THE GROWTH OF MALAWIAN PRESCHOOL-CHILDREN FROM DIFFERENT SOCIOECONOMIC GROUPS

Objective: The growth of Malawian preschool children from different so cioeconomic groups was examined to determine the relevance of the NCHS /WHO growth reference data for assessing child nutritional status in M alawi. Design: The study involved a comparison of anthropometric data from three cross-sectional surveys of preschool children over 24 month s of age. Setting: Malawi, Central Africa. Subjects: Anthropometric me asurements were taken on high income Malawian children (n = 380) durin g a census of affluent preschools in the country's three major urban c entres. Comparative data were obtained from two existing sample survey s of low income urban children (n = 225) and rural village children (n = 667). Results: The distribution of weight-for-age Z-scores (HAZ) fo r the high income children 24-35 months of age closely resembled the N CHS/WHO child reference population (mean HAZ = -0.21: SD = 1.05). Afte r this age HAZ decreased to a mean value of -0.58 between 60 and 71 mo nths, Large differences in growth were observed between children from different socioeconomic groups, Regression analysis showed that at 24 months the high income children were, on average, 6.6 cm taller than t he: low income urban children (P < 0.001), and 9.2 cm taller than the rural children (P < 0.001). By 59 months of age these differences incr eased to 9.6 cm and 11.1 cm, respectively, Conclusions: Although some questions remain regarding the growth potential of Malawian children, the results suggest the NCHS/WHO reference data are relevant for Malaw i and the high levels of child stunting found in the country are due t o environmental not genetic factors, Sponsorship: UNICEF/Malawi and Co rnell Food and Nutrition Policy Program.