Assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition

Updates for the integrated management of childhood illness (IMCI) - Guideline

World Health Organization

children primary health care facilities - obestiy - dmb pubcation cover

Publication details

Number of pages: 73
Publication date: 2017
Languages: English
ISBN: 978 92 4 155012 3



As part of its response to the global epidemic of obesity, WHO has issued guidelines to support primary healthcare workers identify and manage children who are overweight or obese. Specifically, all infants and children aged less than 5 years presenting to primary health-care facilities should have both weight and height measured in order to determine their weight-for-height and their nutritional status according to WHO child growth standards. Comparing a child's weight with norms for its length/height is an effective way to assess for both wasting and overweight.

Where infants and children are identified as overweight, WHO recommends providing counselling to parents and caregivers on nutrition and physical activity including promotion and support for exclusive breastfeeding in the first 6 months and continued breastfeeding until 24 months or beyond. If children are obese, they should be further assessed and an appropriate management plan should be developed. This can be done by a health worker at primary health-care level, if adequately trained, or at a referral clinic or local hospital.

Additionally, stunting is a potential risk factor for children becoming overweight or obese. WHO recommends not providing formulated supplementary foods on a routine basis to children who are moderately wasted or stunted who present to primary health-care facilities. However, there may be a role for the provision of supplementary foods to children with moderate wasting in settings where there is food insecurity, at community or household level, and as part of the continuum of care for the individual child.

Annex 1. Analysis of demographic and health survey and multiple indicator cluster survey datasets

  • Barros A, Victora C.
    pdf, 841kb

    The prevalence of child underweight, wasting and stunting by region: a metaanalysis of epidemiological data from 63 LMIC countries (1993–2012). Geneva: World Health Organization; 2015

Annex 2. Systematic reviews

  • Singh M, Thumburu KK, Jaiswal N, Agarwal A.
    pdf, 2.79Mb

    Anthropometric measures during infancy and childhood and the risk of developing obesity, cardiovascular disease or diabetes mellitus type 2 in later life: a systematic review. Geneva: World Health Organization; 2015
  • Flandez KL.
    pdf, 877kb

    Nutritional assessment and growth monitoring in IMCI countries: a survey of IMCI chart booklets and clinical algorithms used in different countries, reporting current uptake and adaptations of IMCI at national level. Geneva: World Health Organization; 2015
  • Grobler L, Visser M, Siegfried N.
    pdf, 2.97Mb

    Benefits and harms of supplementary foods in moderately and severely undernourished infants and children (6–59 months). Geneva: World Health Organization; 2015

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