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How to measure height in Guatemala

Implementing a standardized evaluation system for measuring health problems.
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Heidi Hernandez, 3, cries as health workers measure her. She is five inches shorter than the minimum recommended height for her age. (Arturo Godoy/GlobalPost)

It’s difficult for policy makers to assess improvements or setbacks in a country’s health indicators when there’s no reliable way to measure the problems. To that end, GHI in Guatemala is also working on strengthening, standardizing, and streamlining the nation’s information systems to ensure officials have an accurate picture of the country’s staggering rate of chronic malnutrition, as well as its other poor health indices.

The Centers for Disease Control and Prevention (CDC) is heading this project and officials are working on supporting Guatemalan authorities to develop and institute a nationwide electronic surveillance system.

“It will take some time,” said Dr. Nelson Arboleda, who heads the CDC’s regional office in Guatemala City. “In some very remote areas, they don’t even have a good paper system in an organized fashion, so reporting the same information is challenging.”

A standardized evaluation system is important, Arboleda said, not only to gauge the extent of Guatemala’s current problems, but also to detect trends and pandemic outbreaks.

Part of CDC’s work will focus on implementing a reliable way to measure stunting, a height deficit that is a prime indicator of chronic malnutrition. How Guatemalan health officials currently evaluate children differs from place to place, CDC officials said, and some only measure weight, not height. Those who do measure height don’t always do it in the same way.

“Height is notoriously measured badly,” said Dr. Maria Jefferds, an epidemic intelligence service officer at the CDC who is working on this portion of the Guatemalan project. Measuring infants and toddlers is especially challenging, she said.

“If chronic malnutrition is a key thing you’re trying to change, you want to make sure you’re measuring it well.”

(More from GlobalPost: The drain of malnutrition in Guatemala).

CDC officials said they hope a standardized information system will also help overcome challenges caused by Guatemala’s constant government turnover. Because no real civil service career ladder exists, bureaucrats shuffle in and out at least as often as government changes. Often, it’s even more frequent. In the past two years, for instance, four different directors have headed Guatemala’s tuberculosis strategy, Arboleda said.

This makes continuity in programs difficult. Officials hope building a dependable surveillance and reporting system will help reduce this obstacle.

“Even if a new person does comes in,” Arboleda said, “all that information will at least be maintained in the same way.”

http://www.globalpost.com/dispatches/globalpost-blogs/global-pulse/measuring-height-guatemala

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