WHO Anthro Manual Rev 5
WHO Anthrofor Personal ComputersHave I nowachieved a motormilestone?ManualHey, I want to knowhow tall I am byWHO standards!Software for assessingassessinggrowth and development of theworld's childrenLet's getgoing!
World Health Organization 2011.All rights reserved.WHO Anthro software license agreement:On the use of the WHO Anthro for personal computers, version 3.2.2Software for assessing growth and development of the world's childrenThis End User License Agreement accompanies the WHO Anthro software for personal computersand all related documentation. It refers to this current software version and any upgrades or modifiedversions of it licensed by WHO. Please read this Agreement carefully before starting the installation.By installing this software you (the User) accept all the terms and conditions of this Agreement.The software and all related documentation are and shall at all times remain the intellectual property ofthe World Health Organization. Nothing contained in this Agreement shall be deemed to convey to theUser any title or ownership in the software or the related documentation. The software is being madeavailable by WHO for use in its present form for the application of the WHO Child Growth Standards.With an identification of the source WHO Anthro may be freely distributed and copied in whole, but notin part nor for sale or for use in conjunction with any commercial or promotional purpose.The software includes the following system components Microsoft .NET 2.0 Compact Framework andMicrosoft SQL Server 2005 Compact Edition.The User is not permitted to modify, adapt, translate, reverse-engineer, decompile, disassemble, orotherwise attempt to discover the source code of the software, without prior permission from WHO. Inaddition, the User is not permitted to use any part of the contents of the software to develop a productthat is to be sold or licensed for a fee. Users interested in developing any derived products are askedto contact: Department of Nutrition, World Health Organization, 20 Avenue Appia, 1211 Geneva 27,Switzerland (fax: 41 22 791 4156).All reasonable precautions have been taken by the World Health Organization to verify the informationcontained in this software. However, the software is being distributed without warranty of any kind,either express or implied. The responsibility for the use of the software lies with the User. In no eventshall the World Health Organization be liable for damages arising from its use.(i) Suggested citationAny mention of the software in published reports should include the following citation of the source:WHO Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth anddevelopment of the world's children. Geneva: WHO, 2010(http://www.who.int/childgrowth/software/en/ ).i
WHO Anthrofor Personal ComputersSoftware for assessing growthand development of the world's childrenDesigned and developed byMonika BlössnerAmani SiyamElaine BorghiMercedes de OnisAdelheid OnyangoHong YangDepartment of Nutritionfor Health and Development, Geneva, SwitzerlandJürgen ErhardtSEAMEO TROPMED, Jakarta, IndonesiaSimon Goumaz and Luc Doblerblue-infinity, sa, Geneva, SwitzerlandDepartment of Nutrition forHealth and Developmentii
AcknowledgmentsThe software was updated with the support of blue-infinity (b-i) sa, Geneva, Switzerland. We want toacknowledge the good work conducted by the b-i team.We are extremely grateful to the many individuals who helped test the new version and providedvaluable feedback, in particular: Jørn Klungsøyr (Software developer, Centre for International Health,University of Bergen, Norway), Amir Moez Naïmi (IT consultant, ServiceGeneva, Switzerland), ourcolleagues at WHO, UNICEF and SCN.The guidance and continual solid support rendered by Patrick Briand, Dorothy Leonore and LilianaPievaroli (WHO/AME) are greatly acknowledged.For the French, Portuguese, Spanish and Russian language labels we received generous assistancefrom our WHO colleagues in Geneva, Copenhagen and country offices in Mozambique, Russia,Tajikistan and Ukraine. The Chinese language version was developed in collaboration with JacobMcKean and his team of New Day Creations in Beijing, China.The development of this software was financed by a grant from the Bill and Melinda Gates Foundationto the Department of Nutrition.iii
Table of contentsWHO Anthro software license agreement: . iAcknowledgments . iiiAbbreviations.viWhat is WHO Anthro for personal computers . viiOrganization of this manual . viiiTypographic conventions . viii1.2.3.The WHO Child Growth Standards . 11.1Background and innovative aspects . 11.2Technical details on attained growth indicators . 11.3Standard growth measurement procedures. 21.4Motor development milestones. 2WHO Anthro setup. 32.1Requirements. 32.2Installation. 32.3Re-installation . 42.4Un-install the software. 52.5Configuration and language versions . 5Basic software functions . 63.1Icons . 63.2Data entry . 73.2.1Age. 73.2.2Oedema. 83.2.3Anthropometric data . 83.2.4Motor development . 93.3Results . 93.3.1BMI. 103.3.2Percentiles and z-scores . 103.3.3Colour coding . 113.3.4Graphs. 113.3.5Note on WHO standards versus NCHS reference . 123.4Variables and codes. 143.4.1Data codes . 143.4.2Flags and error tracking. 143.4.3Motor milestone codes. 144.Software modules: use and functions. 154.1Main window . 154.2Anthropometric calculator (AC). 164.2.1Data-entry window . 16iv
4.2.2Graphs. 174.3Individual assessment (IA) . 184.3.1Main window. 184.3.2New child . 214.3.3Motor milestones assessment . 244.3.4Child report. 294.3.5Import from file. 294.3.6Export to file . 294.3.7Manage additional data . 304.3.8Options . 314.4Nutritional survey (NS) . 324.4.1Windows and functions. 324.4.2Add new record to a survey . 354.4.3A special note on age . 354.4.4Options . 374.4.5Flagging on data entry . 374.4.6Motor milestones assessment . 384.4.7Address data . 404.4.8Manage additional data . 414.4.9Special spreadsheet functions . 424.4.10Results . 434.4.11Data import. 464.4.12Data export. 485.Specific functions and file formats . 485.1Address reference data . 485.1.1Country list . 485.1.2SALB data . 495.1.3State, Province and District list . 505.2Online help . 505.3About . 505.4Error log and error reporting . 515.5File formats . 515.5.1General rules . 515.5.2Notes about the format specifications . 525.5.3IA data format . 525.5.4NS data format . 535.5.5Address reference data . 546.Troubleshooting . 567.References . 57v
AbbreviationsThe following abbreviations are used in this manual:ACBAPAnthropometric calculator moduleBMI-for-age percentileBAZBMIBMI-for-age z-scoreBody mass index (weight in kg divided by height in metres squared)DoBDoVDate of birthDate of visitFAOHAPUnited Nations Food and Agricultural OrganizationLength or height-for-age percentileHAZHCLength or height-for-age z-scoreHead circumferenceHCPHCZHead circumference-for-age percentileHead circumference-for-age z-scoreIAIDIndividual assessment moduleIdentification numberMGRSMMWHO Multicentre Growth Reference StudyMotor milestonesMSMUACMicrosoftMid-upper arm circumferenceMUACPMUACZMid-upper arm circumference-for-age percentileMid-upper arm circumference-for-age z-scoreNANCHSNot availableNational Center for Health StatisticsNSOSNutritional survey moduleOperating systemPCSALBPersonal computerSecond Administrative Level BoundariesSDSSFStandard deviationSubscapular skinfoldSSFPSSFZSubscapular skinfold-for-age percentileSubscapular skinfold-for-age z-scoreTSFTSFPTriceps skinfoldTriceps skinfold-for-age percentileTSFZWAPTriceps skinfold-for-age z-scoreWeight-for-age percentileWAZWHOWeight-for-age z-scoreWorld Health OrganizationWHPWHZWeight-for-height percentileWeight-for-length and weight-for-height z-scorevi
What is WHO Anthro for personal computersWHO Anthro version 3.2.2 for personal computers, hereafter referred to as WHO Anthro, is a softwarefor use on desktop personal computers or laptops using MS Windows. It was developed to facilitateapplication of the WHO Child Growth Standards in monitoring growth and motor development inindividuals and populations of children up to 5 years of age.A first version of this software was published in 2006 together with the first set of the WHO ChildGrowth Standards (i.e. weight-for-age, height-for-age, weight-for-height, BMI-for-age and windows ofachievement for six gross motor milestones). In 2007 WHO published the second set of standards forthe indicators head-circumference-for-age, arm-circumference-for-age, triceps and subscapularskinfold-for-age, triggering the need to update the software. This provided the opportunity to furtherenhance the software, include French and Spanish language versions as well as an online help facility.The version 3 provided in addition a Russian language option and enables users in the Nutritionalsurvey module to collect address reference data and correct for cluster sampling in the analysis section.Upon request from the country office in Mozambique we developed version 3.1 which includes theoption to change the language setting to Portuguese. The Chinese-based team of the New DayCreations, a non-governmental organization developed the traditional Chinese language versionincorporated in version 3.2.2.WHO Anthro consists of three modules: Anthropometric calculator (AC) Individual assessment (IA) Nutritional survey (NS)Each module facilitates specific functions, i.e. to assess a child's nutritional status, follow a child'sdevelopment and growth over time, or conduct nutritional surveys, respectively.To continue monitoring children's growth when they are older than 60 months their individualassessment records can be imported into WHO AnthroPlus a similar software available fromwww.who.int/growthref/tools.This manual provides an overview of the WHO Child Growth Standards including the motordevelopment milestones, and instructions on how to apply them with the software. It provides guidanceon software installation and management, navigation through the fields, entering data and derivingresults.WHO Anthro for personal computers (PCs) mirrors the functionalities of WHO Anthro for mobiledevices (MDs), the sister software that has been developed for MDs running MS PocketPC 2003 or MSWindows Mobile 5.0. As both platforms are MS Windows-based, data can easily be exchangedbetween them. Both softwares use common command icons, enable the user to execute similarfunctions, and allow importing data from and exporting data to compatible file formats. WHO Anthro forPCs applies, by default, the new WHO Child Growth Standards and the former NCHS reference can beselected as an option for deriving results in the IA and the NS.The WHO Anthro software for PC and MD, their manuals can be downloaded fromwww.who.int/childgrowth/software.For more information, please contact:WHO AnthroDepartment of NutritionWorld Health OrganizationAvenue Appia 201211 Geneva 27Switzerlandfax: 44 22 791 4156Or go to web site www.who.int/childgrowthvii
Organization of this manualThe first section of this manual provides background information and presents the application of theWHO child growth standards including the gross motor development milestones.The next part describes the various software products and provides information on general installationoptions and technical requirements.Given that several software features and applications are common in all modules, particularlyconcerning data-entry, these are outlined beforehand.A separate section describes the specifications of the PC platform with step-by-step working examplesfor each of the modules.In the last sections the user will find guidance on other functions and troubleshooting.Typographic conventionsThis manual uses the following typographic conventions:ItemExample/descriptionInterface buttons with textClick Search Interface iconClickKeyboard keysPress Ctrl Alt Delete Menu pathsClick File Open Interface fields/items (labels, boxes etc.)NameUser inputType [Jane] in the Name fieldSystem menu pathsClick Start Programs Interface windowsMain(same as Add )Whenever the manual refers to titles or names that appear on the software interface, these are printedin italics.Important notes to users appear grey-shaded, as shown here, to be distinguished from the running text.viii
1. The WHO Child Growth Standards1.1 Background and innovative aspectsIn 1990 the WHO constituted a Working Group on Infant Growth to develop recommendations forappropriate uses and interpretation of anthropometry in infants and young children. The WorkingGroup’s report (WHO, 1994) led to the conclusion that the National Center for Health Statistics(NCHS)/WHO international reference was flawed and failed to depict physiologic growth adequately.Its scientific weaknesses were sufficient to interfere with the sound nutritional management of youngchildren, and the Working Group concluded that new growth curves were needed.Consequently the WHO Multicentre Growth
Organization of this manual The first section of this manual provides background information and presents the application of the WHO child growth standards including the gross motor development milestones. The next part describes the various software products and provides information on
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