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Rachel Durkalski DO, MPhil

  • Graduate 2019
Scholarly Research Project

Standardization of the Well-Child Check-in Rural Honduras

Rachel Durkalski, DO, Tania Castillo, MD, N. Randall Kolb, MD, and Mark Meyer, MD


Children in rural Honduras have a high risk of malnutrition and stunting, and often lack access to medical services.  During two-yearly site visits to the San Jose area, Shadyside Family Medicine Residents work with a Pittsburgh non-profit to provide well-child visits at schools. Previously, height and weight were measured without standardization, data was collected but not recorded, children potentially below the growth curve were not recognized, and no intervention was performed. This project’s objective was to standardize data collection during well-child visits and to track children below the growth curve, providing referrals when indicated.


World Health Organization standards for measuring height and weight, using a digital scale and stadiometer were followed to standardize measurements. Two electronic tablets with Z-score applications were used to calculate growth curves. Children who fell below -2 on the growth chart for height and/or weight were considered for referral for further evaluation.


During Fall Brigade 2018, the team collected standardized height and weight data for 82 children in the Cerro Prieto region; 10 were flagged for a referral.  Spring Brigade collected data from 91 patients and made seven referrals.


Gathering and tracking height/weight allows for monitoring of stunted children.  Unfortunately, many children screened are too old for any intervention against stunting.  However, school children usually are accompanied by their mothers and younger siblings so flagging school children who may be beyond intervention for stunting can become a way to intervene with younger siblings who could benefit from standardized growth measurement and nutrition intervention.