Primary health care centers (PHCCS) in Saudi Arabia provide regular check ups for children aged 0 to 5 years, which include anthropometric measurements. These data are used for individual patient assessment only. We used these measurements to assess the growth and status of the population (50,000) served by one PHCC in Riyadh Saudi Arabia and to discover ways to improve the system.
Methodology
For 20 days we obtained the weight, height, and birth date of all children aged 0 to < five years of age who visited the well baby clinic of the Rawdah PHCC. We calibrated scales each day, nurses made routine measurements and we remeasured each tenth child to verify accuracy. We interviewed mothers about feeding and weaning practices, history of diarrhea, family size, and socioeconomic characteristics. Measurements were converted to standardized z scores using the WHO reference standard. Simple and multiple linear regression was used to compare standardized scores to potential risk factors for undernutrition.
Results
We assessed 484 children. Both the weight for age z-score (WAZ) and the height for age z-score (HAZ) were slightly below (-0.20 z for both) the reference standard (p< 0.01, t-test). Height for age of 6% of children was below -2.0 z compared with an expected value of 2.1% (p <0.001, Chi squared test). Multiple regression analysis of WAZ, HAZ, and against four explanatory variables revealed that WAZ and HAZ decreased with increasing age, and total siblings and increased with increasing birth weight. For all family sizes above 3 the WAZ was less than -0.32 and were different than the reference standard (p < 0.01, t-test). We found no association between WAZ, HAZ with feeding practices or recent diarrheal illness.
Conclusion
Surveillance of anthropometric measurements made in PHCC indicated several possible areas of concern but did not suggest severe or moderate undernutrition in this population. Routine collection and processing and analysis of these data is a simple matter and could be extended to other PHCC for a complete anthropometric surveillance system.