Child Growth Monitoring Research Articles

Growth monitoring and promotion (GMP) for children in low and middle income countries

Growth monitoring and promotion (GMP) for children in low and middle income countries

Caregivers Knowledge, Attitude and Practices on Child Growth Monitoring and Promotion Activities in Lawra District, Upper West Region of Ghana

<i>Background</i>: Growth monitoring and promotion (GMP) activities serve as an important platform for the implementation of child survival interventions to reduce malnutrition, infectious diseases and death among children. In recent times, there has been a steady decline in GMP outcome indicators in the Lawra district. The appropriate practices of GMP help in improving knowledge, attitudes and practices of caregivers towards child nutrition and health. Therefore, this study seeks to assess knowledge, attitude and practices of growth monitoring and promotion and associated factors among caregivers. <i>Methods</i>: A descriptive cross-sectional study design was used to study 300 caregivers’. Multi-stage sampling technique was used to select the participants. A semi-structured questionnaire applying face to face interview approach was used to collect data from participants. Descriptive statistics and associations between dependent and independent variables were done using Pearson chi-square and logistic regression analysis. <i>Results</i>: The results indicated 53% of the caregivers’ with good (high) knowledge in Growth Monitoring and Promotion (GMP) activities, 98% with good (high) attitudes towards GMP activities and 70% with good (high) practices in GMP. Also, 16.2% of caregivers’ children had faltered in growth. Occupation was associated with knowledge (<i>p</i>=.013), and attitude (<i>p</i>=.014). Again, educational status (<i>p</i>=.026) was associated with knowledge in GMP, marital status (<i>p</i>=.009) and child relation with caregiver (<i>p</i>=.021) were associated with attitude in GMP. Also tribe (<i>p</i>=.019) and child relation with caregiver (<i>p</i>=.019) were significantly associated with practices in GMP. Conclusions: Notwithstanding the achievement in the coverage of GMP, implementation of Infant and Young Child Feeding (IYCF) program and Information, Education and Communication (IE&C) activities in district, the findings on GMP outcome (knowledge and practice) is not satisfactorily. District Health Directorate need to intensify and strengthen IYCF activities, home visits, health education, and growth monitoring and promotion services.

Practices of growth assessment in children: Is anthropometric measurement important?

Assessing and monitoring growth iscommon practice in pediatric care, andhealth professionals accept routine growthmonitoring in children as a standardcomponent of community child health servicesthroughout the world. In clinical level, by theseactivities one can detect and intervene while growthfaltering happens. The internationally recommendedway to assess malnutrition at population level is to takeanthropometric measurements. In developedcountries, growth monitoring is an intrinsic part of‘well child’ clinics. As growth is a proxy for childhealth, the child who grows well is generally healthyand illness in a child is usually associated with poorgrowth. Interpretation of child growth is based onanthropometric indicators established in a referencepopulation with cut-off points to differentiate under-and overnutrition, short stature or tall stature,proportionate or disproportionate growth. Practicesof growth monitoring consist of regularly measuringthe weight and height of children, then plotting theinformation on a growth chart to make abnormalgrowth visible. When growth is abnormal, the healthworker does something in concert with the family andas a result of these actions the child receivesappropriate social or medical support, his or hernutrition improves, or a serious condition is diagnosedearlier.

Avaliação do crescimento em longo prazo no recém‑nascido pré‑termo egresso de unidade de terapia intensiva neonatal

Objetivos: Avaliar a recuperação do crescimento em crianças que foram prematuras, nascidas com idade gestacional (IG) menor ou igual a 34 semanas, com idade entre 16 e 24 meses, egressas de unidade de terapia intensiva neonatal (UTIN) com tempo de internação maior ou igual a 4 semanas. Buscou-se também relacionar a recuperação do crescimento à história materna, às condições de nascimento, à alimentação e à intervenção terapêutica utilizada durante a internação em UTIN. Metodologia: O cenário de realização da pesquisa foi o Ambulatório de Prematuridade do Ambulatório de Especialidades “Dr. Nelson da Costa Chaves”, do Conjunto Hospitalar de Sorocaba (CHS), no período de agosto de 2014 a abril de 2015, identificando o lactente e, posteriormente, analisando diretamente os prontuários. Foi utilizado um formulário composto de cinco partes: história materna, condições de nascimento, intervenção terapêutica do recém-nascido (RN), alimentação e avaliação do crescimento da criança. Resultados: Dos 11 participantes, 2 não recuperaram o crescimento esperado, 2 não recuperaram o perímetro cefálico e apenas um não recuperou o peso mínimo esperado. Conclusão: Maior atenção deve ser dada ao acompanhamento pré-natal, principalmente devido às patologias que podem resultar em uma restrição de crescimento intrauterino e no trabalho de parto prematuro, gerando prejuízos muitas vezes irreparáveis aos RNs.

Small investment, big returns: examining the effects of having a ‘Yellow Card’ on immunization and growth monitoring of young children in Lao PDR

Small investment, big returns: examining the effects of having a ‘Yellow Card’ on immunization and growth monitoring of young children in Lao PDR

Stunting in children (0–59 months): what is the current trend in South Africa?

ABSTRACTBackground: Stunting continues to affect young children as a global nutritional disorder. The aim of our study was to assess the prevalence, associated risk factors and spatial clustering for stunting in a disadvantaged South African District. Methods: A community-based cross-sectional weighted survey of households was conducted in the iLembe district, KwaZulu-Natal in 2014. Children aged 0–59 months were included in the study sample. Height for age Z scores were calculated for the children and the spatial clustering was assessed. Results: Of the 572 children included in the weighted analyses, 21.1% (95% confidence intervals (CI) 18.0–24.5) were classified as stunted and of these 7.5% (95% CI 5.3–10.4) were severely stunted. Conclusion: Stunting is a major public health burden in SA that requires intervention at a community level. A multi-sectoral approach is required to reduce stunting prevalence, focusing on child growth and development monitoring, nutrition education and household food security.

Anthropometric measures are simple and accurate paediatric weight-prediction proxies in resource-poor settings with a high HIV prevalence

RationaleAccurate weight measurements are essential for both growth monitoring and drug dose calculations in children. Weight can be accurately measured using calibrated scales in resource-rich settings; however, reliable scales are...

Growth surveillance in the context of the Primary Public Healthcare Service Network in Brazil: literature review

Abstract Objectives: to identify and analyze the scientific literature on child growth monitoring in the context of the primary public healthcare service network in Brazil, focusing on the main problems detected in studies. Methods: the review was based on searches ofSciELO, Lilacs and PubMed databases to identify articles published between 2006 and 2014. The articles were categorized according to the analytical categories of structure (items needed to carry out primary activities) or work processes (set of activities and procedures used in the management of resources). Results: of the 16 articles included in this review, only six dealt with structure and, in these, thetraining of professionals and availability of protocols were the most frequently identified problems. Processes, addressed in 15 articles, highlighted the underutilization of Child Health Handbook to record growth measurements and the adoption of guidelines on the basis of notes taken. Conclusions: the difficulties found demonstrate the everyday circumstances of the public health service which have a detrimental effect on growth surveillance.

Mothers Perception Of The Collective Monitoring On The Child Growth And Development

Background: Child´s Growth and Collective Development Monitoring is a practice that involves low-cost and high-efficiency technologies, based on the prerogative of health promotion. This study aims to describe the mothers´ perception about the collective monitoring of child growth and development. Method: This is a descriptive research with a qualitative approach, carried out with 13 mothers, through semi-structured interviews and participant observation. Data analysis was the technique of content analysis proposed by Bardin. Results: From the data analysis, two categories emerged: “The exchange of experiences and the autonomy of the subjects from the health promotion model”, where it was identified that the collective monitoring of child growth and development is a time favoring the approach between professionals and patients by motivating family participation by the emphasis on health promotion actions; and “The ability to recognize the reality and identify the difficulties” that indicated the change in care practice by professionals as a difficult task, but of great importance for health care. Conclusion: The mothers´ perception about the collective monitoring is directed at the health promotion model, being observed greater involvement among the participants in the consultations, bond, and autonomy.

Gender Differences in Anthropometric Indices Among Primary School Children in Delta South-Senatorial District, Delta State Nigeria

Purpose: the purpose of this study was to assess gender differences in anthropometrics of weight, height, body mass index (BMI) and mid upper-arm-circumference. Method: the method was the exploratory study design. The sampled population was 510 primary school children between the ages of 6 – 12 years obtained by multi-stage sampling techniques along with simple ballot method. Two research questions and one hypothesis guided the study. Data were obtained through the use of weighing bathroom scale, standiometer, tape and calculating BMI from wt (kg)/ht(m)2. Findings: there was no significant difference between weight and reference standard weight; between height and reference standard height; between muac and reference standard muac. It was found that boys have advantage over girls in weight, body mass index and mid upper-arm-circumference, while height was equal in both genders. There was no significant difference in weight and reference standard weight, in height and reference standard height except in bmi and reference standard bmi. It was found that gender anthropometric was not significantly different from the international reference standard. It was evident from this study that there was no gender difference in anthropometric measures among children in this study. Recommendation: it was recommended that the present nutritional status of children be maintained and regular growth monitoring of children as health surveillance as to maintain the status and detect early warning signs, among others.

An assessment of facilities and services at Anganwadi centers under the Integrated Child Development Service scheme in Northeast District of Delhi, India.

The current study was aimed to assess the facilities and services being provided at the Anganwadi Centres (AWCs) by the Anganwadi workers with regards to the norms laid down by Integrated Child development Service (ICDS) scheme, with special emphasis on the children of 0-6 years of age. Cross-sectional study. A resettlement colony of North-West District of Delhi, having a population of hundred thousand. A total of 41 AWCs were present in the study area and were included in our study. The Anganwadi workers at these AWCs were interviewed. The outcome measures were the facilities present at the AWCs and knowledge of Anganwadi workers regarding the services to be provided and revised supplementary nutrition norms laid down by ICDS. The AWCs in the area were covered under three projects namely Project A, B and C consisting of 18, 9 and 14 AWCs, respectively. The mean room size for all the AWCs was 108.97 ± 62.18 square feet. A weighing machine was present in 29 (70.7%) of the AWCs. Growth charts for growth monitoring of children were present in 28 (68.3%) of AWCs. A drug kit was not present in 14 (34.1%) of the 41 AWCs. The mean number of children of 0-3 years enrolled per AWC was 45.78 ± 14.07. However, the mean number of children present at the time of the visit at the AWCs was 6.24 ± 5.39. Knowledge of Anganwadi workers regarding revised norms for calorie and protein for beneficiaries was found to be poor. This study showed a lack of facilities at the AWCs and poor knowledge of Anganwadi workers. Thus a regular training and supportive supervision of the Anganwadi workers is recommended along with the availability of adequate facilities and infrastructures.

Availability of Village Health and Nutrition Day services in Uttarakhand, India.

Background:Village Health and Nutrition Day (VHND) was identified to provide primary care services (health, nutrition and sanitation) at village level under National Rural Health Mission.Aim:The study aimed to assess availability of health, nutrition and sanitation services, required instruments/equipment and medicines at VHND with client satisfaction from the VHND services.Materials and Methods:A cross-sectional study was conducted in three districts of Uttarakhand at Nainital, Tehri-Garhwal and Chamoli involving 24 villages in six blocks using multistage stratified sampling using predesigned pretested observation checklists (quantitative data). All the concerned functionaries of health, Integrated Child Development Services and Panchayati Raj Institution were interviewed (qualitative data) to understand the gap in services and remediation.Results:Of the 24 VHNDs observed, blood pressure measurement was done at 11 (45.83%) and weight at 13 (54.17%) sites in ante-natal care services; non-availability of blood pressure instrument and adult weighing machine were 45.83% and 41.66% sites, respectively. Immunization for children was provided at 22 sites; however, availability of other services were poor-vitamin A (three), growth monitoring of children (seven); supplementary nutrition (five); identification of households for construction of toilet (eight). Yet, one-third of clients provided three and four for satisfaction from VHND services on the scale score of 1–5.Conclusion:It was noted that none of the VHND site was providing all the stipulated services, though immunization was provided mostly. Anganwadi centers were lacking availability of various essential instruments and equipment. So regular orientation of village functionaries for ensuring all the VHND services with the availability of required logistic is recommended.

Awareness, perception and practice of stakeholders in India regarding Village Health and Nutrition Day.

Background:Village Health and Nutrition Day (VHND) is a community-based health service package delivered on a fixed day approach. Services like early registration of pregnancy, regular antenatal care and postnatal care, growth monitoring and referral of sick children, discussion of health topics to generate awareness, and convergence between health and ICDS, are delivered every month at VHND at the Anganwadi Center. This study explores the awareness, perception and practice of service providers, and beneficiaries, regarding VHND.Materials and Methods:It was a cross-sectional study conducted in Odisha during December 2009–November 2010. Personal interviews were conducted at the VHND sessions with 111 beneficiaries and 45 service providers using a semi-structured schedule to know their awareness, perception and practice regarding VHND sessions. Data analysis was done and reported as simple percentages.Results:Most of the health worker females and anganwadi workers considered health awareness as a key component of VHND. 52% of HWFs and 41% of AWWs had misconception about additional roles and responsibilities. 34% of beneficiaries had knowledge regarding fixed day approach of VHND, while 24% did not have knowledge regarding any of its purpose. Only 8% of referral cases had complete knowledge on the reason of referral. There was significant difference in between awareness and practice among the blocks.Conclusion:Service providers’ orientation should be improved. Behavior change communication activities should also be increased by the state. Referral cases should be properly counseled. The community believed that such a program should continue with better package and quality of services.

Effect of Nutritional Intervention among Children with Protein Energy Malnutrition

Nutritional problems like protein energy malnutrition (PEM), anemia and vitamin A deficiency continue to plague a large proportion of Indian children. Faulty feeding practices and recurrent infections make this age group more vulnerable1. A quasi experimental one group pretest post test study was conducted among 109 under five children in Koayam district to determine the effectiveness of nutritional intervention to the children with protein energy malnutrition. The study population consisted of 109 children in the age group of 2–5 years and their mothers aending selected anganwadies of Koayam District, during the period of data collection. The subjects were selected by using non probability purposive sampling technique. To identify the effectiveness of nutritional interventional programme of PEM repeated measures ANOVA was used. Mauchly's W test was used to check the homogeneity of variances. Since the P value (0.051) is more than 0.05, the variances are equal. The P value for the factor, sphericity assumed is <0.05 (F=114.403). Hence there is a difference in mean PEM over a period of time. It indicates the nutritional intervention is effective. Keeping in mind the results obtained in this study reveals the need for multi pronged approach like maternal and child health care, nutrition education and growth monitoring to combat the problem of malnutrition.

Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states.

Update on primary hypobetalipoproteinemia.

"Primary hypobetalipoproteinemia" refers to an eclectic group of inherited lipoprotein disorders characterized by low concentrations of or absence of low-density lipoprotein cholesterol and apolipoprotein B in plasma. Abetalipoproteinemia and homozygous familial hypobetalipoproteinemia, although caused by mutations in different genes, are clinically indistinguishable. A framework for the clinical follow-up and management of these two disorders has been proposed recently, focusing on monitoring of growth in children and preventing complications by providing specialized dietary advice and fat-soluble vitamin therapeutic regimens. Other recent publications on familial combined hypolipidemia suggest that although a reduction of angiopoietin-like 3 activity may improve insulin sensitivity, complete deficiency also reduces serum cholesterol efflux capacity and increases the risk of early vascular atherosclerotic changes, despite low low-density lipoprotein cholesterol levels. Specialist laboratories offer exon-by-exon sequence analysis for the molecular diagnosis of primary hypobetalipoproteinemia. In the future, massively parallel sequencing of panels of genes involved in dyslipidemia may play a greater role in the diagnosis of these conditions.

Perceived responsibilities and operational difficulties of anganwadi workers at a coastal south Indian city

<b>Context:</b> Anganwadi worker (AWW) is an important functionary in integrated child development scheme (ICDS). <b>Aim:</b> To study perceived responsibilities, workload, operational difficulties, and satisfaction level of AWWs. <b>Materials and Methods:</b> Prospective observational cross-sectional study of 66 AWWs using a pre-designed proforma: Analysis using Statistical package for social sciences (SPSS) version 11.5. <b>Results:</b> Pre-school education, house visits, records-keeping were perceived as important activities by 92.4%, 60.6%, and 57.6%, respectively, growth monitoring and immunization by 3% and 4.5%, respectively; 51.5% did not have adequate time for duties, and 74.2% were doing non-ICDS duties. Heavy workload was the major perceived operational difficulty for 66.7% of the respondents. Timely supplementary food was available as per 92.4%. Inadequacies in equipments, workspace, training, and staffing were noted by 47%, 18.2%, 7.6%, 7.6%, respectively. No operational difficulties were seen by 10.6%. Induction job training was provided to 36 (54.5%), and 17/66 (25.8%) felt they were inadequately trained despite yearly refresher courses. Dissatisfaction with monthly honorarium, availability of equipment, supplementary food, and maintenance of registries was reported by 89.4%, 53%, 54.6%, and 43.9%, respectively. Despite this, 62.1% (40/66) were satisfied. <b>Conclusions:</b> Supplementary nutrition, growth monitoring, and immunization of children along with health education though being primary duties were given less emphasis. Heavy workload was the major perceived operational difficulty. Adequate staff, workspace, equipments, timely monthly honorarium should be provided along with training and avoidance of non-ICDS duties would help in achieving the objectives of ICDS.

Acompanhamento do crescimento infantil em unidades básicas de saúde da família do município de Queimadas, Paraíba, Brasil

Estudo transversal que teve por objetivo avaliar as ações de acompanhamento do crescimento no contexto da atenção básica à saúde, no município de Queimadas, Paraíba, Brasil destacando aspectos estruturais e processuais. Foi aplicado um questionário às 204 mães das crianças estudadas, bem como analisados os instrumentos destinados ao acompanhamento da saúde das crianças e as 16 unidades de saúde do município. Na estrutura, observaram-se a completitude da equipe mínima e a capacitação dos enfermeiros para o atendimento à criança como principais limitações. Quanto ao processo, o pior desempenho foi para os registros de peso e de estatura nos últimos três meses. Para o registro de peso nos últimos três meses, o melhor desempenho foi constatado na zona urbana. Em função de atos realizados em discordância com o que preconizam as políticas públicas de atenção à saúde da criança, os achados indicam a não consolidação efetiva da ação de acompanhamento do crescimento.

Assessment the Relationship between Parents' Literacy Level with Children Growth in Mashhad: An Analytic Descriptive Study

Introduction: Present children are the investments of community in the future. Preparing children health which leads to the stability of community health, provided to accurate implementation of educational and health programs in the community and especially in mothers. So it is necessary to determine the relationship between parents' literacy with growth rate in children. Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 300 mothers referring to 10 selected Mashhad health-care centers for monitoring their 6-24-month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic statistics and using SPSS 16. Results: Present findings showed a significant relationship between literacy level of parents with child growth status, breast feeding rate, junk food consumption, referring to health care center for growth monitoring, the age of initiating supplementary nutrition, the use of oil and butter in baby food and rate of attending in educational classes. So that higher literacy level of parents was associated with using more formula, less junk food, oil and butter in baby's food and more referring times to health care center for monitoring child growth, desirable growth, and also initiating supplementary food more at the assigned time (P<0.05). Conclusion: Parents' literacy level influence on children growth status. However, with increasing parents' literacy level, using formula for infants has been increased, but breast milk feeding is also high in this group.

Comparison of NCHS-1977, CDC-2000 and WHO-2006 Nutritional Classification in 32 to 60 month-old Children in the Central Highlands of Peru (1992-2007)

Objective. The aim is to compare the three references used for the classification of the nutritional status of 36 to 60 month-old children in Huancayo province (Peru). For a long time, NCHS-1977 reference has been used for child growth monitoring, recently the new WHO-2006 Child Growth Standards is being used, and CDC-2000 reference usage has been restricted. Methods. Data collected from 2640 children over the period 1992 to 2007 served as basis for determining the nutritional children status using Anthro V.3.0 and EpiInfo 6.04. Internationally cutoff points used in every assessed reference system helped to determine the nutritional status and to calculate the Z-scores of height-for-age, weight-for-age, weight-for-height and body mass index differentiated by sex. Results. The underweight, stunting and wasting percentages (period 992-2007), determined with NCHS-1977 reference were 8.4%, 28.8% and 0.9%; with CDC-2000 reference were 10.2%; 19.1% and 3.3%, and with WHO-2006 standard were 6.6%, 33.9% and 1.4% respectively. The overweight and obesity percentages determined with CDC-2000 standard were 11.4% and 4.20%, and with WHO-2006 standard were 8.0% and 0.9%, respectively. Conclusions. A more realistic and accurate detection of malnutrition prevalence in 36-to-60 month-old children from Huancayo province was carried out using the new WHO Child Growth Standard. Using the CDC-2000 standard is recommended in overweight monitoring cases.