Growth monitoring: the role of community healthvolunteers

Melville, Bendley; Fidler, T; Mehan, D; Bernard, Emmanuelle; Mullings, Jasneth

doi:10.1016/s0033-3506(05)80004-6

Cited by 16 publications

(13 citation statements)

References 2 publications

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“…As an alternative, community members without formal training could be employed as anthropometrists [18], [19], [20]. However, the reliability of measurements made from community-drawn anthropometrists has not typically been reported in prior studies.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Measurements Performed by Community-Drawn Anthropometrists from Rural Ethiopia

Ayele

Aemere²,

Gebre

et al. 2012

PLoS ONE

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BackgroundUndernutrition is an important risk factor for childhood mortality, and remains a major problem facing many developing countries. Millennium Development Goal 1 calls for a reduction in underweight children, implemented through a variety of interventions. To adequately judge the impact of these interventions, it is important to know the reproducibility of the main indicators for undernutrition. In this study, we trained individuals from rural communities in Ethiopia in anthropometry techniques and measured intra- and inter-observer reliability.Methods and FindingsWe trained 6 individuals without prior anthropometry experience to perform weight, height, and middle upper arm circumference (MUAC) measurements. Two anthropometry teams were dispatched to 18 communities in rural Ethiopia and measurements performed on all consenting pre-school children. Anthropometry teams performed a second independent measurement on a convenience sample of children in order to assess intra-anthropometrist reliability. Both teams measured the same children in 2 villages to assess inter-anthropometrist reliability. We calculated several metrics of measurement reproducibility, including the technical error of measurement (TEM) and relative TEM. In total, anthropometry teams performed measurements on 606 pre-school children, 84 of which had repeat measurements performed by the same team, and 89 of which had measurements performed by both teams. Intra-anthropometrist TEM (and relative TEM) were 0.35 cm (0.35%) for height, 0.05 kg (0.39%) for weight, and 0.18 cm (1.27%) for MUAC. Corresponding values for inter-anthropometrist reliability were 0.67 cm (0.75%) for height, 0.09 kg (0.79%) for weight, and 0.22 kg (1.53%) for MUAC. Inter-anthropometrist measurement error was greater for smaller children than for larger children.ConclusionMeasurements of height and weight were more reproducible than measurements of MUAC and measurements of larger children were more reliable than those for smaller children. Community-drawn anthropometrists can provide reliable measurements that could be used to assess the impact of interventions for childhood undernutrition.

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Section: Discussionmentioning

confidence: 99%

Reliability of Measurements Performed by Community-Drawn Anthropometrists from Rural Ethiopia

Ayele

Aemere²,

Gebre

et al. 2012

PLoS ONE

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“…30,67 Although growth monitoring is considered potentially important in child health clinics, there is often a lack of appropriate follow-up action. 6,[68][69][70] As much as functional health services may need to be made available, in order to address infectious diseases as a cause of protein-energy malnutrition it is likewise important to promote breast-feeding, improve the water supply and sanitation, and educate people about hygiene. 7,15,[71][72][73][74] The multifaceted horizontal approach of the WHO-supported Integrated Management of Childhood Illness initiative has recently been shown to be an effective strategy.…”

Section: Management and Controlmentioning

confidence: 99%

Malnutrition and health in developing countries

Müller

Krawinkel²

2005

Canadian Medical Association Journal

925

715

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MALNUTRITION, WITH ITS 2 CONSTITUENTS of protein–energy malnutrition and micronutrient deficiencies, continues to be a major health burden in developing countries. It is globally the most important risk factor for illness and death, with hundreds of millions of pregnant women and young children particularly affected. Apart from marasmus and kwashiorkor (the 2 forms of protein– energy malnutrition), deficiencies in iron, iodine, vitamin A and zinc are the main manifestations of malnutrition in developing countries. In these communities, a high prevalence of poor diet and infectious disease regularly unites into a vicious circle. Although treatment protocols for severe malnutrition have in recent years become more efficient, most patients (especially in rural areas) have little or no access to formal health services and are never seen in such settings. Interventions to prevent protein– energy malnutrition range from promoting breast-feeding to food supplementation schemes, whereas micronutrient deficiencies would best be addressed through food-based strategies such as dietary diversification through home gardens and small livestock. The fortification of salt with iodine has been a global success story, but other micronutrient supplementation schemes have yet to reach vulnerable populations sufficiently. To be effective, all such interventions require accompanying nutrition-education campaigns and health interventions. To achieve the hunger- and malnutrition-related Millennium Development Goals, we need to address poverty, which is clearly associated with the insecure supply of food and nutrition

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“…The basic message was that diet was a critical determinant of growth and development. A similar intervention in south Trelawny, Jamaica, noted a 34% decrease in prevalence of underweight coincident with the introduction of growth monitoring at home by community health volunteers, compared with a 13% decrease for the Parish as a whole, but the sample size was small (∼100) (Melville et al. 1995).…”

Section: Evidence Of Effectiveness Of Growth Monitoring Programmesmentioning

confidence: 99%

Growth monitoring and promotion: review of evidence of impact

Ashworth

Shrimpton²,

Jamil

2008

Maternal & Child Nutrition

160

185

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Table of Contents Summary86 1. Background88 1.1 History and development of growth monitoring programmes88 1.2 Objectives of growth monitoring89 2. Expected benefits of growth monitoring and growth promotion90 3. Objectives of this review91 4. Methodology91 5. Evidence of effectiveness of growth monitoring programmes91 5.1 Nutritional status and mortality of young children91 5.1.1 Studies before 199091 5.1.2 Studies since 199096 5.2 Utilization of primary health services103 6. Quality of implementation104 7. Caregivers' knowledge and understanding of growth charts105 8. Empowerment and community mobilization106 9. Coverage and attendance10710. Potential consequences if withdrawn10811. Feasibility and conditions under which growth monitoring and promotion can be expected to work10812. Cost‐effectiveness10913. Potential adverse consequences10914. Policy considerations and recommendations110References113 Summary The rationale for growth monitoring and promotion is persuasive but even in the 1980s the appropriateness of growth monitoring programmes was being questioned. The concerns centred largely around low participation rates, poor health worker performance and inadequacies in health system infrastructure that constrained effective growth‐promoting action. More recently there has been a call for a general review of the impact of large‐scale growth monitoring and promotion programmes to determine if the investments are justified. The launch of the new World Health Organization growth standard and charts has been a timely reminder of this debate. It is within this context that this review has been undertaken: the main purpose is to analyse the evidence that growth monitoring programmes are effective in conferring measurable benefits to the children for whom growth charts are kept. The benefits considered here are improved nutritional status, increased utilization of health services and reductions in mortality. There is evidence from small‐scale studies in Nigeria, Jamaica, India (Narangwal and Jamkhed), and from large programmes in Tanzania (Iringa), India (Tamil Nadu Integrated Nutrition Project), Madagascar and Senegal that children whose growth is monitored and whose mothers receive nutrition and health education and have access to basic child health services have a better nutritional status and/or survival than children who do not. There is tentative evidence from a large‐scale programme in Brazil (Ceara) that participation in growth monitoring confers a significant benefit on nutritional status independent of immunization and socio‐economic status. There is evidence from India (Integrated Child Development Services) and Bangladesh (Bangladesh Rural Advancement Committee and Bangladesh Integrated Nutrition Project) that growth monitoring has little or no effect on nutritional status in large‐scale programmes with weak nutrition counselling. There is evidence from Tamil Nadu in a randomized trial that when mothers are visited fortnightly at home and have unhurried counselling, no additional benefit accrues...

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Growth monitoring: the role of community healthvolunteers

Cited by 16 publications

References 2 publications

Reliability of Measurements Performed by Community-Drawn Anthropometrists from Rural Ethiopia

Reliability of Measurements Performed by Community-Drawn Anthropometrists from Rural Ethiopia

Malnutrition and health in developing countries

Growth monitoring and promotion: review of evidence of impact

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