Evaluation of growth monitoring activity in Yopougon-Est Health District (Abidjan, Côte d’Ivoire)

Abstract

Abstract Background Malnutrition represents 11% of disease burden in the world and is an underlying cause of 45% of under-5 deaths. Prevention is paramount in the fight strategy. That is why, “growth monitoring” which goal is to prevent and to detect malnutrition, has been integrated into health programs. In Côte d’Ivoire, although this activity is carried out in the health centers and despite the existence of Guidelines to improve services, under-5 malnutrition prevalence remains above thresholds. Our purpose was to assess the gap between the National Guidelines for growth monitoring and the practices of health workers. Methods A descriptive cross-sectional study was conducted in all the 6 public health centers of Yopougon-Est District, from August 22 to September 05, 2018. Data were collected using an observation grid developed from the Guidelines and 3 questionnaires. Six growth monitoring sessions were observed; 6 responsibles, 9 health workers assigned to the activity and 133 mothers came to monitor their child were interviewed after informed consent. Results The growth monitoring sessions were held every working day in 4 centers. Half of health workers assigned to the activity had not received training. All centers had baby scale, 5 had horizontal height, but only one had vertical height and person scale. Most health workers (78%) were not aware of Guidelines. The steps of “interrogation and examination” component were only 58% completed. The steps for weight measurement were completed at 96% and at 70% for size. The nutritional status of children was evaluated in only one center. In no center, health workers traced growth curve. Nearly half of the mothers surveyed (45%) had not received counseling during their visits. Conclusions The study highlighted shortcomings that do not allow the achievement of growth monitoring objectives. This study cannot be extrapolated however it raises real questions about the quality of the services provided in health centers. Key messages An evaluation at large scale needs to be conducted and corrective actions to be taken to improve the growth monitoring activity for effective prevention and early detection of malnutrition. Growth monitoring will be effective in preventing malnutrition only if it is well conducted by health workers.