Worldwide implementation of the WHO Child Growth Standards
Worldwide implementation of the WHO Child Growth Standards
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DOI：
10.1017/s136898001200105x
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发表时间：
2012-09-01
影响因子：
3.2
通讯作者：
Lutter, Chessa
中科院分区：
文献类型：
--
作者：
de Onis, Mercedes;Onyango, Adelheid;Lutter, Chessa
目的：描述世界卫生组织儿童生长标准（“WHO标准”）在全球范围内的实施情况。设计：向卫生当局发送一份关于WHO标准采用情况的问卷。这些问题涉及所采用的人体测量指标、新采用的指标、年龄范围、使用按性别划分的图表、以前使用的参考资料、分类系统、为推广标准而开展的活动以及未采用的原因。截至2011年4月，125个国家采用了世卫组织的标准，另有25个国家正在考虑采用这些标准，30个国家尚未采用。不采用的主要原因是偏好当地参考文献。体重饲料几乎被普遍采用，其次是长度/身高年龄（104个国家）和体重长度/身高（88个国家）。几个国家（36个）报告最近采用了年龄BMI。大多数国家选择了按性别分列的图表和Z分数分类。许多国家重新设计了儿童健康记录，更新了关于婴儿喂养、免疫接种和其他健康信息的建议。大约三分之二的国家报告说，它们已将这些标准纳入了职前培训。其他活动包括将标准纳入计算机化信息系统，提供人体测量设备和动员资源用于标准的推广。结论：世卫组织标准发布五年后，得到了广泛的审查和实施。各国采用并统一了儿童生长评估方面的最佳做法，并将母乳喂养的婴儿确定为评估儿童充分实现其遗传生长潜力的权利是否得到遵守的标准。
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-forage 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.