Growth charts: help or hindrance?

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Abstract
The use of growth charts is being promoted world-wide, particularly by UNICEF, as one of the essential ingredients of any primary health care programme. Though they are being adopted in many countries, their effectiveness has been evaluated in very few. In this analysis of the effectiveness of the use of growth charts in Papua New Guinea it is hypothesized that growth charts are used to fulfil four purposes: (a) to assist health workers to diagnose children who are suffering from, or are in danger of suffering from, malnutrition; (b) to select those children that are seriously malnourished and may need referral; (c) to evaluate the impact of nutrition programmes; and (d) to assist health workers to educate mothers about child growth and nutrition. A review of research in Papua New Guinea reveals that growth charts, as they are being used at present, do not fulfil any of these purposes. As such, it is questioned whether, considering the resources that are necessary to carry Out growth monitoring with growth charts, it is sensible to continue promoting their use.

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