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A Capability Approach to Child Growth

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Abstract

For decades, child growth monitoring has been performed by measuring anthropometric indicators and comparing them against universal standards. Since the 1970s various efforts have been made to expand the focus from anthropometric indicators and include broader contextual and structural factors that influence children’s growth. However, those efforts have so far not led to changes in the dimensions that are taken into account in child growth monitoring. In this paper we introduce the Capability Approach asan evaluative framework for growth monitoring of children under five years old. Applying the CA helps focusing on what children are able to achieve by analyzing their available resources (endowments), as well as the mechanisms that could enhance or restrict their access to those resources (conversion factors). In addition, children’s growth could be assessed alongside the caregivers’ capabilities that children rely on to achieve their full growth potential. We present a child growth evaluation framework as well as a matrix, which has different categories of dimensions that interact with each other and ultimately shape children’s growth. The framework is a flexible tool, and is thus broad enough to accommodate contextual differences.

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Notes

  1. The project is run at the Department of Demography, the University of Groningen, funded by NWO/WOTRO project W01.70.300.002, under the umbrella of IUNS Task Force “toward multidimensional indicators of child growth and development.

  2. Although some literature has suggested that the interpretation of the charts and the communication with caregivers during growth monitoring practices is not always effective (Gerein and Ross 1991; Roberfroid et al. 2007; Ben-Joseph et al. 2009), the tool itself and the anthropometric measures do not impose any limitations.

  3. It is also important to keep in mind that in some rural areas, health facilities might be far away, and thus difficult to get to (Ashworth et al. 2008).

  4. In this paper, we make several references to ‘caregivers,’ which could include biological or non-biological parents, same sex or heterosexual couples, grandparents or other relatives, who contribute to providing direct care to the child (depending on the culture and context). Providing further analysis on the nuances that are involved in any form and shapes of families and caregivers, or the fact that often, mothers might be the main caregiver, crucial as it is, is beyond the scope of this paper.

  5. It is not our aim in this section to provide definitions for those concepts, as doing so is beyond the scope of this paper. Thus, we merely refer to those initiatives to acknowledge the previous attempts that have inspired our framework.

  6. http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTCY/EXTECD/0,,contentMDK:20260280~menuPK:524346~pagePK:148956~piPK:216618~theSitePK:344939,00.html

  7. However, we argue that when it comes to very young children, it would be very difficult to assign an intentional component to mutual sharing. We would like to acknowledge that children’s capabilities and agency develops over time. Therefore, for older children it is crucial to examine their participation, agency and choices. However, in the context of our article and the particular focus we have for children under the age of two, child participation would not be relevant.

  8. Team agency describes the circumstance where agency is expressed by a group (e.g. the child and her caregiver) and where the actions made by the actors are interdependent to such an extent that every contribution is essential for reaching the overall result (Bellanca et al. 2011)

  9. The matrix was discussed in a brainstorming session with a group of scholars from different fields (epidemiology, nutrition, political and social sciences) in a workshop (Toward a multi-dimensional approach to child growth and development Research Workshop) in Milan, February 23rd – 24th, 2015.

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Funding

This work is financed by the Netherlands Organisation for Scientific Research (NWO) in relation to the research programme “Normative indicators of child growth and nutrition – once size fits all”, the grant (NWO/WOTRO W01.70.300.002) was awarded to Hinke Haisma in 2012.

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Authors and Affiliations

  1. Population Research Centre, University of Groningen, Groningen, the Netherlands

    Sepideh Yousefzadeh & Hinke Haisma

  2. Department of Economics and Management, University of Florence, Florence, Italy

    Mario Biggeri

  3. ARCO - Action Research for Co-Development, University of Florence, Florence, Italy

    Caterina Arciprete

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  1. Sepideh Yousefzadeh
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  2. Mario Biggeri
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  3. Caterina Arciprete
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  4. Hinke Haisma
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Correspondence to Caterina Arciprete.

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IUNS (International Union of Nutritional Sciences) Task Force (Members of the IUNS task force: Hinke Haisma (chair), Gretel Pelto, Sridhar Venkatapuram, Enrica Chiappero Martinetti, Pieter Boele, Ko van Wouwe, Shirish Darak, Sepideh Yousefzadeh.) “Toward a multidimensional approach to child health and nutrition - one size fits all?”

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Yousefzadeh, S., Biggeri, M., Arciprete, C. et al. A Capability Approach to Child Growth. Child Ind Res 12, 711–731 (2019). https://doi.org/10.1007/s12187-018-9548-1

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