A Simple Nutrition Screening Tool for Detecting Stunting of Pre-Schoolers: Development and Validity Assessment

Abstract

Background and Objective: Routine height measurement for school children has been conducted for 110 years. However, the validity of height measurement tools are questionable and have resulted in varying practices and data of stunting prevalence. This study aimed to assess the sensitivity of the wall growth chart for use as a nutrition screening tool in kindergarten schools. Materials and Methods: This study was a cross-sectional study. A total sample of 180 pre-schoolers were involved and recruited from eight kindergarten schools in Deli Serdang district. Each child was measured using a wall growth chart and the gold standard. A validity test was conducted to determine six validity indices; sensitivity, specificity, positive predictive value, negative predictive value, false negative and true positive. Results: The height measurements from the wall growth chart and the gold standard were quite similar. The validity indices showed that the wall growth chart had strong sensitivity and specificity, at 91.0 and 92.0%, respectively. The prevalence of stunting detected by both tools ( 21.7 vs 19.4%) was not significantly different (p<0.00). Conclusion: Wall growth charts demonstrate high validity and reliability for use as a nutrition screening tool. In future use, this tool has an ability of at least 81.5% to correctly detect stunted and normal children. The use of this tool may assist the Indonesia Education Act to conduct growth monitoring and properly prevent stunting in school children.