NCMP data using WHO growth standards: information and methods
Published 20 April 2023
Applies to England
© Crown copyright 2023
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This publication is available at https://www.gov.uk/government/statistics/analysis-of-ncmp-data-using-who-growth-standards-2021-to-2022/ncmp-data-using-who-growth-standards-information-and-methods
Introduction
These statistics were requested by the Office for National Statistics (ONS) to use to report on specific Sustainable Development Goals (SDGs). The SDGs are a universal call to action to end poverty, protect the planet and improve the lives and prospects of everyone, everywhere. Seventeen goals were adopted by all United Nations (UN) member states in 2015, as part of the 2030 Agenda for Sustainable Development.
ONS is coordinating and reporting on the global SDG indicators for the UK. This fulfils the mandate placed on all countries by the UN General Assembly.
ONS has requested data for stunting and malnutrition (wasting and overweight), categorised using the SDG definition. Child stunting refers to a child who is too short for their age and is the result of chronic or recurrent malnutrition. Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients and is published here for wasting (low weight for height) and overweight.
This publication contains data for the following SDG indicators:
- indicator 2.2.1: prevalence of stunting (height for age less than 2 standard deviation from the median of the World Health Organization (WHO) child growth standards) among children under 5 years of age
- indicator 2.2.2: prevalence of malnutrition (weight for height greater than 2 or less than 2 standard deviation from the median of the WHO child growth standards) among children under 5 years of age, by type (overweight and wasting)
Standard deviation is a measure of the amount of variation of a set of values.
Further information about malnutrition can be found in the WHO factsheet on Sustainable Development Goals health targets - nutrition, overweight and obesity .
Data source and methodology
The figures presented in the accompanying data tables are based on data from the National Child Measurement Programme (NCMP), for academic year 2021 to 2022. The 2021 to 2022 NCMP was the first data collection since the coronavirus (COVID-19) pandemic that was unaffected by school closures and other public health measures.
Almost 570,000 children aged 4 to 5 years old were measured, which is 93% of all children that were eligible to take part. This participation rate, though high, is lower than pre-pandemic years where participation had been at 95% since the data collection in 2014 to 2015. This is likely to be due to resourcing issues within some local authorities during the pandemic recovery process.
The analysis is only for children aged 4 years old in reception school year at the time of measurement (age group 48 to 59 months old). These children would have turned 5 within the academic year. Children who had already turned 5 at the time of measurement are excluded from this analysis.
The dataset variables used for the analysis were:
- age (in months)
- height
- sex
- weight
- index of multiple deprivation (originally deciles, and recoded into quintiles)
- ethnic group
- rural or urban indicator (recoded into a binary classification)
Further details on these variables are included in the accompanying spreadsheet.
This analysis uses WHO child growth standards to classify children as stunted and malnourished. This allows values calculated for SDG indicators to be compared across countries. WHO child growth standards were developed based on a sample of children from 6 countries: Brazil, Ghana, India, Norway, Oman and the USA.
In England, the British 1990 growth reference (UK90) for body mass index (BMI) is recommended for use to determine weight status according to a child’s age and sex. Analysis of the NCMP dataset normally uses the UK90 growth reference, which was developed based on a sample of children in England, Scotland and Wales. Values in this analysis calculated using WHO child growth standards should not be compared to analysis of the NCMP that uses the UK90 growth reference.
The analysis for the data using the WHO child growth standards was done by running the NCMP data through a bespoke R package, anthro, developed by the WHO specifically for supplying SDG-related figures.
Background on NCMP reporting
The NCMP is a nationally mandated public health programme. The annual surveillance programme measures the height and weight of over one million primary school children each year in reception (age 4 to 5 years) and year 6 (age 10 to 11 years) within mainstream state-maintained schools in England. Some independent and special schools also choose to participate, but these records are excluded from the analysis for national NCMP reports as the majority of such schools do not take part.
The analysis was produced using the NCMP national analysis dataset provided to the Office for Health Improvement and Disparities (OHID) by NHS England. The data used in this publication will also be published on the ONS SDG data website, which includes interactive charts and tables, and other metrics on poverty, health and education.
NHS England and OHID also publish analyses of the NCMP dataset annually and many local authorities undertake additional analyses to inform their work to tackle obesity. The National Child Measurement Programme, England, 2021 to 2022 school year report can be found on the NHS England website.
For queries and feedback relating to this document, please contact: pha-ohid@dhsc.gov.uk.