Assessment of growth monitoring activities conducted in anganwadi centers: A qualitative study in urban field practice area of a medical college in West Bengal

Abstract

Background: Growth monitoring under Integrated Child Development Services (ICDS) program is an essential strategy for the prevention and control of malnutrition. Objective: To assess growth monitoring activities done by Anganwadi workers (AWWs), the influencing factors related to it and perception of mothers about growth monitoring service. Materials and Methods: A cross-sectional study was conducted in all the Anganwadi canters of urban field practice area of Community Medicine Department of Bankura Sammilani Medical College. Qualitative data collection methods were employed which comprised of nonparticipant observation of growth monitoring activities, in depth interview (IDI) of AWWs, and focus group discussion (FGD) with mothers of enrolled children. While the checklists had been compiled in Microsoft Excel, transcripts of IDIs and FGDs were analyzed based on the thematic analysis. Results: Growth chart plotting, interpretation of growth curve, and discussion regarding child's growth had been carried out diligently, but preparation for weighing, putting child in the pants and actual weighing of the child were not properly done in all cases. AWWs mentioned logistic issues such as nonavailability of Taring scale and short supply of growth registers, perceived pressure of register maintenance, inadequate infrastructure, lack of periodic training, and supervision among the difficulties. Most of them were satisfied about community participation in growth monitoring process. Many mothers knew about weighing process, but the use of a growth chart had been reiterated by only a few. Conclusion: Logistic and infrastructural issues needed redressal while supportive supervision was essential to ensure the quality of the growth monitoring process. Mothers should also be made more involved in this key activity of ICDS.