Is One Nutritional Benchmark Appropriate? Dilemma in Nutritional Assessment and Growth Monitoring of Children under Five Years of Age in Fiji

Abstract

The same criteria for assessing nutritional status of children, including internationally recommended anthropometric reference data and standard cut-off values, are commonly applied across different ethnic groups and to meet several programme objectives. the situation in Fiji is used to illustrate some issues that arise from this. Fiji has two major ethnic groups with very different physiques, Fijians and Indians. When using the same weight-forage criteria to assess children of both ethnic groups, the results always show a much higher prevalence of underweight among Indian than among Fijian children. Yet, it is Fijian children who have a higher infant mortality rate due to infections and diarrhoeal diseases and have a higher hospital admission rate due to malnutrition. Work pressures in clinics militate against using different criteria for growth monitoring and meeting clinic reporting requirements. the implications are discussed. the “best” criteria here will differ across programme objectives but must also take account of the work setting.