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MEA
SUR
ING
A
ND
PR
OM
OTI
NG
C
HIL
D
GRO
WTH
Part
icip
ant’s
Wor
kboo
k
Vers
ion
2, A
ugus
t 20
11
Nut
ritio
n To
olki
t
Glo
bal H
ealth
N
utri
tion
Cen
tre
of E
xper
tise
Mea
suri
ng a
nd P
rom
otin
g C
hild
Gro
wth
Too
lA
Mod
ule
of th
e N
utrit
ion T
oolk
it
Part
icip
ant’s
Wor
kboo
kVe
rsio
n 2,
Aug
ust
2011
Nut
ritio
n C
entr
e of
Exp
ertis
e
Wor
ld V
isio
n In
tern
atio
nal,
Glo
bal H
ealth
and
WA
SH
MPCG
Wor
ld V
isio
n is
a C
hris
tian
relie
f, de
velo
pmen
t an
d ad
voca
cy o
rgan
isat
ion
dedi
cate
d to
wor
king
with
chi
ldre
n, fa
mili
es a
nd t
heir
com
mun
ities
wor
ldw
ide
to r
each
the
ir
full
pote
ntia
l by
addr
essi
ng t
he c
ause
s of
pov
erty
and
inju
stic
e. W
orld
Vis
ion
serv
es a
ll pe
ople
, reg
ardl
ess
of r
elig
ion,
rac
e, e
thni
city
or
gend
er.
Cop
yrig
ht ©
Wor
ld V
isio
n In
tern
atio
nal 2
010
Term
s o
f Use
Wor
ld V
isio
n of
fers
the
mat
eria
ls t
hat
mak
e up
the
Mea
suri
ng a
nd P
rom
otin
g C
hild
Gro
wth
Too
l for
you
r us
e. Yo
u ar
e fr
ee t
o re
prod
uce
and
use
all t
he m
ater
ials
und
er t
he fo
llow
ing
cond
ition
s:
• Wor
ld V
isio
n’s
logo
is r
etai
ned
on t
he m
ater
ials
and
not
rep
lace
d w
ith y
our
own
logo
.
• So
urce
of t
he m
ater
ials
mus
t be
ack
now
ledg
ed a
nd, w
here
app
ropr
iate
, the
cop
yrig
ht n
otic
e in
clud
ed.
• Wor
ld V
isio
n is
ack
now
ledg
ed a
s th
e cr
eato
r an
d ow
ner
of t
he M
easu
ring
and
Pro
mot
ing
Chi
ld G
row
th T
ool a
nd r
elat
ed m
ater
ials
.
• N
o fe
es a
re c
harg
ed fo
r th
e w
orks
hop
and
the
mat
eria
ls a
re n
ot s
old.
Publ
ishe
d by
Nut
ritio
n C
entr
e of
Exp
ertis
e, G
loba
l Hea
lth a
nd W
ASH
on
beha
lf of
Wor
ld V
isio
n In
tern
atio
nal.
For
furt
her
info
rmat
ion
abou
t th
is o
r ot
her
nutr
ition
too
ls a
nd p
ublic
atio
ns c
onta
ct t
he N
utri
tion
Cen
tre
of E
xper
tise:
nutr
ition
_coe
@w
vi.o
rg.
For
info
rmat
ion
abou
t Wor
ld V
isio
n In
tern
atio
nal p
ublic
atio
ns c
onta
ct w
vi_p
ublis
hing
@w
vi.o
rg.
Wor
ld V
isio
n In
tern
atio
nal w
ould
app
reci
ate
rece
ivin
g de
tails
of a
ny u
se m
ade
of t
his
mat
eria
l in
trai
ning
,rese
arch
or
prog
ram
me
desi
gn,
impl
emen
tatio
n or
eva
luat
ion.
1
MPC
G
Ack
now
ledg
emen
ts
The
Mea
suri
ng a
nd P
rom
otin
g C
hild
Gro
wth
Too
l, on
e to
ol w
ithin
the
Nut
ritio
n To
olki
t, co
ntai
ns a
ll th
e es
sent
ial i
nfor
mat
ion
need
ed fo
r a
trai
ner
who
is b
uild
ing
the
skill
s an
d co
mpe
tenc
ies
of t
hose
who
mea
sure
chi
ld g
row
th (
anth
ropo
met
ry).
Man
y pe
ople
con
trib
uted
to
the
final
ver
sion
of t
he M
easu
ring
and
Pro
mot
ing
Chi
ld G
row
th T
ool. W
e w
ant
to t
hank
all
thos
e w
ho h
elpe
d m
ake
this
too
l a r
ealit
y, by
dev
elop
ing
the
conc
ept,
wri
ting
and
reor
gani
sing
the
tex
t, pr
ovid
ing
tech
nica
l fee
dbac
k on
the
acc
urac
y an
d flo
w, e
ditin
g, ill
ustr
atin
g, an
d te
stin
g th
e to
ol in
pro
ject
site
s.
Mir
iam
Yia
nnak
is o
f Wor
ld V
isio
n’s
Nut
ritio
n C
entr
e of
Exp
ertis
e (N
CO
E), p
rovi
ded
over
all l
eade
rshi
p to
thi
s pr
ojec
t. N
aom
i Kla
as (
cons
ulta
nt)
was
the
lead
aut
hor.
The
follo
win
g in
divi
dual
s pr
ovid
ed t
echn
ical
com
men
ts a
nd r
evie
w o
n va
riou
s dr
afts
:
Wor
ld V
isio
n In
tern
atio
nal N
utri
tion
Cen
tre
of E
xper
tise:
Alis
on M
ildon
, Mir
iam
Yia
nnak
is, C
arol
yn M
acD
onal
d, C
olle
en E
mar
y, C
arm
en T
se, A
imee
Web
b
Tech
nica
l Exp
erts
:
Em
ily L
evit
t (F
AN
TA),
Mar
k M
yatt
Wor
ld V
isio
n C
anad
a
Mir
iam
Cha
ng, M
elan
i Fel
low
s, M
ario
n R
oche
, Abe
na T
hom
as, J
eann
ette
Ula
te, B
arba
ra M
ain
The
follo
win
g in
divi
dual
s w
ere
invo
lved
in fi
eld-
test
ing
an e
arlie
r dr
aft
of t
he t
ool i
n In
done
sia:
Est
her
Indr
iani
(W
orld
Vis
ion
Asi
a Pa
cific
Reg
iona
l Offi
ce)
Sigi
t Su
listy
o, M
arku
s P
uthu
t H
arm
iko,
Can
dra
Wija
ya, a
nd t
he e
ntir
e te
am in
Alo
r Are
a D
evel
opm
ent
Pro
gram
me,
(W
orld
Vis
ion
Indo
nesi
a)
Rep
ublic
of I
ndon
esia
Min
istr
y of
Hea
lth
Staf
f M
elan
i Fel
low
s (W
orld
Vis
ion
Can
ada)
Bet
h Fe
llow
s (c
onsu
ltant
) ill
ustr
ated
the
Mea
suri
ng a
nd P
rom
otin
g C
hild
Gro
wth
Too
l, w
hile
Per
ry D
’Elia
(co
nsul
tant
) pr
ovid
ed g
raph
ic d
esig
n an
d la
yout
exp
ertis
e. N
umer
ous
draf
ts o
f the
too
lkit
wer
e ed
ited
by L
oria
Kul
athu
ngam
(N
CO
E) a
nd K
ila R
eim
er (
Con
sulta
nt).
We
are
grat
eful
to
Felic
ity
Sava
ge K
ing
and
Ann
Bur
gess
for
gene
rous
ly a
llow
ing
us t
o us
e ex
cerp
ts fr
om t
heir
boo
k, N
utrit
ion
for D
evel
opin
g Co
untr
ies
(2nd
ed,
199
3), i
n Le
sson
s 2,
4 a
nd 1
1.
We
hope
tha
t th
e M
easu
ring
and
Pro
mot
ing
Chi
ld G
row
th T
ool w
ill e
nhan
ce y
our
effo
rts
to b
uild
cap
acity
in fi
eld
staf
f so
they
will
be
able
to
resp
ond
quic
kly
and
appr
opri
atel
y to
ca
ses
of m
alnu
triti
on a
mon
g ch
ildre
n in
the
com
mun
ities
in w
hich
the
y liv
e an
d w
ork.
Ulti
mat
ely,
we
wan
t to
see
chi
ldre
n gr
ow a
nd d
evel
op a
s th
ey s
houl
d so
the
y ca
n re
ach
thei
r fu
ll po
tent
ial a
s ch
ildre
n, a
nd la
ter
on in
life
, as
adul
ts.
Sinc
erel
y,
Mir
iam
Yia
nnak
is
Car
olyn
Mac
Don
ald
Tech
nica
l Spe
cial
ist,
Cap
acity
Bui
ldin
g N
utri
tion
Dire
ctor
and
NC
OE
Lead
N
utri
tion
Cen
tre
of E
xper
tise
N
utri
tion
Cen
tre
of E
xper
tise,
W
orld
Vis
ion
Inte
rnat
iona
l
Wor
ld V
isio
n In
tern
atio
nal
1
MPC
GW
elco
me
and
Intr
oduc
tion
Pro
per
mea
sure
men
t of
chi
ld g
row
th is
an
impo
rtan
t pa
rt o
f ass
essm
ent
and
eval
uatio
n su
rvey
s (in
clud
ing W
orld
Vis
ion
Chi
ld W
ell-B
eing
Out
com
es a
nd T
rans
form
atio
nal
Dev
elop
men
t In
dica
tors
), sp
onso
rshi
p pr
ogra
mm
es, s
ecto
r-sp
ecifi
c pr
ojec
ts in
nut
ritio
n, h
ealth
, fo
od s
ecur
ity o
r ot
her
area
s, an
d em
erge
ncy
prog
ram
mes
. By
mea
suri
ng c
hild
gro
wth
, we
get
info
rmat
ion
that
hel
ps u
s de
term
ine
the
leve
ls o
f mal
nutr
ition
with
in o
ur c
omm
uniti
es a
nd
info
rms
our
prog
ram
min
g de
cisi
ons.
Of c
ours
e w
e al
so o
btai
n an
d us
e th
is in
form
atio
n to
do
rout
ine
mon
itori
ng o
f chi
ldre
n in
ord
er t
o su
ppor
t th
e he
alth
y gr
owth
of t
he in
divi
dual
chi
ld.
The
Mea
suri
ng a
nd P
rom
otin
g C
hild
Gro
wth
mod
ule
of t
he N
utri
tion
Tool
kit
is d
esig
ned
to in
crea
se fa
ctua
l kno
wle
dge,
und
erst
andi
ng a
nd p
ract
ical
ski
lls o
f peo
ple
resp
onsi
ble
for
mea
suri
ng c
hild
gro
wth
.
The
re a
re s
ever
al d
iffer
ent
task
s in
volv
ed in
mon
itor
ing
child
gro
wth
. The
se in
clud
e ta
king
acc
urat
e m
easu
rem
ents
of h
eigh
t, w
eigh
t an
d si
ze o
f the
upp
er a
rm. O
ther
tas
ks a
re
colle
ctin
g ac
cura
te in
form
atio
n ab
out
the
age
and
sex
of c
hild
ren;
rec
ordi
ng t
his
info
rmat
ion;
ca
lcul
atin
g th
e re
sults
of t
he d
ata;
and
inte
rpre
ting
the
data
. The
pro
cess
of g
row
th m
onito
ring
is n
ot c
ompl
ete
with
out
coun
selli
ng fo
r m
othe
rs a
bout
the
gro
wth
of t
heir
chi
ldre
n. It
is a
lso
impo
rtan
t to
gro
up t
he d
ata
into
a ‘b
ig p
ictu
re’ t
hat
help
s us
to
see
if th
ere
is w
ides
prea
d m
alnu
triti
on w
ithin
a c
omm
unity
.
Ant
hrop
omet
rics
is a
long
wor
d th
at m
eans
‘mea
sure
men
t of
hum
an b
eing
s’. W
e m
easu
re
the
rate
tha
t ch
ildre
n gr
ow t
o un
ders
tand
a c
hild
’s nu
triti
onal
sta
tus.
If a
child
is g
row
ing
at a
no
rmal
rat
e, h
e or
she
is a
lmos
t ce
rtai
nly
wel
l nou
rish
ed. A
chi
ld w
ho is
not
gro
win
g at
the
no
rmal
rat
e is
pro
babl
y no
t w
ell n
ouri
shed
. Par
ents
may
not
kno
w if
a c
hild
is g
row
ing
at t
he
norm
al r
ate,
and
the
y ne
ed h
elp
to fi
nd o
ut. T
he o
nly
way
for
pare
nts
and
nutr
ition
wor
kers
to
be c
erta
in a
bout
how
a c
hild
is g
row
ing
is t
o m
easu
re a
chi
ld r
egul
arly
(i.e
. ant
hrop
omet
ry).
Thi
s se
ctio
n of
the
Nut
ritio
n To
olki
t w
ill h
elp
you
to u
nder
stan
d ho
w t
o co
llect
and
how
to
use
ant
hrop
omet
ric
info
rmat
ion
to m
onito
r th
e gr
owth
of y
oung
chi
ldre
n in
you
r de
velo
pmen
t pr
ojec
ts. L
esso
ns w
ill s
how
the
pra
ctic
al s
teps
for
corr
ectly
mea
suri
ng h
eigh
t, w
eigh
t, up
per-
arm
siz
e an
d ag
e of
chi
ldre
n.
Wel
com
e to
the
Tra
inin
g on
How
to
Mea
sure
Chi
ldre
n
Prop
er m
easu
rem
ent o
f chi
ldre
n is
an im
port
ant p
art
of h
elpi
ng m
othe
rs a
nd h
ealth
wor
kers
kno
w
wha
t the
y ca
n do
to h
elp
child
ren
grow
bet
ter.
Mea
suri
ng C
hild
Gro
wth
(A
nthr
opo
met
rics
)
2
MPC
GLE
SSO
N
3
MPC
GLE
SSO
N
1W
elco
me
and
Intr
oduc
tion
Wo
rksh
op
Pur
pose
Pur
pose
1
To t
rain
par
ticip
ants
to
wei
gh a
nd m
easu
re c
hild
ren
accu
rate
ly;
and
to c
alcu
late
and
rec
ord
grow
th a
ccur
atel
y.
Pur
pose
2
To t
rain
par
ticip
ants
to
inte
rpre
t ch
ild n
utri
tiona
l sta
tus
and
com
mun
ity n
utri
tiona
l sta
tus
accu
rate
ly.
Pur
pose
3To
incr
ease
par
ticip
ants
’ und
erst
andi
ng o
f the
pur
pose
and
im
port
ance
of c
ouns
ellin
g m
othe
rs a
nd c
areg
iver
s an
d to
bui
ld
skill
s fo
r ap
prop
riat
e co
unse
lling
.
Ski
lls T
o L
earn
Skill
1. W
e w
ill le
arn
the
tech
niqu
e fo
r w
eigh
ing
and
mea
suri
ng
child
ren
unde
r 5.
Skill
2. W
e w
ill le
arn
the
tech
niqu
e fo
r fin
ding
out
a c
hild
’s ex
act
age.
Skill
3. W
e w
ill le
arn
how
to
reco
rd in
form
atio
n cl
earl
y on
ap
prop
riat
e fo
rms.
Skill
4. W
e w
ill le
arn
to in
terp
ret
the
mea
ning
of t
he d
ata
gath
ered
in o
rder
to
dete
rmin
e a
child
’s nu
triti
onal
sta
tus
accu
rate
ly.
Skill
5. W
e w
ill le
arn
how
to
coun
sel m
othe
rs a
bout
nut
ritio
n.
Skill
6. W
e w
ill le
arn
to u
se t
he in
form
atio
n to
hel
p us
mak
e de
cisi
ons
abou
t w
hen
inte
rven
tions
are
nee
ded
to im
prov
e ch
ild g
row
th.
Day
1D
ay 2
Day
3
Mor
ning
Less
on 1
– W
elco
me
and
Intr
oduc
tion
(60
min
)Le
sson
2 –
Wha
t Is
A
nthr
opom
etry
? (6
0 m
in)
Less
on 6
– M
easu
ring
Len
gth
and
Hei
ght
(2 h
ours
)
Less
on 9
– Im
prov
ing
Indi
vidu
al C
hild
G
row
th
(2 h
ours
)
Bre
ak
(15
min
utes
)
Mor
ning
Less
on 3
– In
form
atio
n A
bout
Sex
and
Age
of
Chi
ldre
n U
nder
5
(90
min
)
Less
on 7
– M
id-U
pper
Arm
C
ircum
fere
nce
(60
min
)Le
sson
8 –
Pre
para
tion
for
the
Stan
dard
isat
ion
Exer
cise
(6
0 m
in)
Less
on 1
0 –
Cou
nsel
ling
(2 h
ours
)
Lunc
h
Aft
erno
onLe
sson
4 –
Han
ging
Sca
les
(2 h
ours
)Le
sson
8 –
Sta
ndar
disa
tion
Exer
cise
(2
hour
s)
Less
on 1
1 –
Popu
latio
n N
utri
tiona
l Sta
tus
(60
min
)
Bre
ak
(15
min
utes
)
Aft
erno
onLe
sson
5 –
Sta
ndin
g Sc
ales
(2
hou
rs)
Less
on 8
– S
tand
ardi
satio
n Ex
erci
se c
ont’d
(2
hour
s)C
losi
ng
2
MPC
GLE
SSO
N
3
MPC
GLE
SSO
N2
Wha
t Is
Ant
hrop
omet
ry?
Defi
ning
Ant
hro
pom
etri
cs
Why
do
we
wei
gh a
nd m
easu
re
child
ren
unde
r 5 y
ears
of a
ge?
The
thr
ee m
ain
reas
ons
fo
r fo
cusi
ng o
n th
is a
ge r
ange
are
:
• C
hild
ren
unde
r 5
grow
ver
y ra
pidl
y; th
is is
esp
ecia
lly t
rue
for
the
peri
od fr
om b
irth
to
two
year
s ol
d. T
his
grow
th in
clud
es p
hysi
cal g
row
th a
s w
ell m
enta
l dev
elop
men
t.
• H
ow w
ell c
hild
ren
grow
in t
heir
firs
t fiv
e ye
ars
will
influ
ence
how
hea
lthy
they
are
for
the
rest
of t
heir
live
s, an
d ho
w w
ell t
hey
will
be
able
to
fight
infe
ctio
ns a
nd il
lnes
s.
• G
row
th d
urin
g th
is e
arly
per
iod
of a
chi
ld’s
life
will
als
o af
fect
how
wel
l a c
hild
lear
ns in
sc
hool
in la
ter
year
s an
d ho
w m
uch
stre
ngth
he
or s
he w
ill h
ave
as a
n ad
ult.
We
can
sum
mar
ise
by s
ayin
g: w
e m
easu
re h
ow w
ell a
chi
ld is
gro
win
g fr
om b
irth
to
five
year
s be
caus
e th
is is
a c
ritic
al p
erio
d of
gro
wth
with
long
-ter
m c
onse
quen
ces
for
a ch
ild’s
men
tal
and
phys
ical
hea
lth. W
e m
easu
re c
hild
ren’
s gr
owth
by
gath
erin
g th
eir
heig
ht, w
eigh
t, ag
e an
d se
x in
form
atio
n.
The
pro
cess
of w
eigh
ing
and
mea
suri
ng is
cal
led
anth
ropo
met
rics
.
Rea
sons
rel
atin
g to
the
indi
vidu
al c
hild
:a)
We
com
pare
a c
hild
’s w
eigh
t an
d he
ight
and
age
to
heal
thy
child
ren’
s gr
owth
pat
tern
s to
te
ll us
how
wel
l tha
t ch
ild is
gro
win
g. W
hen
a ch
ild d
oes
not
gain
wei
ght
or h
eigh
t at
the
sa
me
rate
as
heal
thy
child
ren,
he
or s
he is
con
side
red
mal
nour
ishe
d.
b) T
he m
easu
rem
ent
info
rmat
ion
lets
us
know
if t
he c
hild
is w
ell n
ouri
shed
or
mal
nour
ishe
d.
c) W
e w
ant
to fi
nd o
ut if
the
chi
ld is
not
gro
win
g w
ell s
o th
at w
e ca
n ta
ke a
ctio
n to
cor
rect
it
beca
use:
• C
hild
ren
who
don
’t gr
ow n
orm
ally
do
not
deve
lop
to t
heir
full
pote
ntia
l.
• Po
or n
utri
tion
affe
cts
a ch
ild’s
abili
ty t
o th
ink
and
grow
.
• Po
or n
utri
tion
also
mak
es a
chi
ld w
eak
and
can
caus
e a
child
to
get
sick
ofe
n.
Rea
sons
rel
atin
g to
the
com
mun
ity:
a) W
e ca
n co
mbi
ne t
he g
row
th in
form
atio
n fr
om a
ll th
e ch
ildre
n to
see
whe
ther
the
rat
e of
m
alnu
triti
on in
a c
omm
unity
is lo
w, m
ediu
m o
r hi
gh.
b) A
hig
h le
vel o
f mal
nutr
ition
mea
ns w
e ne
ed t
o st
art
or s
tren
gthe
n nu
triti
on in
terv
entio
ns.
c) M
ediu
m o
r hi
gh le
vels
of m
alnu
triti
on in
dica
te t
hat
ther
e m
ay b
e pr
oble
ms
in t
he c
omm
unity
(e.
g. la
ck o
f acc
ess
to c
are,
cle
an w
ater
, hea
lthy
food
).
d) B
y m
easu
ring
the
leve
l of m
alnu
triti
on in
a
com
mun
ity a
t re
gula
r in
terv
als,
we
can
see
how
w
ell o
ur n
utri
tion
inte
rven
tions
are
wor
king
.
Tha
t is
why
it is
impo
rtan
t fo
r us
to
know
how
wel
l ou
r ch
ildre
n ar
e gr
owin
g.
4
MPC
GLE
SSO
N
5
MPC
GLE
SSO
N
2W
hat
Is A
nthr
opom
etry
?
Wha
t Are
Z-S
core
s?•
a Z
-sco
re is
a s
tand
ard
devi
atio
n (S
D)
• it
refe
rs t
o ho
w fa
r an
d in
wha
t di
rect
ion
the
mea
sure
men
t is
from
a r
efer
ence
or
med
ian
• cu
t-of
fs fo
r th
e ca
tego
ries
(m
ild, m
oder
ate
or s
ever
e) o
f und
ernu
triti
on a
re b
ased
on
nega
tive
Z-s
core
s
Was
ting
(w
eigh
t-fo
r-he
ight
/leng
th (
WH
Z)
less
tha
n -2
SD
)•
iden
tifies
chi
ldre
n w
ho a
re ‘w
aste
d’ o
r th
inne
r th
an a
hea
lthy
child
of t
he s
ame
heig
ht/le
ngth
.•
desc
ribe
s ch
ildre
n w
ho h
ave
stop
ped
grow
ing
and
may
be
losi
ng w
eigh
t•
refle
cts
rece
nt, s
hort
-ter
m (
acut
e) m
alnu
triti
on•
is u
sefu
l for
indi
vidu
al a
sses
smen
t, as
wel
l as
com
mun
ity a
sses
smen
t, es
peci
ally
in a
n em
erge
ncy
situ
atio
n.•
may
be
influ
ence
d by
ann
ual s
easo
ns a
nd t
imes
of f
ood
inse
curi
ty
Stun
ting
(he
ight
/leng
th-fo
r-ag
e (H
AZ
) le
ss t
han
-2 S
D)
• id
entifi
es c
hild
ren
who
are
‘stu
nted
’ or
shor
ter
than
exp
ecte
d fo
r a
heal
thy
child
of t
he
sam
e ag
e
• gr
owth
in h
eigh
t sl
ows
whe
n a
child
is u
nder
nour
ishe
d
• a
child
who
is s
tunt
ed h
as b
een
unde
rnou
rish
ed fo
r a
long
tim
e, s
o w
e ca
ll th
at c
hron
ic
unde
rnut
ritio
n
• m
easu
ring
cha
nges
in a
chi
ld’s
heig
ht is
diffi
cult
to d
o ac
cura
tely,
and
cha
nges
tak
e a
long
tim
e to
hap
pen
• m
easu
ring
stu
ntin
g is
bes
t fo
r as
sess
ing
the
nutr
ition
situ
atio
n in
a c
omm
unity
Und
erw
eigh
t (w
eigh
t-fo
r-ag
e (W
AZ
) le
ss t
han
-2 S
D)
• id
entifi
es c
hild
ren
who
are
‘und
erw
eigh
t’ or
wei
gh le
ss t
han
expe
cted
for
a he
alth
y ch
ild o
f th
e sa
me
age.
• de
scri
bes
a ch
ild w
ho m
ay w
eigh
less
bec
ause
the
chi
ld h
as lo
st w
eigh
t, ha
s no
t gr
own
norm
ally
in h
eigh
t, or
bot
h.
• m
easu
ring
incr
ease
s in
wei
ght
is a
goo
d w
ay t
o m
onito
r in
divi
dual
chi
ldre
n be
caus
e it
is e
asy
and
wei
ght
chan
ges
quic
kly
so t
hat
actio
n ca
n be
tak
en t
o pr
even
t w
orse
ning
und
ernu
triti
on.
• m
easu
ring
und
erw
eigh
t is
less
use
ful t
han
stun
ting
or w
astin
g fo
r un
ders
tand
ing
nutr
ition
in
a co
mm
unity
bec
ause
one
can
not
know
if t
he u
nder
nutr
ition
is a
cute
or
chro
nic.
Exce
rpts
wer
e ta
ken
from
: Sav
age
Kin
g F,
Burg
ess A
. Nut
ritio
n fo
r Dev
elop
ing
Coun
trie
s, 2n
d ed
. Oxf
ord:
O
xfor
d U
nive
rsity
Pre
ss, 1
993.
Stan
dard
Dev
iatio
n (S
D) f
rom
Med
ian
0.13
%2.
14%
13.5
9%
34.1
%34
.1%
0.13
%2.
14%
13.5
9%
Severe
Moderate
Mild
32
10
12
3
4
MPC
GLE
SSO
N
5
MPC
GLE
SSO
N2
Wha
t Is
Ant
hrop
omet
ry?
Ass
essm
ent:
a)
To
know
whe
ther
the
re is
cur
rent
or
pote
ntia
l ris
k of
mal
nutr
ition
in a
n in
divi
dual
chi
ld;
b) T
o id
entif
y th
e pr
esen
ce a
nd s
ever
ity o
f a n
utri
tion
prob
lem
in a
com
mun
ity.
Targ
etin
g:
a)T
o id
entif
y ne
ed;
b) T
o pr
iori
tise
reso
urce
s. c)
To
scre
en in
divi
dual
s fo
r pr
ogra
mm
e se
rvic
es.
Mon
itor
ing:
a) T
o tr
ack
indi
vidu
al g
row
th p
atte
rns;
b) T
o sh
ow p
rogr
amm
e pe
rfor
man
ce.
Eva
luat
ion:
a)
To
eval
uate
and
mea
sure
cha
nges
in n
utri
tion
over
tim
e;b)
To
dem
onst
rate
pro
gram
me
impa
ct o
n in
divi
dual
s an
d on
the
com
mun
ity.
Adv
ocac
y:
a) T
o ad
voca
te fo
r in
crea
sed
prog
ram
mes
and
ser
vice
s to
add
ress
chi
ld m
alnu
triti
on (
such
as
incr
ease
d fu
ndin
g fo
r sa
lari
es, s
uppl
ies
and
prim
ary
heal
th s
ervi
ces)
.
Sta
tist
ics W
ork
for
Eve
ryo
ne
How
Can
We
Use
Ant
hro
pom
etri
c In
form
atio
n?
6
MPC
GLE
SSO
N
7
MPC
GLE
SSO
N
2W
hat
Is A
nthr
opom
etry
?
Whe
n D
o W
e Ta
ke A
nthr
opo
met
ric
Mea
sure
men
ts?
Base
line
asse
ssm
ent:
Dur
ing
proj
ect
impl
emen
tatio
n:
Mid
term
eva
luat
ion:
End
of p
roje
ct e
valu
atio
n:
Wha
t In
form
atio
n D
o W
e N
eed
to G
athe
r?
We
need
sev
eral
diff
eren
t pi
eces
of i
nfor
mat
ion
in o
rder
to
calc
ulat
e w
heth
er o
r no
t a
child
is
grow
ing
wel
l.
• Age
(us
ing
date
of b
irth
to
calc
ulat
e ag
e in
mon
ths)
• Se
x (m
ale
or fe
mal
e)
• Wei
ght
• H
eigh
t/le
ngth
• M
UA
C (
Mid
-Upp
er A
rm C
ircum
fere
nce)
6
MPC
GLE
SSO
N
7
MPC
GLE
SSO
N2
Be r
espe
ctfu
lBe
acc
urat
e Be
car
eful
Be p
atie
ntBe
app
ropr
iate
Wha
t Is
Ant
hrop
omet
ry?
The
re a
re fi
ve t
hing
s to
rem
embe
r ab
out
ga
ther
ing
this
kin
d o
f inf
orm
atio
n fr
om
chi
ldre
n.
Be
resp
ectf
ul! I
t is
impo
rtan
t to
be
resp
ectfu
l and
gen
tle w
ith m
othe
rs a
nd t
heir
chi
ldre
n du
ring
the
who
le p
roce
ss o
f wei
ghin
g an
d m
easu
ring
.
Be
cons
iste
nt a
nd a
ccur
ate
and
prec
ise
in t
akin
g m
easu
rem
ents
.
Be
care
ful!
Be s
ure
to r
ecor
d th
e in
form
atio
n ne
atly
on
the
corr
ect
form
s.
Be
pati
ent!
Get
ting
prec
ise
data
req
uire
s w
illin
gnes
s, pa
tienc
e an
d gr
eat
care
in m
easu
ring
.
Be
appr
opri
ate!
Alw
ays
use
good
qua
lity
mea
suri
ng e
quip
men
t.
8
MPC
GLE
SSO
N
9
MPC
GLE
SSO
N
3In
form
atio
n ab
out
Sex
and
Age
of C
hild
ren
Und
er 5
No.
N
ame
of M
othe
rN
ame
of C
hild
Dat
e of
Bir
th
yy/m
m/d
dA
ge in
M
onth
s*Se
xM
/F
Chi
ld’s
Leng
th/
Hei
ght
(cm
)
Chi
ld’s
Wei
ght
(kg)
MU
AC
(cm
or
colo
ur)
STA
ND
ING
SC
ALE
ON
LYU
se t
hese
tw
o co
lum
ns w
ith y
oung
ch
ildre
n w
ho c
anno
t st
and.
only
for
6-59
m
onth
sM
othe
r’s W
eigh
t (k
g)M
othe
r+C
hild
’sW
eigh
t (k
g)
Chi
ldre
n 0–
59 m
ont
hs
Rem
embe
r to
:
1.R
ecor
dth
eda
teo
fbir
th(
year
/mon
th/d
ay)
and
the
sex
(Mo
rF)
oft
hec
hild
.
2.R
ecor
dth
ech
ild’s
heig
ht/le
ngth
to
near
est
0.1
cm,w
eigh
tto
0.1
kg
and
MU
AC
to
0.1
cmo
rco
lour
.
3.R
ecor
dth
eda
teo
fmea
sure
men
t.
AD
P/Pr
ogra
m:
Dat
eof
Mea
sure
men
t(y
y/m
m/d
d):
Com
mun
ity:
Nam
eof
Dat
aC
olle
ctor
:
Dat
a C
olle
ctio
n Fo
rm
* N
ot n
eces
sary
whe
n co
llect
ing
data
for
surv
eys.
8
MPC
GLE
SSO
N
9
MPC
GLE
SSO
N3
Info
rmat
ion
abou
t Se
x an
d A
ge o
f Chi
ldre
n U
nder
5
Is t
he C
hild
a B
oy o
r a
Gir
l?
Ask
ing
the
mo
ther
It is
ver
y im
port
ant
that
we
know
if a
chi
ld is
a b
oy o
r gi
rl
beca
use
ther
e ar
e di
ffere
nces
in g
row
th fo
r bo
ys a
nd g
irls
.
Do
not
assu
me
that
you
kno
w w
heth
er
a ch
ild is
mal
e or
fem
ale.
ALW
AY
S as
k th
e m
othe
r if
the
child
is a
boy
or
a gi
rl.
Show
a b
oy b
y w
ritin
g an
M fo
r m
ale
on t
he
form
.
Show
a g
irl b
y w
ritin
g F
for
fem
ale
on t
he
form
.
Det
erm
ine
the
Chi
ld’s
Age
Bir
th r
ecor
dA
sk t
he m
othe
r to
sho
w y
ou t
he r
ecor
d of
the
chi
ld’s
date
of b
irth
. If t
he d
ate
of b
irth
is n
ot r
ecor
ded
on t
he c
hild
’s gr
owth
mon
itori
ng o
r im
mun
isat
ion
card
, or
if t
he c
hild
doe
s no
t ha
ve a
car
d, a
sk t
he m
othe
r to
tel
l you
the
chi
ld’s
date
of
birt
h.
Alw
ays
reco
rd t
he d
ate
of b
irth
as
wel
l as
the
child
’s cu
rren
t ag
e on
the
Dat
a C
olle
ctio
n Fo
rm. D
ate
of b
irth
is s
omet
imes
wri
tten
DO
B.
In t
he D
OB
colu
mn,
wri
te t
he c
orre
ct y
ear,
mon
th a
nd d
ay a
ccor
ding
to
the
form
at u
sed,
e.g
. dd/
mm
/yy.
Whe
n th
e ex
act
DO
B is
unk
now
n, e
stim
ate
the
DO
B us
ing
a co
mm
unity
tim
elin
e.
10
MPC
GLE
SSO
N
11
MPC
GLE
SSO
N
3In
form
atio
n ab
out
Sex
and
Age
of C
hild
ren
Und
er 5
If th
e m
othe
r doe
s no
t kno
w th
e ch
ild’s
prec
ise y
ear a
ndm
onth
of b
irth,
use
a co
mm
unity
tim
elin
e.
Est
imat
ing
Dat
e o
f Bir
thVIS
UA
LEm
pow
er
Eq
uip
Ad
vo
cate
Glo
bal H
ealth
& W
ASH
Nut
riti
on
Cen
tre
of E
xper
tise
Com
mun
ity E
vent
s T
imel
ine
3.3
200
420
05
200
720
08
200
9
June
June
Mar
Dec
July
Nov
Feb
Oct
July
April
May
Oct
Aug
Feb
200
6
Jan
April
Jan
Year
of t
he G
reat
Dro
ught
Year
of t
he G
ood
Har
vest
Last
Rain
Hea
lth P
ost F
ixed
Scho
ol B
uilt
Larg
e M
aize
Har
vest
Wed
ding
of T
each
er
Com
mun
ity F
estiv
al
Rain
s Sta
rted
Elep
hant
s Sta
mpe
ded
Well
Dril
led
Food
Dist
ribut
ion
Bega
n
Locu
sts C
ame
Twin
s Bor
n To
Chief
The
Flood Ty
phoi
d O
utbr
eak
Well
Fixe
d Har
vest
Fes
tival
Nat
iona
l Im
mun
isatio
n D
ays
Visit
of S
tate
Gov
erno
r
Nov
Har
vest
Fes
tival
10
MPC
GLE
SSO
N
11
MPC
GLE
SSO
N3
Cal
cula
te a
Chi
ld’s
Age
in M
ont
hs F
rom
Dat
e o
f Bir
th
To h
elp
you
calcu
late
the
age
of a
chi
ld in
mon
ths,
use
the
tabl
e:
Put a
sm
all t
ick (√
) in
the
birt
h m
onth
.
Put a
sm
all x
in th
e cu
rren
t mon
th.
Coun
t the
num
ber o
f ful
l mon
ths
star
ting
with
the
mon
th a
fter t
he ti
ck (√
).
Exe
rcis
es:
1.
A b
oy w
as b
orn
May
3, 2
005.
His
mot
her
brou
ght
him
to
be w
eigh
ed o
n D
ecem
ber
15,
2008
. Wha
t is
the
boy
’s ag
e in
mon
ths?
2.
A g
rand
mot
her
brin
gs a
you
ng g
irl i
nto
the
heal
th c
linic
on
Mar
ch 2
8, 2
008.
The
re is
no
reco
rd o
f the
chi
ld’s
birt
h da
te, b
ut t
he g
rand
mot
her
says
she
will
be
one
year
old
nex
t w
eek.
Wha
t is
the
chi
ld’s
age
in m
onth
s?
3.
A s
mal
l gir
l is
brou
ght
to t
he h
ealth
pos
t fo
r im
mun
isat
ion
on M
ay 2
9, 2
008.
Her
bir
th
date
is r
ecor
ded
as Ju
ly 1
5, 2
007.
Wha
t is
the
chi
ld’s
age
in m
onth
s?
Info
rmat
ion
abou
t Se
x an
d A
ge o
f Chi
ldre
n U
nder
5
May
04
Ju
n 04
Ju
l 04
A
ug 0
4
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr
05
May
05
Jun
05
Jul 0
5 A
ug 0
5 Se
p 05
O
ct 0
5
Nov
05
Dec
05
Jan
06
Feb
06
Mar
06
Apr
06
May
06
Jun
06
Jul 0
6 A
ug 0
6 Se
p 06
O
ct 0
6
Nov
06
Dec
06
Jan
07
Feb
07
Mar
07
Apr
07
May
07
Jun
07
Jul 0
7 A
ug 0
7 Se
p 07
O
ct 0
7
Nov
07
Dec
07
Jan
08
Feb
08
Mar
08
Apr
08
May
08
Jun
08
Jul 0
8 A
ug 0
8 Se
p 08
O
ct 0
8
Nov
08
Dec
08
Jan
09
Feb
09
Mar
09
Apr
09
12
MPC
GLE
SSO
N
13
MPC
GLE
SSO
N
3In
form
atio
n ab
out
Sex
and
Age
of C
hild
ren
Und
er 5
Rec
ord
ing
Num
bers
Cle
arly
1 –
Dra
w t
he n
umbe
r 1
as a
sin
gle
vert
ical
line
.
2,3
– W
rite
the
num
bers
2 a
nd 3
w
ithou
t ex
tra
loop
s.
4 –
Leav
e th
e nu
mbe
r 4
open
. A c
lose
d 4
can
look
like
a 9
.
5 –
Don
’t cl
ose
the
5. A
clo
sed
5 ca
n lo
ok li
ke a
6.
6 –
Be c
aref
ul t
hat
the
circ
le o
n th
e 6
does
not
look
like
a 0
.
7 –
Mak
e a
smal
l hor
izon
tal l
ine
to c
ross
th
e 7.
Thi
s w
ill d
istin
guis
h it
from
a 1
.
8 –
Mak
e tw
o ci
rcle
s to
dra
w t
he
num
ber
8 so
tha
t it
does
not
look
like
a
0. D
on’t
sepa
rate
the
tw
o ci
rcle
s.
9 –
Clo
se t
he c
ircle
on
the
num
ber
9 so
th
at it
doe
s no
t lo
ok li
ke a
4.
0 –
Put
a di
agon
al li
ne t
hrou
gh t
he 0
so
that
it is
eas
y to
iden
tify
and
does
not
lo
ok li
ke a
6.
CORR
ECT
INCO
RREC
T
Pra
ctis
e th
e N
umbe
rs in
Diff
eren
t Si
zed
Box
es
One
of t
he m
ost
co
mm
on
erro
rs m
ade
in n
utri
tio
nal
asse
ssm
ents
is r
eco
rdin
g th
e m
easu
rem
ents
unc
lear
ly.
12
MPC
GLE
SSO
N
13
MPC
GLE
SSO
N3
Info
rmat
ion
abou
t Se
x an
d A
ge o
f Chi
ldre
n U
nder
5
Rec
ord
Num
bers
Cle
arly
on
Sam
ple
Rec
ord
ing
Form
Circ
le t
he e
rror
s yo
u fin
d on
thi
s fo
rm.
14
MPC
GLE
SSO
N
15
MPC
GLE
SSO
N
4H
angi
ng S
cale
s
Wei
ght
is t
he m
easu
rem
ent
mos
t co
mm
only
use
d by
the
Min
istr
y of
Hea
lth t
o ev
alua
te n
utri
tiona
l st
atus
of c
hild
ren.
The
act
ual w
eigh
t of
a c
hild
can
var
y fo
r di
ffere
nt r
easo
ns. F
or e
xam
ple,
wei
ght
can
be a
ffect
ed b
y:
1. T
he c
loth
es a
chi
ld is
wea
ring
2. F
ood/
drin
k th
e ch
ild h
as
rece
ntly
con
sum
ed.
3. I
ncor
rect
cal
ibra
tion
of
the
scal
es.
4. I
ncor
rect
pla
cem
ent
of
the
scal
es.
5. U
se o
f poo
r qu
ality
equi
pmen
t.
6. I
mpr
oper
wei
ghin
g te
chni
que.
Cal
ibra
tio
nTo
‘cal
ibra
te’ m
eans
to
use
know
n w
eigh
ts t
o se
e if
the
scal
es a
re r
eadi
ng
corr
ectl
y.
At
the
begi
nnin
g of
eac
h da
y’s w
eigh
ing
sess
ion,
you
sho
uld
wei
gh t
wo
or t
hree
kno
wn
wei
ghts
on
the
scal
es t
o m
ake
sure
the
sca
les
are
still
acc
urat
e.
For
exam
ple,
you
can
wei
ght
a fiv
e ki
logr
am b
ag o
f gra
in o
r sa
ck o
f ric
e th
at h
as b
een
purc
hase
d fr
om a
sto
re a
nd m
ake
sure
the
sca
les
read
five
kilo
gram
s. M
ake
sure
you
do
thi
s w
ith t
wo
or t
hree
kno
wn
wei
ghts
to
ensu
re t
he s
cale
s ar
e ac
cura
te.
Zer
oin
gTo
mak
e su
re t
hat
the
wei
ghin
g yo
u do
is a
ccur
ate,
you
mus
t ch
eck
the
scal
es b
efor
e yo
u w
eigh
eac
h ch
ild a
nd e
nsur
e th
at t
he n
eedl
e on
the
sca
les
poin
ts t
o ze
ro (
this
is
calle
d ‘z
eroi
ng’ t
he s
cale
s).
To r
epea
t, be
fore
you
wei
gh a
chi
ld, y
ou m
ust
chec
k th
at t
he n
eedl
e on
the
sca
les
poin
ts t
o ‘z
ero’
with
the
wei
ghin
g ba
sket
or
slin
g, bu
t no
chi
ld.
If yo
u do
n’t
incl
ude
the
wei
ghin
g ba
sket
or
slin
g w
hen
zero
ing
the
scal
es, t
hen
this
ex
tra
wei
ght
will
be
adde
d to
the
wei
ght
of t
he c
hild
and
the
wei
ght
reco
rded
will
be
inco
rrec
t.
If th
e ne
edle
doe
s no
t po
int
to z
ero,
adj
ust
the
scal
es u
sing
the
dia
l or
scre
w o
n th
e sc
ales
so
the
need
le p
oint
s to
zer
o.
Exc
erpt
s w
ere
take
n fr
om F
. Sav
age
Kin
g an
d A
. Bur
gess
, Nut
riti
on fo
r D
evel
opin
g C
ount
ries
, 2n
d ed
. (O
xfor
d: O
xfor
d U
nive
rsit
y P
ress
, 199
3).
14
MPC
GLE
SSO
N
15
MPC
GLE
SSO
N4
Han
ging
Sca
les
Pro
cedu
re fo
r M
easu
ring
Wei
ght W
ith
Han
ging
Sca
les
PR
EPA
RE
TH
E S
CA
LES
1. H
ang
scal
es fr
om a
str
ong
supp
ort,
such
as
a tr
ee.
2. S
et s
cale
s at
eye
leve
l.
3. W
ith w
eigh
ing
bask
et o
r sl
ing
atta
ched
, adj
ust
the
scal
es t
o ze
ro.
PR
EPA
RE
TH
E C
HIL
D
4. M
othe
r as
sist
s m
easu
rer
to
rem
ove
the
child
’s ou
ter
clot
hing
.
5. P
lace
the
chi
ld in
bas
ket
or s
ling.
ME
ASU
RE
CH
ILD
’S W
EIG
HT
6. S
uppo
rt t
he c
hild
whi
le a
ttac
hing
bas
ket
or s
ling
to t
he s
cale
s.
7. H
old
the
scal
es s
tead
y an
d re
ad t
he
num
bers
alo
ud.
8. R
ecor
d th
e w
eigh
t.
16
MPC
GLE
SSO
N
17
MPC
GLE
SSO
N
5 Intr
odu
ctio
n to
Sta
ndin
g S
cale
s
Use
han
ging
sca
les
whe
neve
r po
ssib
le t
o w
eigh
chi
ldre
n un
der
5, b
ut if
the
y ar
e no
t av
aila
ble,
use
sta
ndin
g sc
ales
.
Usi
ng s
tand
ing
scal
es r
equi
res
an e
xtra
cal
cula
tion.
1. W
eigh
the
mot
her
and
child
tog
ethe
r.
2. W
eigh
the
mot
her
alon
e.
3. F
ind
the
wei
ght
of t
he c
hild
by
subt
ract
ing
the
wei
ght
of t
he m
othe
r al
one
from
the
wei
ght
of t
he
mot
her
and
child
tog
ethe
r.
Stan
ding
Sca
les
ALW
AYS
USE
GO
OD
QU
ALI
TY
ELEC
TRO
NIC
STA
ND
ING
SCA
LES.
Com
mon
hou
seho
ld s
cale
s wi
ll no
t gi
ve
accu
rate
or
cons
iste
nt m
easu
rem
ents
.
• Dig
ital
sca
les
have
dig
ital
num
bers
.
• Ana
logu
e sc
ales
hav
e a
need
le t
hat
mov
es t
o po
int
to t
he n
umbe
rs
on a
dia
l.
16
MPC
GLE
SSO
N
17
MPC
GLE
SSO
N5
Stan
ding
Sca
les
How
to
Wei
gh C
hild
ren
Two
to
F
ive
Year
s (w
ho c
an s
tand
wel
l al
one
)
1. S
et s
cale
s on
sm
ooth
har
d su
rfac
e in
go
od li
ght.
2. Z
ero
the
scal
es.
3. A
sk t
he m
othe
r to
rem
ove
the
child
’s sh
oes
and
oute
r cl
othi
ng.
4. C
hild
sta
nds
with
feet
at
cent
re o
f the
sc
ales
.
5. R
eade
r kn
eels
by
the
scal
es a
nd r
eads
al
oud
the
wei
ght
of t
he c
hild
.
6. R
ecor
der
stan
ds b
ehin
d th
e re
ader
and
re
cord
s th
e w
eigh
t on
the
form
. Rea
der
chec
ks in
form
atio
n fo
r ac
cura
cy.
How
to
Wei
gh C
hild
ren
Und
er T
wo
Yea
rs O
ld o
r C
hild
ren
Who
Can
not
Sta
nd W
ell A
lone
3. M
othe
r re
mov
es
child
’s ou
ter
clot
hes.
4. M
othe
r ho
lds
child
and
sta
nds
on c
entr
e of
the
sc
ales
.
5. R
eade
r re
ads
alou
d th
e w
eigh
t of
mot
her
and
child
.
6. R
ecor
der
puts
th
e in
form
atio
n on
the
offi
cial
fo
rm.
7. M
othe
r st
ands
on
scal
es a
lone
.
8. R
eade
r re
ads
the
wei
ght
of t
he m
othe
r al
one.
9. R
ecor
der
reco
rds
wei
ght
of m
othe
r an
d ca
lcul
ates
wei
ght
of c
hild
on
form
(w
eigh
t of
chi
ld =
wei
ght
of
mot
her+
child
min
us w
eigh
t of
mot
her
alon
e). R
eade
r ch
ecks
info
rmat
ion
for
accu
racy
.
1. S
et s
cale
s on
sm
ooth
ha
rd s
urfa
ce in
goo
d lig
ht.
2. Z
ero
the
scal
es.
18
MPC
GLE
SSO
N
19
MPC
GLE
SSO
N
6L
engt
h o
r H
eigh
t?
• Le
ngth
= m
easu
rem
ent
of a
chi
ld
lyin
g do
wn.
• We
use
the
leng
th m
easu
rem
ent
for
child
ren
unde
r 2,
any
chi
ld
who
app
ears
to
be le
ss t
han
80
cent
imet
res
tall,
or a
ny c
hild
who
ca
nnot
sta
nd w
ell o
n th
eir
own.
• H
eigh
t =
mea
sure
men
t of
a c
hild
st
andi
ng u
p.
• We
use
the
heig
ht m
easu
rem
ent
for
child
ren
olde
r th
an 2
4 m
onth
s w
ho c
an s
tand
wel
l alo
ne.
• The
sam
e bo
ard
is u
sed
for
both
m
easu
rem
ents
. It
is c
alle
d a
leng
th
boar
d w
hen
mea
suri
ng le
ngth
and
a
heig
ht b
oard
whe
n m
easu
ring
hei
ght.
Mea
suri
ng L
engt
h an
d H
eigh
t
Mea
suri
ng L
engt
h
1. P
lace
the
leng
th b
oard
on
flat
grou
nd o
r a
low
, flat
sur
face
. D
on’t
let
the
child
fall
off!
2. A
sk t
he m
othe
r to
rem
ove
the
child
’s sh
oes
and
anyt
hing
on
the
child
’s he
ad.
3. L
ay t
he c
hild
dow
n on
its
back
on
the
leng
th b
oard
.
4. T
he c
hild
’s bo
dy s
houl
d be
com
plet
ely
flat
on t
he b
oard
.
5. T
he t
op o
f the
chi
ld’s
head
sho
uld
be a
gain
st t
he e
nd o
f the
leng
th
boar
d th
at d
oes
not
mov
e.
6. T
he a
ssis
tant
hol
ds t
he c
hild
’s he
ad s
o th
at t
he c
hild
’s ey
es lo
ok u
p. T
he a
ssis
tant
sho
uld
look
dire
ctly
into
the
chi
ld’s
eyes
.
7. P
ress
gen
tly o
n th
e ch
ild’s
knee
s to
str
aigh
ten
them
and
mov
e th
e fo
otpi
ece
so t
he c
hild
’s fe
et a
re fl
at a
gain
st it
.
8. Q
uick
ly r
ead
alou
d th
e le
ngth
mea
sure
men
t, be
fore
the
ch
ild m
oves
.
9. T
he a
ssis
tant
re
cord
s th
e in
form
atio
n.
10. G
ently
hel
p th
e ch
ild t
o ge
t up
off
the
boar
d an
d re
turn
to
his
or h
er m
othe
r.
Rec
ord
the
Mea
sure
men
t
18
MPC
GLE
SSO
N
19
MPC
GLE
SSO
N6
Mea
suri
ng L
engt
h
1. P
lace
the
leng
th b
oard
on
flat
grou
nd o
r a
low
, flat
sur
face
. D
on’t
let
the
child
fall
off!
2. A
sk t
he m
othe
r to
rem
ove
the
child
’s sh
oes
and
anyt
hing
on
the
child
’s he
ad.
3. L
ay t
he c
hild
dow
n on
its
back
on
the
leng
th b
oard
.
4. T
he c
hild
’s bo
dy s
houl
d be
com
plet
ely
flat
on t
he b
oard
.
5. T
he t
op o
f the
chi
ld’s
head
sho
uld
be a
gain
st t
he e
nd o
f the
leng
th
boar
d th
at d
oes
not
mov
e.
6. T
he a
ssis
tant
hol
ds t
he c
hild
’s he
ad s
o th
at t
he c
hild
’s ey
es lo
ok u
p. T
he a
ssis
tant
sho
uld
look
dire
ctly
into
the
chi
ld’s
eyes
.
7. P
ress
gen
tly o
n th
e ch
ild’s
knee
s to
str
aigh
ten
them
and
mov
e th
e fo
otpi
ece
so t
he c
hild
’s fe
et a
re fl
at a
gain
st it
.
8. Q
uick
ly r
ead
alou
d th
e le
ngth
mea
sure
men
t, be
fore
the
ch
ild m
oves
.
Mea
suri
ng L
engt
h an
d H
eigh
t
How
to
Mea
sure
Hei
ght
Thi
s is
the
pro
per
posi
tioni
ng o
f the
he
ight
boa
rd, t
he m
easu
rer
and
the
assi
stan
t.
1.Pl
ace
the
heig
ht b
oard
on
flat
grou
nd a
nd a
gain
st a
wal
l or
tree
. The
boa
rd c
anno
t m
ove.
How
to
Pla
ce t
he C
hild
Aga
inst
the
Hei
ght
Boa
rd
Rec
ord
the
Mea
sure
men
t
2. T
he c
hild
mus
t be
bar
efoo
t w
ith n
othi
ng o
n hi
s or
her
he
ad.
3. S
tand
the
chi
ld o
n th
e pl
atfo
rm a
t th
e ba
se o
f the
he
ight
boa
rd w
ith h
is o
r he
r bo
dy fi
rmly
aga
inst
the
ba
ck o
f the
boa
rd.
4. L
ift t
he c
hild
’s ch
in s
o th
e ch
ild’s
eyes
ar
e lo
okin
g st
raig
ht a
head
.
5. T
he a
rms
shou
ld b
e ha
ngin
g at
the
chi
ld’s
side
s. T
he c
hild
sh
ould
be
stan
ding
on
both
feet
.
6. T
he m
easu
rer
squa
ts in
fr
ont
of t
he c
hild
at
eye
leve
l with
the
chi
ld.
7. S
lide
the
mov
eabl
e he
adpi
ece
dow
n un
til it
tou
ches
the
cr
own
of t
he c
hild
’s he
ad a
nd h
old
firm
ly.
8. T
he m
easu
rer
read
s th
e m
easu
rem
ent
alou
d.
9. T
he a
ssis
tant
w
rite
s nu
mbe
rs
clea
rly.
Mea
suri
ng H
eigh
t o
f C
hild
ren
Ove
r Tw
o
Year
s o
f Age
20
MPC
GLE
SSO
N
21
MPC
GLE
SSO
N
6M
easu
ring
Len
gth
and
Hei
ght
Wha
t is
cor
rect
? In
corr
ect?
20
MPC
GLE
SSO
N
21
MPC
GLE
SSO
N7
Mid
-Upp
er A
rm C
ircum
fere
nce
(MU
AC
)
MU
AC
Cut
-off
Poin
ts
• Be
low
11.
5 (r
ed)
for
seve
re m
alnu
triti
on; n
eeds
im
med
iate
med
ical
att
entio
n
• 11
.5 -
12.
4 cm
(ye
llow
) fo
r m
oder
ate
mal
nutr
ition
• A
mea
sure
men
t of
12.
5 cm
or
grea
ter
(gre
en)
is
cons
ider
ed a
nor
mal
mid
-upp
er a
rm c
ircum
fere
nce.
The
cut-o
ff po
int o
f 11.
5 cm
is s
till u
sed
in C
MAM
pro
gram
mes
be
caus
e th
is wa
s th
e WH
O re
com
men
datio
n in
200
7 an
d th
ere
are
high
cas
eloa
ds e
ven
with
this
low
er c
ut-o
ff. In
200
9, W
HO
re
com
men
ded
incr
easin
g th
e cu
t-off
poin
t to
11.5
cm
bec
ause
ev
iden
ce s
how
s th
at c
hild
ren
with
sm
alle
r mid
-upp
er a
rm
circu
mfe
renc
e th
an 1
1.5
cm a
re a
t gre
ater
risk
of d
eath
than
th
ose
abov
e th
is cu
t-off.
MU
AC
is a
sim
ple
and
easy
bod
y m
easu
rem
ent
that
is o
ften
used
for
scre
enin
g in
em
erge
ncy
situ
atio
ns a
nd is
al
so u
sed
in n
utri
tion
surv
eys
in d
evel
opm
ent
cont
exts
.
MU
AC
hel
ps u
s to
det
erm
ine
the
leve
l of m
alnu
triti
on in
larg
e gr
oups
of p
eopl
e qu
ickl
y.
MU
AC
is b
ased
on
the
fact
tha
t a
smal
l or
decr
easi
ng a
rm c
ircum
fere
nce
sign
als
the
loss
of m
uscl
e m
ass.
(Circ
umfe
renc
e m
eans
‘out
side
edg
e of
a c
ircle
’). M
uscl
e m
ass
is k
now
n to
be
impo
rtan
t in
mai
ntai
ning
bod
y fu
nctio
ns a
nd in
figh
ting
infe
ctio
ns.
MU
AC
is a
goo
d pr
edic
tor
of im
med
iate
ris
k of
dea
th. T
his
is w
hy w
e us
ually
use
MU
AC
in e
mer
genc
y si
tuat
ions
, fo
r a
quic
k as
sess
men
t of
nut
ritio
nal s
tatu
s.
MU
AC
is n
ot u
sed
to m
easu
re m
alnu
triti
on in
chi
ldre
n un
der
six
mon
ths
beca
use
we
don’
t ha
ve e
stab
lishe
d cu
t-of
f lev
els
for
this
age
gro
up.
MU
AC
can
be
used
with
chi
ldre
n an
d ad
ults
to
find
the
rece
nt u
nder
nutr
ition
rat
es in
a p
opul
atio
n.
You
shou
ld m
easu
re M
UA
C t
o id
entif
y ac
ute
mal
nutr
ition
and
in n
utri
tion
surv
eys
to e
stim
ate
bene
ficia
ry
umbe
rs fo
r em
erge
ncy
nutr
ition
pro
gram
mes
.stu
ntin
g w
e us
e he
ight
and
age
. Was
ting
is s
omet
imes
mea
sure
d us
ing
wei
ght
and
heig
ht. Y
ou s
houl
d m
easu
re M
UA
C t
o id
entif
y ac
ute
mal
nutr
ition
and
in n
utri
tion
surv
eys
to
estim
ate
bene
ficia
ry n
umbe
rs fo
r em
erge
ncy
nutr
ition
pro
gram
mes
.
1. W
ork
at e
ye le
vel.
2. A
sk m
othe
r to
rem
ove
clot
hing
cov
erin
g th
e ch
ild’s
arm
.
Red
Yello
wG
reen
22
MPC
GLE
SSO
N
23
MPC
GLE
SSO
N
7M
id-U
pper
Arm
Circ
umfe
renc
e (M
UA
C)
3. L
ocat
e th
e tip
of t
he c
hild
’s sh
ould
er w
ith y
our
finge
rtip
s.
4. B
end
the
child
’s el
bow
so
the
arm
mak
es a
rig
ht a
ngle
.
5. P
lace
a m
ark
on t
he c
hild
’s ar
m h
alf w
ay b
etw
een
the
shou
lder
tip
and
the
elb
ow. T
his
is t
he m
id-p
oint
.
6. S
trai
ghte
n th
e ch
ild’s
arm
.
7. W
rap
the
MU
AC
ban
d ar
ound
the
chi
ld’s
arm
at
the
mid
-poi
nt m
ark
you
have
just
mad
e. In
sert
the
end
of t
he b
and
thro
ugh
the
thin
op
enin
g at
the
oth
er e
nd o
f the
ban
d.
a) K
eep
the
colo
urs
or n
umbe
rs o
n th
e ba
nd r
ight
sid
e up
so
that
you
can
see
the
m, a
nd b
e su
re t
hat
the
band
is fl
at a
gain
st t
he s
kin.
b) M
ake
sure
the
ban
d is
not
too
tig
ht (
if th
e ba
nd is
too
tig
ht, t
his
bunc
hes
up t
he s
kin
and
we
do n
ot g
et a
n ac
cura
te r
eadi
ng).
c) M
ake
sure
the
ban
d is
not
too
loos
e (t
he b
and
is t
oo lo
ose
if yo
u ca
n fit
a p
enci
l und
er it
)
8. R
ead
the
mea
sure
men
t al
oud
(eith
er
the
colo
ur o
r nu
mbe
r w
hich
sho
ws
mos
t co
mpl
etel
y in
the
wid
e w
indo
w o
n th
e ba
nd).
Ask
the
ass
ista
nt t
o re
peat
the
mea
sure
men
t al
oud
and
to r
ecor
d it
on t
he fo
rm.
a) C
heck
tha
t th
e m
easu
rem
ent
is r
ecor
ded
corr
ectly
.
b) G
ently
rem
ove
the
band
fr
om t
he c
hild
’s ar
m. T
hank
the
m
othe
r an
d th
e ch
ild fo
r th
eir
coop
erat
ion.
22
MPC
GLE
SSO
N
23
MPC
GLE
SSO
N8
Stan
dard
isat
ion
Exer
cise
Com
mon
Err
ors
Solu
tion
1. A
ll M
easu
rem
ents
Res
tless
chi
ldPo
stpo
ne m
easu
rem
ent.
Invo
lve
pare
nt in
pro
cedu
re.
Inac
cura
te r
eadi
ngTr
aini
ng a
nd r
etra
inin
g st
ress
ing
accu
racy
.
Rec
ordi
ngR
ecor
d re
sults
imm
edia
tely
afte
r ta
king
mea
sure
men
ts a
nd
confi
rm r
ecor
d.
2. L
engt
h/H
eigh
t
Inco
rrec
t m
etho
d fo
r ag
eU
se le
ngth
onl
y w
hen
child
is <
2 ye
ars
old
[or
unab
le t
o st
and
prop
erly
].
Foot
wea
r/he
adge
arR
emov
e.
Hea
d no
t in
cor
rect
pla
ne, c
hild
not
str
aigh
t, kn
ees
bent
, or
feet
not
flat
on
floor
Cor
rect
tec
hniq
ue w
ith p
ract
ise
and
regu
lar
retr
aini
ng.
Prov
ide
adeq
uate
ass
ista
nce.
Cal
m t
he c
hild
.
Chi
ld n
ot s
trai
ght
alon
g bo
ard
and
foot
not
pa
ralle
l with
mov
able
boa
rdPa
rent
or
assi
stan
t sh
ould
be
pres
ent.
[Mov
e he
ad b
oard
to
com
pres
s ha
ir.]
Slid
ing
boar
d no
t fir
mly
aga
inst
hee
ls/h
ead
Cor
rect
pre
ssur
e sh
ould
be
prac
tised
. [M
ove
head
boa
rd t
o co
mpr
ess
hair.
]
3. W
eigh
t
Scal
e no
t ca
libra
ted
to z
ero
Rec
alib
rate
afte
r ev
ery
mea
sure
men
t. [Z
ero
afte
r ev
ery
mea
sure
men
t, re
calib
rate
at
the
star
t of
eac
h w
eigh
ing
sess
ion
with
a k
now
n w
eigh
t.]
Chi
ld w
eari
ng h
eavy
clo
thin
gR
emov
e or
mak
e al
low
ance
s fo
r cl
othi
ng.
Chi
ld m
ovin
g or
anx
ious
Wai
t un
til c
hild
is c
alm
or
rem
ove
caus
e of
anx
iety
.
4. M
UA
C
Chi
ld n
ot s
tand
ing
in t
he c
orre
ct p
ositi
onPo
sitio
n su
bjec
t co
rrec
tly.
Mid
arm
poi
nt in
corr
ectly
mar
ked
Mea
sure
mid
-poi
nt c
aref
ully.
Exam
iner
not
leve
l with
sub
ject
, tap
e ar
ound
th
e ar
m n
ot a
t m
id p
oint
, tap
e to
o tig
ht/t
oo
loos
e
Cor
rect
tec
hniq
ues
with
tra
inin
g, su
perv
isio
n an
d re
trai
ning
. Ta
ke in
to a
ccou
nt c
ultu
ral p
ract
ices
for
exam
ple,
wea
ring
of
arm
ban
ds.
Thi
s ch
art
is a
dapt
ed fr
om A
ppen
dix
2, p
age
39, ‘S
ourc
es o
f err
or in
tak
ing
anth
ropo
met
rica
l mea
sure
men
ts’ i
n: F
ood
Secu
rity
Ana
lysi
s U
nit
for
Som
alia
(FS
AU
). N
utri
tion:
A G
uide
to
Dat
a C
olle
ctio
n, A
naly
sis,
Inte
rpre
tatio
n an
d U
se. (
Nai
robi
; FSA
U, 2
005)
.
The
se c
omm
on e
rror
s ar
e co
ntro
lled
by:
• Le
arni
ng a
nd a
pply
ing
corr
ect
mea
suri
ng t
echn
ique
s.
• Ta
king
car
e to
rea
d th
e m
easu
rem
ents
cor
rect
ly.
• R
ecor
ding
the
mea
sure
men
ts c
orre
ctly
and
cle
arly
so
that
som
eone
el
se c
an e
asily
rea
d th
e nu
mbe
rs.
• Be
ing
patie
nt w
ith t
he m
easu
rem
ent
proc
ess,
and
bein
g w
illin
g to
do
the
job
corr
ectly
.
• If
a lo
ng t
ime
has
pass
ed s
ince
you
mea
sure
d ch
ildre
n, r
evie
w t
he
tech
niqu
e w
ith s
omeo
ne w
ho h
as e
xper
ienc
e an
d w
ho c
an g
uide
yo
u.
24
MPC
GLE
SSO
N
25
MPC
GLE
SSO
N
8 Thi
ngs
to R
emem
ber
BE
FR
IEN
DLY
: Rem
embe
r th
at e
ach
child
is a
spe
cial
indi
vidu
al, n
ot a
pro
ject
num
ber.
Be k
ind
and
frie
ndly
whe
n yo
u re
late
to
the
child
and
the
mot
her.
BE
CLE
AR
: Exp
lain
in s
impl
e te
rms
wha
t yo
u ar
e do
ing.
Ask
the
mot
her
if sh
e ha
s an
y qu
estio
ns.
BE
SA
FE: N
ever
leav
e th
e ch
ild a
lone
with
the
equ
ipm
ent.
Mak
e su
re t
he c
hild
doe
s no
t sl
ip o
r fa
ll.
BE
PA
RTN
ER
S: T
wo
peop
le w
ork
toge
ther
to
take
the
mea
sure
men
ts. T
his
help
s en
sure
tha
t th
e ch
ild is
pla
ced
corr
ectly
on
the
heig
ht b
oard
or
the
scal
es. I
f the
re is
no
othe
r tr
aine
d pe
rson
av
aila
ble
to a
ssis
t, th
en e
xpla
in t
he p
roce
dure
to
the
child
’s m
othe
r an
d as
k he
r to
hel
p yo
u.
BE
BE
TT
ER
: Wor
k ha
rd t
o do
bet
ter
qual
ity w
ork
ever
y da
y.
Be F
rien
dly
Be C
lear
Be S
afe
Be P
artn
ers
Be B
ette
r
Stan
dard
isat
ion
Exer
cise
24
MPC
GLE
SSO
N
25
MPC
GLE
SSO
N8
Stan
dard
isat
ion
Exer
cise
Form
1 W
eigh
t St
anda
rdis
atio
n
Nam
e of
Par
ticip
ant:
__
____
____
____
____
____
____
____
____
____
Dat
e of
Mea
sure
men
t:
____
___
/___
__ /_
____
(yy
/mm
/dd)
Nam
e of
Chi
ldA
ge in
M
onth
sN
o.M
y M
easu
reSt
anda
rd
Mea
sure
Diff
eren
ce
Sign
(+, -
)
Size
of
Diff
eren
ce
(L, M
, S)
1 2 3 4 5 6 7 8 9 10
Size
of D
iffer
ence
s:
Num
ber
of L
arge
Diff
eren
ces
(0
.3 k
g or
mor
e)
Box
1
Num
ber
of M
ediu
m D
iffer
ence
s
(0
.2 k
g)
Bo
x 2
N
umbe
r of
Sm
all D
iffer
ence
s
(0.0
- 0
.1 k
g)
Bo
x 3
Diff
eren
ces:
N
umbe
r of
pos
itive
sig
ns (
+) _
____
____
_
Num
ber
of n
egat
ive
sign
s (-
) __
____
____
26
MPC
GLE
SSO
N8
Stan
dard
isat
ion
Exer
cise
Form
2 H
eigh
t/Le
ngth
Sta
ndar
disa
tion
Nam
e of
Par
ticip
ant:
__
____
____
____
____
____
____
____
____
____
Dat
e of
Mea
sure
men
t:
____
___
/___
__ /_
____
(yy
/mm
/dd)
Nam
e of
Chi
ldA
ge in
M
onth
sN
o.M
y M
easu
reSt
anda
rd
Mea
sure
Diff
eren
ce
Sign
(+, -
)
Size
of
Diff
eren
ce
(L, M
, S)
1 2 3 4 5 6 7 8 9 10
Size
of D
iffer
ence
s:
Num
ber
of L
arge
Diff
eren
ces
(1
.0 c
m o
r m
ore)
Bo
x 1
N
umbe
r of
Med
ium
Diff
eren
ces
(0.6
- 0
.9 c
m)
Bo
x 2
N
umbe
r of
Sm
all D
iffer
ence
s
(0.0
- 0
.5 c
m)
Bo
x 3
Diff
eren
ces:
N
umbe
r of
pos
itive
sig
ns (
+) _
____
____
_
Num
ber
of n
egat
ive
sign
s (-
) __
____
____
27
MPC
GLE
SSO
N8
Stan
dard
isat
ion
Exer
cise
Form
3 M
UA
C S
tand
ardi
sati
on
Nam
e of
Par
ticip
ant:
__
____
____
____
____
____
____
____
____
____
Dat
e of
Mea
sure
men
t:
____
___
/___
__ /_
____
(yy
/mm
/dd)
Nam
e of
Chi
ldA
ge in
M
onth
sN
o.M
y M
easu
reSt
anda
rd
Mea
sure
Diff
eren
ce
Sign
(+, -
)
Size
of
Diff
eren
ce
(L, M
, S)
1 2 3 4 5 6 7 8 9 10
Size
of D
iffer
ence
s:
Num
ber
of L
arge
Diff
eren
ces
(0
.5 c
m o
r m
ore)
Bo
x 1
N
umbe
r of
Med
ium
Diff
eren
ces
N/A
Bo
x 2
N/A
N
umbe
r of
Sm
all D
iffer
ence
s
(0.0
- 0
.5 c
m)
Bo
x 3
Diff
eren
ces:
N
umbe
r of
pos
itive
sig
ns (
+) _
____
____
_
Num
ber
of n
egat
ive
sign
s (-
) __
____
____
28
MPC
GLE
SSO
N
29
MPC
GLE
SSO
N
9Im
prov
ing
Indi
vidu
al C
hild
Gro
wth
Your
C
ount
ry’s
Road
to
Hea
lth C
ard
28
MPC
GLE
SSO
N
29
MPC
GLE
SSO
N9
Impr
ovin
g In
divi
dual
Chi
ld G
row
th
Ros
e (F
emal
e)
DO
B: M
arch
200
7B
irth
Wei
ght:
3.2
kg
Gro
wth
Mon
itor
ing
Res
ults
Apr
il 20
073.
2 kg
May
200
73.
8 kg
June
200
73.
9 kg
July
200
74.
0 kg
Aug
ust
2007
4.2
kg
Sept
embe
r 20
074.
3 kg
Oct
ober
200
74.
4 kg
Nov
embe
r 20
075.
3 kg
Dec
embe
r 20
076.
1 kg
Janu
ary
2008
6.4
kg
Apr
il 20
086.
8 kg
June
200
87.
2 kg
Sept
embe
r 20
087.
8 kg
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Wei
ght-
for-
age
GIR
LSB
irth
to
5 y
ears
(z-
sco
res)
Ag
e (c
om
ple
ted
mo
nth
s an
d y
ears
)
Weight (kg)
5 ye
ars
4 ye
ars
3 ye
ars
2 ye
ars
1 ye
arBi
rth
24
68
102
46
810
24
68
102
46
810
24
68
10M
onth
s
24681012141618202224262830
24681012141618202224262830
-2 -33 02
30
MPC
GLE
SSO
N
31
MPC
GLE
SSO
N
9Im
prov
ing
Indi
vidu
al C
hild
Gro
wth
Exe
rcis
e: G
raph
ing
a C
hild
’s G
row
th
Dat
e W
eigh
t (k
g)
Mar
ch2
007
(DO
B)3.
7
Apr
il20
073.
7
May
200
74.
3
June
200
74.
4
July
200
74.
5
Aug
ust
2007
4.7
Sept
embe
r20
074.
8
Oct
ober
200
74.
9
Nov
embe
r20
075.
8
Dec
embe
r20
076.
6
Janu
ary
2008
6.9
Apr
il20
087.
3
June
200
87.
7
Sept
embe
r20
088.
3
Nan
di: (
fem
ale)
Dat
eW
eigh
t (k
g)
July
200
7(D
OB)
3.5
Aug
ust
2007
4.4
Oct
ober
200
75.
2
Nov
embe
r20
077.
3
Dec
embe
r20
078.
0
Febr
uary
200
88.
8
Apr
il20
0810
.2
June
200
810
.5
Sin
to: (
mal
e)
Dat
eW
eigh
t (k
g)
Nov
200
7(D
OB)
2.3
Dec
embe
r20
072.
9
Febr
uary
200
83.
8
Mar
ch2
008
4.3
Apr
il20
084.
7
June
200
85.
6
July
200
86.
3
Aug
ust
2008
6.7
Oct
ober
200
87.
2
Tin
u: (
mal
e)
Dat
eW
eigh
t (k
g)
June
200
7(D
OB)
3.6
Aug
ust
2007
4.5
Oct
ober
200
75.
7
Nov
embe
r20
075.
8
Janu
ary
2008
6.2
Febr
uary
200
86.
4
Mar
ch2
008
6.4
May
200
86.
5
July
200
86.
8
Sept
embe
r20
087.
0
Oct
ober
200
87.
1
Dec
embe
r20
087.
5
Har
jinde
r: (
fem
ale)
Dat
eW
eigh
t (k
g)
Feb
2008
(D
OB)
2.0
Mar
ch2
008
2.5
Apr
il20
083.
1
May
200
83.
5
June
200
84.
0
July
200
84.
6
Aug
ust
2008
5.0
Sept
embe
r20
085.
4
Oct
ober
200
85.
9
Nov
embe
r20
086.
2
Janu
ary
2009
6.9
Sar
ah: (
fem
ale)
30
MPC
GLE
SSO
N
31
MPC
GLE
SSO
N9
Impr
ovin
g In
divi
dual
Chi
ld G
row
th
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Wei
ght-
for-
age
GIR
LSB
irth
to
5 y
ears
(z-
sco
res)
Ag
e (c
om
ple
ted
mo
nth
s an
d y
ears
)
Weight (kg)
5 ye
ars
4 ye
ars
3 ye
ars
2 ye
ars
1 ye
arBi
rth
24
68
102
46
810
24
68
102
46
810
24
68
10M
onth
s
24681012141618202224262830
24681012141618202224262830
-2 -33 02
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Wei
ght-
for-
age
BOYS
Bir
th t
o 5
yea
rs (
z-sc
ore
s)
Ag
e (c
om
ple
ted
mo
nth
s an
d y
ears
)
Weight (kg)
5 ye
ars
4 ye
ars
3 ye
ars
2 ye
ars
1 ye
arBi
rth
24
68
102
46
810
24
68
102
46
810
24
68
10M
onth
s
246810121416182022242628
246810121416182022242628
-2 -33 02
32
MPC
GLE
SSO
N
33
MPC
GLE
SSO
N
9Im
prov
ing
Indi
vidu
al C
hild
Gro
wth
Fiv
e G
row
th C
urve
s1.
C
hann
el b
elow
-3 S
D (
belo
w t
he lo
wes
t gr
owth
cur
ve):
Very
low
wei
ght-
for-
age
– th
e m
ost
dang
erou
s. •
Mos
t ch
ildre
n ar
e se
vere
ly m
alno
uris
hed
• T
hese
chi
ldre
n ne
ed h
elp
imm
edia
tely
2.
Cha
nnel
bet
wee
n -2
SD
and
-3 S
D: L
ow w
eigh
t-fo
r-ag
e –
a si
gn o
f dan
ger.
• M
ost
child
ren
are
mod
erat
ely
mal
nour
ishe
d•
The
se c
hild
ren
are
at r
isk
for
beco
min
g se
vere
ly m
alno
uris
hed
3.
Cha
nnel
bet
wee
n 2
SD a
nd -2
SD
: Nor
mal
wei
ght-
for-
age
– he
alth
y. •
A h
ealth
y ch
ild’s
wei
ght
shou
ld b
e in
thi
s ch
anne
l
4.
Cha
nnel
bet
wee
n 2
SD a
nd 3
SD
: Nor
mal
to
high
wei
ght-
for-
age
– he
alth
y. •
Mos
t ch
ildre
n ar
e st
ill h
ealth
y in
thi
s ch
anne
l
5.
Cha
nnel
abo
ve 3
SD
: Hig
h w
eigh
t-fo
r-ag
e –
over
wei
ght.
• M
ost
child
ren
in t
his
chan
nel a
re o
verw
eigh
t
RE
ME
MB
ER
: Alw
ays
chec
k th
is d
irect
ion
of t
he g
row
th c
urve
to
see
if th
e ch
ild’s
wei
ght
is
incr
easi
ng o
r no
t. E
ven
a ch
ild in
Cha
nnel
1 (
belo
w -
3 SD
) ca
n be
hea
lthy
as lo
ng a
s he
or
she
is
grow
ing.
Shap
e of
Gro
wth
Cur
ves
• H
ealth
y gr
owth
– g
row
th li
nes
are
risi
ng a
t th
e sa
me
rate
as
the
refe
renc
e cu
rve.
Thi
s sh
ows
the
child
is w
ell-n
ouri
shed
.
• G
row
th fa
lteri
ng –
gro
wth
line
s ar
e ri
sing
mor
e sl
owly
tha
n th
e re
fere
nce
curv
e. T
his
is a
w
arni
ng s
ign
that
the
chi
ld m
ay b
e un
dern
ouri
shed
.
• Fa
iling
gro
wth
– g
row
th li
nes
are
not
incr
easi
ng o
ver
a ce
rtai
n pe
riod
of t
ime
(flat
line
s). T
his
mea
ns t
he c
hild
has
sto
pped
gro
win
g an
d is
und
erno
uris
hed.
• W
eigh
t lo
ss –
gro
wth
line
s ar
e de
crea
sing
, mea
ning
tha
t th
e ch
ild h
as s
topp
ed g
row
ing
and
is lo
sing
wei
ght.
The
chi
ld is
und
erno
uris
hed,
and
usu
ally
als
o ill
with
an
infe
ctio
n. T
his
is
part
icul
arly
ser
ious
.
• Fa
st w
eigh
t ga
in –
whe
n a
child
’s gr
owth
line
ris
es fa
ster
tha
n th
e re
fere
nce
wei
ght-
for-
age
curv
e. F
ast
wei
ght
gain
ofte
n oc
curs
whe
n a
child
is r
ecov
erin
g fr
om u
nder
nutr
ition
or
an
illne
ss, a
nd is
a g
ood
sign
of r
ecov
ery.
It is
als
o ca
lled
‘cat
ch-u
p gr
owth
.’
32
MPC
GLE
SSO
N
33
MPC
GLE
SSO
N9
Impr
ovin
g In
divi
dual
Chi
ld G
row
th
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Leng
th/h
eigh
t-fo
r-ag
e BO
YSB
irth
to
5 y
ears
(z-
sco
res)
Mon
ths
Ag
e (c
om
ple
ted
mo
nth
s an
d y
ears
)
Length/Height (cm)
1 ye
arBi
rth
2 ye
ars
3 ye
ars
4 ye
ars
5 ye
ars
4550556065707580859095100
105
110
115
120
125
4550556065707580859095100
105
110
115
120
125
24
68
102
46
810
24
68
102
46
810
24
68
10
-2 -33 02
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Leng
th/h
eigh
t-fo
r-ag
e G
IRLS
Bir
th t
o 5
yea
rs (
z-sc
ore
s)
Mon
ths
Ag
e (c
om
ple
ted
mo
nth
s an
d y
ears
)
Length/Height (cm)
1 ye
arBi
rth
2 ye
ars
3 ye
ars
4 ye
ars
5 ye
ars
4550556065707580859095100
105
110
115
120
125
4550556065707580859095100
105
110
115
120
125
24
68
102
46
810
24
68
102
46
810
24
68
10
-2 -33 02
34
MPC
GLE
SSO
N
35
MPC
GLE
SSO
N
9Im
prov
ing
Indi
vidu
al C
hild
Gro
wth
Leng
th M
easu
rem
ents
(N
andi
)
Dat
e L
engt
h (c
m)
Mar
ch2
007
(DO
B)53
Apr
il20
0757
May
200
760
June
200
763
July
200
764
Aug
ust
2007
65
Sept
embe
r20
0765
Oct
ober
200
766
Nov
embe
r20
0766
Dec
embe
r20
0766
Janu
ary
2008
67
Apr
il20
0870
June
200
871
Sept
embe
r20
0873
Nan
di: (
fem
ale)
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Leng
th/h
eigh
t-fo
r-ag
e G
IRLS
Bir
th t
o 5
yea
rs (
z-sc
ore
s)
Mon
ths
Ag
e (c
om
ple
ted
mo
nth
s an
d y
ears
)
Length/Height (cm)
1 ye
arBi
rth
2 ye
ars
3 ye
ars
4 ye
ars
5 ye
ars
4550556065707580859095100
105
110
115
120
125
4550556065707580859095100
105
110
115
120
125
24
68
102
46
810
24
68
102
46
810
24
68
10
-2 -33 02
34
MPC
GLE
SSO
N
35
MPC
GLE
SSO
N9
Impr
ovin
g In
divi
dual
Chi
ld G
row
th
Wei
ght
and
Leng
th M
easu
rem
ents
(N
andi
)
Dat
e W
eigh
t (k
g)L
engt
h (c
m)
Mar
ch2
007
(DO
B)3.
753
Apr
il20
073.
757
May
200
74.
360
June
200
74.
463
July
200
74.
564
Aug
ust
2007
4.7
65
Sept
embe
r20
074.
865
Oct
ober
200
74.
966
Nov
embe
r20
075.
866
Dec
embe
r20
076.
666
Janu
ary
2008
6.9
67
Apr
il20
087.
370
June
200
87.
771
Sept
embe
r20
088.
373
WH
O C
hild
Gro
wth
Sta
nd
ard
s
Wei
ght-
for-
leng
th G
IRLS
Bir
th t
o 2
yea
rs (
z-sc
ore
s)
Len
gth
(cm
)
Weight (kg)
4550
5560
6570
7580
8590
9510
010
511
0
24681012141618202224
24681012141618202224
-2 -33 1 -12 0
36
MPC
GLE
SSO
N
37
MPC
GLE
SSO
N
10C
ouns
ellin
g
• H
ave
a co
nver
satio
n w
ith t
he m
othe
r or
car
egiv
er.
• A
sk q
uest
ions
tha
t w
ill h
elp
you
unde
rsta
nd w
hat
prac
tices
she
has
at
hom
e th
at m
ight
con
trib
ute
to t
he c
hild
’s la
ck o
f gro
wth
.
• Li
sten
car
eful
ly t
o th
e an
swer
s an
d m
ake
som
e re
com
men
datio
ns t
o th
e ca
regi
ver.
• Re
ach
an a
gree
men
t ab
out
som
e st
eps
the
care
give
r co
uld
take
at
hom
e.
• A
sk t
he c
areg
iver
to
stat
e w
hat
agre
emen
ts y
ou r
each
ed d
urin
g th
e co
nver
satio
n to
ens
ure
she
unde
rsta
nds
and
rem
embe
rs w
hat
she
agre
ed
to t
ry t
o pr
omot
e he
r ch
ild’s
grow
th.
Gro
wth
Cou
nsel
ling
Rem
inde
rs
Inco
rrec
t
C
orr
ect
The
Mal
awi I
nfan
t an
d Yo
ung
Chi
ld F
eedi
ng N
atio
nal C
ouns
ellin
g C
ards
hav
e be
en in
clud
ed
in t
hese
mat
eria
ls a
s an
exa
mpl
e of
goo
d co
unse
lling
aid
s. Yo
ur c
ount
ry m
ay h
ave
deve
lope
d its
ow
n co
unse
lling
car
ds t
hat
are
appr
opri
ate
for
your
wor
k.
36
MPC
GLE
SSO
N
37
MPC
GLE
SSO
N10
Cou
nsel
ling
Cha
rts
(Nan
di)
WHO Child Growth Standards
Weight-for-age GIRLSBirth to 5 years (z-scores)
Age (completed months and years)
Wei
gh
t (k
g)
5 years4 years3 years2 years1 yearBirth2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10Months
2
4
6
8
10
12
14
16
18
20
22
24
26
28
30
2
4
6
8
10
12
14
16
18
20
22
24
26
28
30
-2
-3
3
0
2
Nandi
WHO Child Growth Standards
Weight-for-length GIRLSBirth to 2 years (z-scores)
Length (cm)
Wei
gh
t (k
g)
45 50 55 60 65 70 75 80 85 90 95 100 105 110
2
4
6
8
10
12
14
16
18
20
22
24
2
4
6
8
10
12
14
16
18
20
22
24
-2
-3
3
1
-1
2
0
Nandi
WHO Child Growth Standards
Length/height-for-age GIRLSBirth to 5 years (z-scores)
Months
Age (completed months and years)
Len
gth
/Hei
gh
t (c
m)
1 yearBirth 2 years 3 years 4 years 5 years
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
-2
-3
3
0
2
Nandi
38
MPC
GLE
SSO
N
39
MPC
GLE
SSO
N
11Po
pula
tion
Nut
ritio
nal S
tatu
s
How
man
y ch
ildre
n in
Shi
ning
Hop
e C
omm
unity
wer
e w
eigh
ed?
How
man
y w
ere
mal
nour
ishe
d an
d to
wha
t ex
tent
?
Cal
cula
te p
erce
ntag
es o
f chi
ldre
n in
eac
h ca
tego
ry o
f m
alnu
triti
on.
To c
alcu
late
per
cent
ages
: = t
he n
umbe
r of
chi
ldre
n in
the
cat
egor
y X
100
th
e to
tal n
umbe
r of
chi
ldre
n
Exam
ple:
30
norm
al c
hild
ren
X 1
00
72 t
otal
chi
ldre
n
= .4
17 X
100
=
41.7
%, w
e ca
n ro
und
this
up
to 4
2%.
42%
of c
hild
ren
have
nor
mal
nut
ritio
n an
d ar
e gr
owin
g w
ell.
Com
mun
ity W
eigh
ing
Sum
mar
y
Num
ber
of C
hild
ren
Wei
ghed
in E
ach
Cat
ego
ry
No
rmal
Mild
ly
Mal
nour
ishe
dM
ode
rate
ly
Mal
nour
ishe
dS
ever
ely
Mal
nour
ishe
dTo
tal
Chi
ldre
n
lllll
lllll
lllll
llll
lllll
lllll
lllll
lllll
llll
llll
llll l
lllll
ll
Tota
ls(
#)
3028
86
72
Tota
ls(
%)
100
38
MPC
GLE
SSO
N
39
MPC
GLE
SSO
N11
Popu
latio
n N
utri
tiona
l Sta
tus
Trig
gers
for
Act
ion
– U
nder
wei
ght
Perc
enta
ge o
f Chi
ldre
n 0-
59 M
ont
hs M
ode
rate
ly a
nd S
ever
ely
Mal
nour
ishe
d
Acc
epta
ble
Att
enti
on
Req
uire
dC
riti
cal
Und
erw
eigh
tM
oder
atel
y/Se
vere
ly
Mal
nour
ishe
d<1
0%10
-19%
≥20%
40
MPC
GLE
SSO
N
41
MPC
GLE
SSO
N
11Po
pula
tion
Nut
ritio
nal S
tatu
s
To c
alcu
late
per
cent
ages
: = t
he n
umbe
r of
chi
ldre
n in
the
cat
egor
y X
100
th
e to
tal n
umbe
r of
chi
ldre
n
Exam
ple:
16
norm
al c
hild
ren
X 1
00
72 t
otal
chi
ldre
n
= .2
2 X
100
=
22 %
22%
of c
hild
ren
have
nor
mal
nut
ritio
n ac
cord
ing
to t
heir
hei
ght-
for-
age
and
are
grow
ing
wel
l.
Leve
l of S
tunt
ing
in T
his
Com
mun
ity
How
man
y ch
ildre
n w
ere
mea
sure
d?
How
man
y w
ere
mal
nour
ishe
d an
d to
wha
t ex
tent
?
Cal
cula
te p
erce
ntag
es o
f chi
ldre
n in
eac
h ca
tego
ry o
f m
alnu
triti
on.
Hei
ght/
Len
gth-
for-
Age
– N
umbe
r o
f Chi
ldre
n
No
rmal
Mild
ly
Mal
nour
ishe
dM
ode
rate
ly
Mal
nour
ishe
dS
ever
ely
Mal
nour
ishe
dTo
tal
Chi
ldre
n
lllll
lllll
lll
lllll
lllll
lllll
lllll
lll
l ll
lllll
lllll
lllll
lllll
Tota
ls16
3221
372
40
MPC
GLE
SSO
N
41
MPC
GLE
SSO
N11
Popu
latio
n N
utri
tiona
l Sta
tus
Trig
gers
for
Act
ion
– St
untin
g
Perc
enta
ge o
f Chi
ldre
n 0-
59 M
ont
hs M
ode
rate
ly a
nd S
ever
ely
Mal
nour
ishe
d
Acc
epta
ble
Att
enti
on
Req
uire
dC
riti
cal
Stu
ntin
g(h
eigh
t-fo
r-ag
e)<
20%
20 –
29%
≥30%
42
MPC
GLE
SSO
N
43
MPC
GLE
SSO
N
11Po
pula
tion
Nut
ritio
nal S
tatu
s
Trig
ger
for
Act
ion
– W
astin
gPe
rcen
tage
of C
hild
ren
0-59
Mo
nths
Mo
dera
tely
and
Sev
erel
y M
alno
uris
hed
Acc
epta
ble
Att
enti
on
Req
uire
dC
riti
cal
Was
ting
(wei
ght-
for-
heig
ht)
<5%
5 –
9%≥1
0%
42
MPC
GLE
SSO
N
43
MPC
GLE
SSO
N11
Popu
latio
n N
utri
tiona
l Sta
tus
44
MPC
GLE
SSO
N
45
MPC
GLE
SSO
N
11Po
pula
tion
Nut
ritio
nal S
tatu
s
Com
pari
ng D
HS
to T
rigg
ers
for
Act
ion
Perc
enta
ge o
f Chi
ldre
n U
nder
5 W
ho A
re M
ode
rate
ly a
nd S
ever
ely
Mal
nour
ishe
d
DH
S T
ota
lD
HS
____
___
Dis
tric
tC
om
mun
ity
Info
rmat
ion
Tri
gger
for
Act
ion
Und
erw
eigh
t≥2
0%
Stun
ting
≥30%
Was
ting
≥10%
Perc
enta
ge o
f Chi
ldre
n U
nder
5 W
ho A
re M
ode
rate
ly a
nd S
ever
ely
Mal
nour
ishe
d
DH
S T
ota
lD
HS
Dis
tric
t(K
ampa
ng C
ham
)
Imm
edia
te A
ctio
n R
equi
red
(Tri
gger
)
Und
erw
eigh
t45
.2%
47.8
%≥2
0%
Stun
ting
44.6
%48
.2%
≥30%
Was
ting
15.0
%15
.6%
≥10%
44
MPC
GLE
SSO
N
45
MPC
GLE
SSO
N11 C
ON
GR
ATU
LAT
ION
S EV
ERYO
NE!
You
have
now
lear
ned
to w
eigh
and
mea
sure
chi
ldre
n w
ith
prop
er t
echn
ique
. You
hav
e al
so le
arne
d ho
w t
o do
gro
wth
m
onito
ring
and
pro
mot
ion.
You
have
beg
un t
o un
ders
tand
w
hat
diffe
rent
mea
sure
s of
mal
nutr
ition
and
gro
wth
mea
n.
We
hope
tha
t th
is t
ool w
ill c
ontin
ue t
o en
able
you
to
supp
ort
your
com
mun
ity t
o im
prov
e th
e nu
triti
on o
f the
ir c
hild
ren
and
fam
ilies
. Goo
d nu
triti
on is
an
impo
rtan
t pa
rt o
f a h
ealth
y co
mm
unity
!
Popu
latio
n N
utri
tiona
l Sta
tus
