Purnima Menon

Hope, hard lessons and the path to better nutrition

Global assessment of childhood growth monitoring: Cross-sectional survey of national policies and practices

Background Monitoring children’s growth is crucial in paediatric care for early identification of health issues, with the World Health Organization (WHO) advocating for its practice throughout childhood. However, the focus and implementation of growth monitoring vary globally, reflecting different health priorities and practices. Methods We conducted a global, cross-sectional, questionnaire-based survey, targeted at representatives of the ministry responsible for growth monitoring and promotion, and at representatives of national paediatric societies. Results We obtained responses from 122 countries. Of these, 88% had national growth monitoring guidance, most often issued by the ministry of health. Weight was the most consistently measured early childhood growth monitoring indicator, recorded routinely in 98% of countries during growth monitoring visits for children aged <1 year. The WHO Child Growth Standards were used in 86% of countries. The most common follow-up action for growth faltering was provision of nutritional or health advice, cited by 91% of respondents for children aged <1 year, with advice frequency decreasing as child age increased. Conclusions Childhood growth monitoring is widely adopted, but implemented with considerable variation across countries. Strengthening its impact will require standardising indicators, integrating evidence-based guidelines into primary care, and ensuring equitable, actionable use across age groups.

India’s national maternity benefit cash transfer program and child anthropometry

This study evaluates the impact of India’s Pradhan Mantri Matru Vandana Yojana (PMMVY), the world’s largest rights-based conditional cash transfer (CCT) program targeting women during their first pregnancy. Using National Family Health Survey data from 2005 to 2021, we assess changes in growth in a nationally representative sample of children, before and after program implementation. To address potential biases, we employ a quasi-experimental approach with a Propensity Scores Matched Difference in Differences analysis. We find that potential exposure to the program is associated with moderate improvements (0.10 SD) in height-for-age and weight-for-age z-scores. These effects likely operate through increased uptake of health interventions and consumption of certain food groups. The study underscores persistent barriers to program access and finds that women from higher socio-economic strata have entered the CCT beneficiary pool since 2017, suggesting a need for more equitable program targeting.