1977 NCHS Reference

The assessment of nutritional status based on the 2006 WHO (World Health Organisation) Standards versus the 1977 NCHS (National Center for Health Statistics) Reference has revealed some differences. A chief criticism of the use of the 1977 NCHS Reference has been that, because the reference is based on children from a developed country it should not be applied for all children around the world. The 2006 WHO Standards, they are assumed to be more robust in assessing the nutritional status of the children, especially infants, than was the case for the 1977 NCHS Reference. In the present paper, we compare the estimates of wasting, stunting and underweight obtained from the 2006 WHO standard and the 1977 NCHS reference for the Cameroonian. A total of 1481 children under five years were interviewed in a cross sectional survey including 1343 from 6-59 months. The nutrition status of the children was assessed using the 1977 NCHS Reference and the 2006 WHO Standards. The Hong-de Onis algorithm was also applied separately for children in all age groups, stratified by region and by sex. The 2006 WHO standard compared to the 1977 NCHS standard classify more children as underweight and stunted (8.0% vs 6.8% and 41.0% vs 38.1% respectively). Both references classified 56.8% of children as not stunted, 91.2% as not wasted and 69.4% as not underweight.  More children are classified as undernourished using the algorithm compared to directly applying the 2006 WHO Standards except for the 6-11months age group. The assessment of malnutrition using 2006 WHO Standards classify significantly more children as underweight and stunted and is closer to that of a healthy population than the 1977 NCHS Reference.