Edinburgh Research Archive logo

Edinburgh Research Archive

University of Edinburgh homecrest
View Item 
  •   ERA Home
  • Social and Political Sciences, School of
  • Science Technology and Innovation Studies
  • Science Technology and Innovation Studies thesis and dissertation collection
  • View Item
  •   ERA Home
  • Social and Political Sciences, School of
  • Science Technology and Innovation Studies
  • Science Technology and Innovation Studies thesis and dissertation collection
  • View Item
  • Login
JavaScript is disabled for your browser. Some features of this site may not work without it.

Growing right: unpacking the WHO Child Growth Standards Development and their implementation in Colombia

View/Open
Niño2018_Redacted.pdf (1.877Mb)
Date
27/11/2018
Item status
Restricted Access
Embargo end date
30/11/2019
Author
Niño Machado, Natalia
Metadata
Show full item record
Abstract
Child growth reference charts have been used since the 1960s to assess children´s growth – enabling comparison of different population groups and the implementation of nutritional surveillance. In 2006, an important critical juncture occurred in the history of anthropometry and nutritional assessment, when the WHO released new growth charts for international comparison after promoting, since 1975, the use of the charts developed by the Centers for Disease Control (CDC) and US National Center for Health Statistics (NCHS). According to the WHO, these charts indicate how children should grow for the best health outcome in contrast to the NCHS/CDC charts that indicated how the average child grows. This shift from a descriptive to a prescriptive –and rather normative – approach allowed the WHO to state that all children in the world have the potential to grow and develop to within the same range of height and weight, thus implying that all children should develop in specific standardised ways, regardless of ethnicity, socioeconomic status and type of feeding. By 2011, approximately 125 countries had adopted the WHO charts for individual growth monitoring as well as the means of producing statistics for under- and over-nutrition, which would be used to assess and monitor a population’s health status. This shift between charts has direct implications for how children’s growth is measured and how malnutrition is assessed. The adoption of the WHO charts has immediate consequences for the calculation of underweight, overweight, stunting, and wasting prevalence. In this sense, the adoption of the new charts considerably changes the estimates to predict nutrition-related emergencies, the assessment of appropriate weaning practices, and the screening and monitoring of populations at risk or with growth deficiencies or excesses. In my doctoral research, I use Colombia as a case study to unpack how a standard developed by an international organisation is negotiated, adopted and constantly transformed once it is scaled down to a specific country. Using the theoretical approach to standards by authors such as Star, Bowker, Timmermans, Berg, and Epstein, in this dissertation I show how, far from being ‘stable’ and ‘value-free’ (as the World Bank would describe them), growth charts are political tools of measurement, charged with specific values regarding children’s bodies. Given that Colombia had previously used the NCHS charts, this research explores how the WHO charts have been adopted within individual growth monitoring programmes in Colombia. I also describe how the change in charts has destabilised the production of under and over-nutrition indicators by national bodies, such as the Ministry of Health and the Instituto Nacional de Salud. My data includes twenty-eight interviews with policy makers, experts and civil servants who actively participated in the process of adopting and adapting the standards in Colombia at the national level; seventeen interviews with nurses and doctors; observation of 158 anthropometric assessments of children under five years old within six health facilities in the Caribbean region that were implementing a growth monitoring programme. By exploring how the WHO charts are interpreted and used in practice, this research contributes to the study of standards and standardisation as a field of study in its own right.
URI
http://hdl.handle.net/1842/33267
Collections
  • Science Technology and Innovation Studies thesis and dissertation collection

Library & University Collections HomeUniversity of Edinburgh Information Services Home
Privacy & Cookies | Takedown Policy | Accessibility | Contact
Privacy & Cookies
Takedown Policy
Accessibility
Contact
feed RSS Feeds

RSS Feed not available for this page

 

 

All of ERACommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsPublication TypeSponsorSupervisorsThis CollectionBy Issue DateAuthorsTitlesSubjectsPublication TypeSponsorSupervisors
LoginRegister

Library & University Collections HomeUniversity of Edinburgh Information Services Home
Privacy & Cookies | Takedown Policy | Accessibility | Contact
Privacy & Cookies
Takedown Policy
Accessibility
Contact
feed RSS Feeds

RSS Feed not available for this page