Background: Undernutrition among pre-school children is a major public health issue in the developing countries including India. Head circumference (HC) is a simple, non-invasive and inexpensive anthropometric measure reflecting physical cranial growth and is considered as an indicator of past nutrition status and development of the
brain. The present cross-sectional study was carried out to determine the prevalence of undernutrition using the HC among rural pre-school children from North Bengal, India. Materials and Methods: The study was conducted among 447 rural pre-school children (boys: 208; girls: 239) aged 2-5 years who frequented the Integrated Child Development Scheme centers located in Siliguri sub-division of Darjeeling District, West Bengal, India. HC was measured and head circumference-for-age Z-score (HCAZ) was calculated using the age-sex specific L (lambda), M (mu), and S (sigma) values of the WHO Growth Reference. HCAZ values between ‘−2 to −3’ and ‘<−3’ were considered as moderately and severely undernourished, respectively. Results: The overall prevalence of
undernutrition using the HC among girls seems to be higher (58.16%) than that in case of boys (53.85%), yet this difference is statistically not significant (p>0.05). The sex-specific overall prevalence of moderate grades of undernutrition was observed to be higher among girls (35.98%) than that of the boys (30.77%) but the difference was not significant (p>0.05). The proportion of severe undernutrition was 22.18% in girls and 23.08% in boys, however, the difference was not significant (p>0.05). Conclusion: The undernutrition is prevalent in more than 50% of 2-5-year old children based on head circumference in this population, however, boys and girls are equally affected. Since HC, brain development and nutrition are all interrelated, steps should be taken in order to improve the nutritional status of these children. The present study recommends routine measurement of HC to assess undernutrition among pre-school children.