National Height Census on May 12 takes stock
of height of Standard 1 children
It’s been 13 years since the first height census was done in Belize, measuring a total of 22,426 children across 262 primary schools. The target for the census was Standard 1 students, ages 6 to 9. The report of that study, titled, “Closing the Gap: National Height Census of School Children in Belize, 1996”, claims that 15.4% of the children showed growth retardation or were too short for their age.
The most affected district was Toledo, where 39% of children were growth retarded, followed by Cayo with 17.8 %, and Orange Walk with 16.8%, Corozal with 15.8 %, and Stann Creek with 13.5 %. The Belize district showed the lowest growth retardation with 4.1 % of children affected, the report added.
It went on to claim that high prevalence of growth retardation was observed in rural areas, “…those enrolled in grade levels Infant I and II, and Standard I, Maya and Hispanic children, school boys, and children attending schools under Assemblies of God management,” says the study’s abstract. “Growth retardation differences were observed for the same ethnic groups across districts, reflecting different environmental-cultural conditions.”
The report said that 48 communities were identified with high level growth retardation, and were said to require intervention; 81% were located in the Toledo and Stann Creek Districts.
This morning, at the Radisson Fort George Hotel in Belize City, when the second such census was launched, there was no overview of what interventions had been done since the previous one. Neither was there any indication of whether the numbers have changed or whether anyone had done anything to address the issue of stunted growth among children across Belize.
Speaking at this morning’s launch, Dr. Peter Allen, the Chief Executive Officer in the Ministry of Health, said that the community needs to do much more to prevent growth retardation, to work towards optimal educational development, and to protect minds and bodies of children.
He pointed to a 1992 Assessment of the Food Nutrition and Health Situation of Belize, which he said showed that 6% of children younger than 5 were underweight; whereas Toledo recorded 39% of its children with stunted growth in the same age group in 1996.
Speakers at today’s launch were staunch in their belief that environmental factors are more at play than genetic factors and ethnicity.
Allen told workshop participants this morning that retarded growth in children is “mainly the result of environmental factors that can be influenced” by individual and collective action.
The second census, slated for Tuesday, May 12, “…will provide representative information at the national, district and village levels, to make timely decisions to implement nutritional activities, and other interventions aimed at improving the health of all Belizean children,” Allen claimed.
“Through this census, population growth retardation can be measured, allowing us to know its magnitude, severity and geographic distribution. Information generated from height censuses, can be used to assist us in lobbying for resources,” he added.
The Ministry of Education is partnering with the Ministry of Health, PAHO, UNICEF, PRESANCA (Programa Regional de Seguridad Alimentaria y Nutricional para Centroamerica) and INCAP (The Institute of Nutrition of Central America and Panama) to undertake this second national height census, which follows a two-day workshop today and tomorrow for over 50 participants who, in turn, are expected to train their colleagues in techniques to undertake the census.
Dr. Natalia Beer, Maternal Child Health Advisor in the Ministry of Health, said that growth rate depends on one’s diet, health, environment, and socioeconomic factors.
The first such census, she said, was done in Costa Rica by INCAP, and now it is widely done throughout the Americas. Belize’s first census in 1996 showed that out of every 100 children measured, 15 were found with growth retardation or stunting, she informed.
She noted that the information can be useful in decision making, the design and evaluation of policies, the redistribution of resources, intervention, and indicating whether responsible agencies have been successful in reducing growth retardation.
Lic. Maria del Carmen Sosa, a nutritionist from El Salvador who has been hired as a consultant to train the trainers and administer the project, told Amandala that such studies need to be done every five years.
According to Sosa, environmental factors, such as the type of floor one has – an earthen floor versus a wooden floor – impacts a child’s growth. When we asked her about the role of one’s genetic makeup in determining height at a particular age, she insisted that environmental factors are what primarily determine one’s height, and something as basic as a clean floor can contribute to healthy growth.
Allan Genitty, Deputy Chief Education Officer, said that across Belize, principals and teachers will be responsible for collecting, classifying and reporting the growth retardation results for their expected schools.
The wider use of the census is that it can help to identify communities that could benefit from targeted nutritional interventions; it can detect growth retardation and screen high-risk groups, such as families, communities and geographical regions; and it can help in constructing poverty maps and developing baselines for food and nutrition surveillance systems.
Sosa did demonstrations of the measuring technique this morning with a boy and a girl from St. Luke’s Methodist School in Belize City. Tapes are calibrated in centimeters and charts are provided which indicate what height a child should theoretically have for his or her age.
A boy who just turned six, for example, should be 106.5 cm or roughly 3 feet 6 inches tall. If the child is two inches shorter, he is categorized as suffering from “severe growth retardation.”
A girl 9 years and 11 months old should not be shorter than 4 feet and 1 inch. If so, the teacher will log that child as moderately or severely retarded in growth.
The persons collecting the data are required to log the child’s name, age, ethnicity, height, address and height classification: normal growth, moderate growth retardation or severe growth retardation.
(We note that the growth classification is made in this manner even though the datum (height) for that child is a snapshot of height at a specific time rather than how that child’s height changes over a period of time – which is really how growth is defined.)
We again took issue with these height-age generalities when we interviewed Beer, and she, like Sosa, insisted that environmental factors, nutrition, health, etc. are the primary factors that determine one’s height, and not one’s genetic makeup or ethnicity.
What about dwarfs, we queried. Beer acknowledged that in the case of dwarfs – not very many in Belize, but they do exist – genetics is clearly the determining factor, but she went on to say that there is “no genetic factor to stunting, [and] …children have the potential to have maximum growth in any environment.”
Once a child’s growth is stunted, said Beer, the damage is permanent, and a child can never catch up.
In Stann Creek, said Beer, the pattern of growth below 6 months compares with international numbers, but there is stagnation after six months in many cases, which she asserted is preventable.
Children start having growth problems younger than 3, and “that is where we need to make the intervention,” Beer advised.
After 6, the results start to show in a child’s height, she offered, justifying their decision to take the census of children ages 6 years and 0 months to 9 years and 11 months.
How does Belize measure up internationally? “The national prevalence of stunting is considered to be low according to WHO international classification (WHO, 1996),” said the Nutrition Country Profile of Belize produced by the FAO in 2003.
According to consultant Maria del Carmen Sosa, the results of the census should be ready within 4 months.
She notes that changes in migration patterns in Belize since the last census might have affected the height-age profile of children ages 6 to 9 in Belize, as it was clear even from the 1996 census that the communities that showed most stunting had high immigrant populations, she claimed.
A project press release says that, “This index is mainly used to identify chronic malnutrition and is also a reflection of socioeconomic and environmental factors that influenced their growth.”
Over 9,000 standard 1 children are being targeted by the new census.