5.3.1  What is an indicator?

An indicator is an index (for example, a scale showing weight for age, or weight for height) combined with specific cut-off values that help you determine whether a child is underweight or malnourished; for example, a child whose weight for age, or weight for height, falls below the cut-off values shown in Table 5.1 is considered to be underweight or malnourished.

You will be able to use anthropometric indicators to assess nutritional status, to evaluate the effects of interventions, to admit children to an intervention (treatment) programme and to discharge them from a programme. These indicators are therefore very important and knowing how to use them will help you plan effective nutrition interventions. Table 5.1 summarises how indicators of underweight, wasting and malnutrition are derived from the weight and height of children relative to their age, with the cut-off values (column 2) for each indicator (column 1) based on the standard deviation (SD) of the child’s measurement from the norm for a child of that age.

The growth chart in each Health Post and on the child health card will help you assess whether a child is underweight.

Table 5.1 Indicators of underweight and malnutrition derived from the weight and height of children relative to their age.
IndexCut-off value based on standard deviation (SD)/percentageWhat it indicates
Weight-for-ageLess than -2 and more than -3 Moderate underweight
Weight-for-ageLess than -3Severe underweight
Height-for-ageLess than -2 and more than -3 (i.e. 70–79.99% of the norm)Moderate acute malnutrition (MAM)
Height-for-ageLess than -3 (i.e. less than 70% of the norm) and/or bilateral pitting oedemaSevere acute malnutrition (SAM)
  • What are the indicators for diagnosing severe acute malnutrition?

  • Indicators for SAM are a child with standard deviation less than 3 and/or bilateral pitting oedema. If one of these signs is detected, the child is suffering from SAM.

5.3  Converting measurements to indices

5.4  Anthropometric measurements used to assess body composition