The same criteria for assessing nutritional status of children,
including internationally recommended anthropometric
reference data and standard cut-off values, are
commonly applied across different ethnic groups and to
meet several programme objectives. The situation in Fiji
is used to illustrate some issues that arise from this. Fiji
has two major ethnic groups with very different physiques,
Fijians and Indians. When using the same weight-forage
criteria to assess children of both ethnic groups, the
results always show a much higher prevalence of underweight
among Indian than among Fijian children. Yet,
it is Fijian children who have a higher infant mortality
rate due to infections and diarrhoeal diseases and have
a higher hospital admission rate due to malnutrition. Work
pressures in clinics militate against using different criteria
for growth monitoring and meeting clinic reporting
requirements. The implications are discussed. The “best”
criteria here will differ across programme objectives but
must also take account of the work setting.