('WHO standards').

Design: A questionnaire on the adoption of the WHO standards was sent to health authorities. The questions concerned anthropometric indicators adopted, newly introduced indicators, age range, use of sex-specific charts, previously used references, classification system, activities undertaken to roll out the standards and reasons for non-adoption.

Setting: Worldwide.

Subjects: Two hundred and nineteen countries and territories.

Results: By April 2011, 125 countries had adopted the WHO standards, another twenty-five were considering their adoption and thirty had not adopted them. Preference for local references was the main reason for non-adoption. Weight-for-age was adopted almost universally, followed by length/height-for-age (104 countries) and weight-for-length/height (eighty-eight countries). Several countries (thirty-six) reported newly introducing BMI-for-age. Most countries opted for sex-specific charts and the Z-score classification. Many redesigned their child health records and updated recommendations on infant feeding, immunization and other health messages. About two-thirds reported incorporating the standards into pre-service training. Other activities ranged from incorporating the standards into computerized information systems, to providing supplies of anthropometric equipment and mobilizing resources for the standards' roll-out.

Conclusions: Five years after their release, the WHO standards have been widely scrutinized and implemented. Countries have adopted and harmonized best practices in child growth assessment and established the breast-fed infant as the norm against which to assess compliance with children's right to achieve their full genetic growth potential.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Height
  • Body Mass Index
  • Body Weight
  • Breast Feeding
  • Child Development*
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Growth Charts*
  • Humans
  • Infant
  • Male
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • World Health Organization*