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close this bookField Guide on Rapid Nutritional Assessment in Emergencies (WHO - OMS, 1995, 70 p.)
View the document(introduction...)
View the documentForeword
View the documentChapter 1. Introduction
View the documentChapter 2. Planning the survey
View the documentChapter 3. Selection of survey subjects
View the documentChapter 4. Selecting the sample
View the documentChapter 5. Survey methodology
View the documentChapter 6. Data recording
View the documentChapter 7. Training and supervision
View the documentChapter 8. Data analysis
View the documentChapter 9. Interpreting results and reporting findings
Open this folder and view contentsAnnexes
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Chapter 3. Selection of survey subjects

In this simplified field assessment, nutritional status is usually measured only in children between the ages of 6 and 59 months. Frequently, children in this age group will be the first to show signs of undernutrition. They are generally highly vulnerable and in times of nutritional crisis may show increased morbidity and mortality. Children under 6 months of age (or about 60 to 65 cm long if age is not known), apart from being more difficult to measure, are often still breast-fed and therefore satisfactorily nourished. The upper limit of 59 months corresponds to approximately 100 to 110 cm in height of the reference population.

Because children in many developing countries are significantly stunted, a sample with the 110 cm cut-off will often include many children over 5 years of age and a correspondingly smaller proportion of the younger and most vulnerable children below 2 years. To maintain an adequate proportion of the younger children, it is recommended to use 100 cm as the cut-off point. At this stage, no distinction is made between sexes.

Target group for the survey: age 6 to 59 months or height 60 to 100 cm

In food emergencies, older children, pregnant and lactating women, the elderly, and the disabled may also be considered high-risk groups. They are generally not weighed and measured because there are no valid references for most of these groups. Since the status of young children reflects that of the general population, relief measures should also be extended to the other vulnerable groups if not to the general population.

It should be noted that, if many older children and adults are affected, the Body Mass Index (BMI = kg/m2) can be used for an estimate in adults. The WHO expert committee on “Physical Status: the Use and Interpretation of Anthropometry” described the condition of low BMI as “thinness”, with the following three grades:

Grade 1: BMI 17.0-18.49 (mild thinness)
Grade 2: BMI 16.0-16.99 (moderate thinness)
Grade 3: BMI <16 (severe thinness).

(WHO Technical Report Series, 1995, in press)