Purnima Menon

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.

Hope, hard lessons and the path to better nutrition

Policy entry points for healthy diets in India: Insights from three consultations

Improving diet quality in India is both urgent and achievable, and the cost of inaction is high. The policy entry points identified through stakeholder consultations offer practical ways forward—from implementing front-of-package labeling and restricting ultra-processed food advertisements, to strengthening nutrition behavior change communication in existing safety net programs and making these programs more nutrition-sensitive. India’s increasingly diverse food production is creating the supply-side foundation for healthier diets. Policy action should now focus on three key areas: making nutritious foods more accessible and affordable through agricultural policies and social protection programs that enable and incentivize crop and diet diversification; fostering healthier food environments by regulating ultra-processed foods with improved labeling, restrictions on advertising and promotion near schools, and limits on sugar, fat, and salt content; and building sustained demand for diverse, nutritious diets through targeted behavior change communication. Implementation should apply a consistent equity lens: prioritizing lagging geographies and marginalized groups, addressing gendered time constraints through childcare and other supports, and enabling women-led and small enterprises that produce nutritious, convenient foods. Success requires prioritizing cost-effective interventions with demonstrated impact, fostering collaboration across government departments and levels, and leveraging India’s growing data infrastructure to ensure interventions reach the most vulnerable populations.