Journal of Global Health. Vol. 16. 2026 Feb 6;16:04034. doi: 10.7189/jogh.16.04034
Global assessment of childhood growth monitoring: cross-sectional survey of national policies and practices
Annariina Koivu1 * , Ulla Ashorn1 * , Elaine Borghi2 , Andreas Hasman3 , Purnima Menon4 , Aman Pulungan5,6 , Julie Ruel-Bergeron7 , Linda ShakerBerbari3 , Madhumita Singh5 , Naveen Thacker5 , Wilson Milton Were8 , Kaisa Ylikruuvi1 , Per Ashorn1,8 ; International Growth Monitoring Survey Consortium
1Centre for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland 2 Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland 3 Child Nutrition and Development, United Nations Children’s Fund, New York, New York, USA 4 Poverty, Health and Nutrition Division, International Food Policy Research Institute, South Asia Office, New Delhi, India 5 International Paediatric Association, Marengo, Illinois, USA 6 Department of Child Health, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia 7 Human Development Network’s Health, Nutrition, and Population, World Bank, Washington D.C., USA 8 Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland *Joint first authorship.
Abstract
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.
Correspondence to: Annariina Koivu Tampere Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University Kalevantie 4, Tampere Finland annariina.koivu@tuni.fi Ulla Ashorn Tampere Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University Kalevantie 4, Tampere Finland ulla.ashorn@tuni.fi
International Growth Monitoring Survey Consortium:
Osama Abdi, Madina Ali Abdirahman, Belen Aguirrezabalaga, Basim Al-Zoubi, Mona Alameh, Cecilia D. Alinea, Christine Jane B. Almira, Hind Alsharhan, Abdulmajeed AlSubaihin, Rola Alzir, Beatrice Amadi, Michael Anastasiades, Kim Ang, Ananias Antonio, Sofijanova Aspazija, Simon Jonas Ategbo, Svitlana Austin, Damte Shimelis Awoke, Khamisa Ayoub, Ingrid Pamela Báez Echeverría, Shamsov Bakhtovar, Cecilia Barragán, Nigar Bayramova, Ramush Bejiqi, Nellie VT Bell, Bruno Bindamba Senge, Nardos Birru, Asma Bouaziz, María Catalina Carvajal, Alvin SM Chang, Jean-Pierre Chanoine, Olga Cirstea, Natália Maria Ferreira da Conceiçâo Rodrigues, Laura María Cristales Telón, Lovely Daisy, Ibrahima Sory Diallo, Ana Lucía Díez Recinos, Željka Draušnik, Ekanem Ekure, Mercedes Esquivel Lauzurique, Ali Faraj Ali Nassr, Julia Fernández Monge, Kouéta Fla, Amorissani Folquet, Christophe Gnimi, Jean Chrysostome Gody, Madonna Grimes, Nadia Guellouz, Sahar Idelbi, Violeta Iotova, Majed Abu Jaish, Tuomas Jartti, Mari-Louie Jeffery, Pawana Kayastha, Mediatrice Kiburente, Georgios Konstantinidis, Anne Mei-Kwun Kwok, Maja Lang Morović, Agnès Linglart, Phim Loan, Kvashnina Lyudmila, Fiawoo Mawouto, Emmie W Mbale, Hubert Désiré Mbassi Awa, María José Mendoza, Gladys Anabella Miranda Fuentes, Ladda Mo-Suwan, Annang Giri Moelyo, Claudia Montesinos Ramirez, Paul Moscoso, Bouraima Mouawiyatou, Yeva Movsesyan, Florence Mtawale, Aida Mujkić, Mehreen Mujtaba, Aimée Mupuala, Pius David Muzzazzi, Barbara Nalubanga, Leyla Namazova-Baranova, Gorban Nataliya, Rute Neves, Pie Nibirantije, Akhmedova Nilufar, Fidele Nkezabahizi, Dler Abdulkhaleq Nooruldeen, Cecelia J. Nuta, Azubuike Benjamin Nwako, Emmanuel Oppong, Fartun Abdullahi H Orey, Altagracia Páez, Huynh Nam Phuong, Mariana del Pino, Doina-Anca Plesca, Jorge Rada Noriega, Tahiana Razafindrakoto, Macarena Riquelme Rivera, María Inés Romero, Marysol Ruilova, Elieth Rumanyika, Masood Sadiq, Haroon Saloojee, Setshedi Sebata, Amela Selimovic, Virendra RS Singh, Selva Kumar Sivapunniam, Santosh Soans, Dirceu Sole, Félix Sonon, Chan Sophal, Adriana Sosa Botana, Shayirbek Alibaevich Sulaimanov, Mariam Sylla, Lila Bikram Thapa, Fathimath Thohira, Vaidotas Urbonas, Ruth Aburto Vallejos, Laura Elizabeth Vásquez Muñoz, Verónica Véliz Rojas, Sergio Venturino, V Pujitha Wickramasinghe, Wei Xiang, Hamda Omar Yousuf, Antipkin Yuriy, Fatima Mohammed Yusuf, Leela Keculah Zaizay, Yue Zhang, Magaly Zurita Villazón, and Siniketiwe Zwane