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Post a reply: Anthropometric survey target group: 0-59 months vs. 6-59 months and implications

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Greetings EN-NET,
When I learned to do anthro surveys years ago, I was taught to sample children 6-59 months old. The rationale includes this group being most vulnerable to nutrition deficits, whereas infants less than 6 months should still be breastfed exclusively and are "protected".
Increasingly I am seeing anthropometric survey reports that are based on sampling 0-59 month olds, including DHS reports and other surveys by UNICEF done in emergency settings. I would really appreciate guidance on:
1) What are the implications on the results and interpretation of the results, when sampling from the 0-59 month age group?
2) Can we compare survey results based on 6-59month olds with DHS/MICS data drawn from 0-59month old sample?
3) we are trying to develop survey guidelines for survey teams in multiple countries and want to have uniformity. We may or may not have functional electronic scales for all countries. Should we sample from 0-59 months? Or stay with 6-59 month olds?

One resource I read from UNHCR also says "The systematic inclusion of infants aged 0-5 months in anthropometric survey is not currently recommended by UNHCR for the following main reasons: (1) The accurate weight measurement of infants 0-5 months requires an infant scale with a higher precision (+/-10g) than those most commonly used on the field (+/- 100g); (2) If a meaningful, precise estimate of infant malnutrition is needed for programmatic purposes, sample size requirements can be difficult to meet; (3) Interpretation of malnutrition results among children aged 6-59 months and 0-59 months are often wrongly used interchangeably and compared; and (4) Reporting malnutrition results among children aged 6-59 months is currently the norm in refugee settings and emergencies. However, in certain circumstances, where there may be particular concerns over the nutritional status of infants 0 – 5 months old, these infants may also be included in the anthropometric assessment if proper scales are used, specialised training is provided for measuring infants’ length (e.g. a cloth needs to be used below the knees of infants during length measurement) and sample size requirements are met. "
Please kindly help me make sense of this dilemma.
Many thanks!

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