Growth Monitoring: Experience from Ghana

Summaryobjective To evaluate maternal comprehension of growth charts used in growth monitoring and promotion (GMP), a worldwide programme with important budgets but contrasting results.methods Systematic literature review through MEDLINE, POPLINE, Global Health, ERIC and the Cochrane Library with the keywords 'growth monitoring' or 'growth chart' limited to the title ⁄ abstract field and to the 0-5 years age range.results Twenty studies from Asia (8), Africa (8) and Latin America ⁄ Caribbean (3) were included in the review. The results of the 14 non-intervention, cross-sectional studies provide convincing evidence that a third to three-fourths of carers in developing countries do not understand the growth charts. Literacy had a strong effect on women's ability to interpret the cards. Appropriate training and educational activities also increased substantially maternal comprehension as demonstrated in five of the six intervention trials.conclusions Many carers have poor comprehension of growth charts, but their comprehension increases not only with literacy, but also with training. Activities aimed at improving communication skills of health staff and at empowering parents to practice responsive parenting could greatly improve GMP outcomes.

“…Four other studies mentioned similar results but did not report quantitative evidence (Owen & Owen 1983; Gopaldas et al. 1990; Owusu & Lartey 1992; Rasheed et al. 1996).…”

Section: Resultsmentioning

confidence: 92%

“…1994); 14, (Morley 1994); 15, (Fagbule et al. 1990); 16, (Owusu & Lartey 1992); 17, (Wit et al. 1984); 18, (Owen & Owen 1983); 19, (Vasundhara & Harish 1993); 20, (Hughson et al.…”

Section: Discussionmentioning

confidence: 99%

Plot and see! Maternal comprehension of growth charts worldwide

Roberfroid

Pelto

Kolsteren

2007

“…Using participation rate to the weighing sessions as an indirect indicator, the observation that in many settings compliance drops after completing the immunization schedule, raises questions about the real acceptability of GMP by caretakers (Owusu & Lartey 1992; Msefula 1993; Rasheed et al. 1996; Mapatano et al.…”

Section: Resultsmentioning

confidence: 99%

“…1990; Ruel et al. 1990; Owusu & Lartey 1992; Ruel & Habicht 1992; Brown & Morley 1993; McAuliffe et al. 1993; Vasundhara & Harish 1993; Karim et al.…”

mentioning

confidence: 99%

Do growth monitoring and promotion programs answer the performance criteria of a screening program? A critical analysis based on a systematic review

Roberfroid

Kolsteren

Hoerée

et al. 2005

Summaryobjective Growth Monitoring and Promotion programs (GMP) have been intensively promoted to improve children's health in developing countries. It has been hoped that regularly weighing children would result in the early detection of growth falterers, and that the growth chart would serve as an educational tool to make that state apparent to both health workers and caretakers in order to trigger improved caring practices. Our objective was to review whether GMP answers the theoretical grounds of a screening and intervention program.method A systematic literature review was performed. The WHO framework developed by Wilson and Jungner for planning and evaluating screening programs guided the analysis.results Sixty-nine studies were retrieved. Overall, evidence is weak on the performance of GMP as a screening program for malnutrition through early detection of growth falterers. The main results are:(1) malnutrition remains a public health problem, but its importance is context specific; (2) the value of a low weight velocity to predict malnutrition is unknown and likely to vary in different contexts; (3) the performance of GMP for improving nutrition status of children and in reducing mortality and morbidity is unknown; (4) the performance of the screening is affected by the unreliability of weight measurements; (5) the promotional and educational effectiveness of GMP is low, in particular the growth chart is poorly understood by mothers; (6) the acceptability seems low in regards of low attendance rates; (7) evidence is lacking regarding cost-effectiveness.conclusions We conclude that there is too little scientific evidence to indiscriminately support international promotion of GMP. However GMP could constitute a valid strategy of public nutrition in specific situations. We indicate paths for further research and how prevention programs could be developed.

“…This contrasts with mothers' poor understanding of growth charts in other settings ( Nicholas et al . 1991 ; Owusu & Lartey 1992). Next, the detrimental effect of partial weaning on subsequent morbidity should not be overlooked.…”

Section: Discussionmentioning

confidence: 99%

How useful are anthropometric, clinical and dietary measurements of nutritional status as predictors of morbidity of young children in central Africa?

Tonglet

Lembo²,

Zihindula³

et al. 1999

Summaryobjective To identify useful predictors of morbidity of young children in central Africa. method Population-based follow-up study in Northern Kivu, Congo, of 842 children under two years of age who completed weekly follow-up interviews and health examinations during three months. Main outcome measures were crude and adjusted effects of summary measures of nutritional status on one-month cumulative incidence of malaria, respiratory illness, and diarrhoea.results Anthropometric indicators appeared to perform badly in predicting morbidity. In contrast, nonanthropometric variables such as growth as judged by the caretaker, child's diet at the time of examination, and occurrence of disease in the month preceding the interval of observation were useful.conclusions In the context of the 'Sick Child Initiative', simple tests and diagnostic tools to improve quality of both prevention and cure in first-level facilities need to be identified. Focusing on non-anthropometric indicators should be encouraged to offer a comprehensive appraisal of health status to all children.