Child growth standards

Factors associated with unconstrained growth among affluent Ghanaian children

Owusu WB, Lartey A, de Onis M, Onyango AW, Frongillo EA Jr

Acta Paediatrica 2004;93:1115-9


To identify socio-economic factors associated with unconstrained growth among children living in well-off neighbourhoods of Accra, Ghana.


A cross-sectional study involving the assessment of the anthropometric status of preschool children. Children (n = 309) between the ages of 12 and 23 mo who live in affluent communities in Accra, Ghana were recruited for the study. Weight, length and mid-upper arm circumference were taken. Information was collected on household demographics and socio-economic status, including parental education and household income. Associations between these variables and attained growth were analysed to establish cut-offs for screening children with unconstrained growth.


The mean weight-for-age (WA), length-for-age (LA) and weight-for-length (WL) Z-scores of the sub-sample selected on the basis of high socio-economic criteria were -0.18, -0.40 and 0.16, respectively. Among these well-off children, 0% were underweight, 3.0% were stunted and 0% were wasted (Z-scores <-2). Factors associated with better anthropometric status were paternal education and household income. Two screening criteria combining the two variables were selected: polytechnic education and income­ more than ¢1 000 000 (US$435) or university education and income above ¢200 000.


The children experiencing unconstrained growth belonged to a sub-population of affluent households characterized by high paternal education and household income. This sub-population was targeted for screening for the WHO Multicentre Growth Reference Study in Ghana.