Growth assessment is basically a kind of comparison. The comparison is with a reference normally called a growth reference”. Without such a reference, growth assessment becomes arbitrary. Now the question arises: what is the difference between Growth Reference and Growth Standard? The difference between a growth reference and a growth standard is very pertinent and relevant to the development and application of growth charts.
Growth reference: A growth reference is a tool for providing a common basis for purposes of comparison (WHO Working Group on Infant Growth, 1995). Cameron (2002) defines a growth reference is essentially a database defining the statistical distribution of one or more measures of size or growth, indexed by sex, age and or other factors.
Growth standard: A growth standard is a concept of a norm or target, that is, a value judgment (WHO Working Group on Infant Growth, 1995). In simple terms, a reference describes “what is,” whereas a standard prescribes “what should be.”
In practice, however, reference values are often used as standards (de Onis and Habicht, 1996). The growth references have to take into account the effects of all the confounding factors. Growth references are sometimes called “Growth charts”.
The process of developing growth references is composed of the following successive stages:
- i) Choice of the. Reference population
- ii) Drawing of the sample
- iii) Data collection and data analysis iv) production of the final growth chart
The function of the growth reference is to provide a way of displaying the expected growth as a function of the other factors affecting growth in a compact, accessible, and visually appealing form.
Use of growth references
The construction and release of growth charts has implications for health-care workers, child caregivers, agency officials, researcher, and others who use growth information.