Child Growth Monitoring Research Articles

Counseling and Controlling Child Development based on Information Technology at Fajar Harapan Infant and Toddler Orphanage

The orphanage is the best place for neglected children to get services, education, skills to become quality and useful children for many people. To create all that, it is necessary to improve the quality of the Orphanage. The Fajar Harapan Infant and Toddler Orphanage is currently experiencing several problems, including: Monitoring child growth using only the Manual Towards Health Card (KMS), Lack of knowledge of caregivers about child growth and development, and lack of child health equipment. Based on the existing problems, the following solutions can be given: Designing child development applications; Provide counseling, training and guidance to caregivers related to children's growth and development and nutritional intake, as well as providing orphanage health equipment. From the results of Community Service activities that have been carried out, namely the availability of applications for monitoring web-based growth and development that can be accessed online, making it easier for caregivers to see the growth and development of their foster children and making it easier for administrators to monitor the growth and development of foster children. Availability of health equipment such as scales, height measuring instruments, head circumference measuring instruments, thermometers, mattresses, and first aid kits to support growth and development control. With the existence of growth and development counseling activities, it provides the benefit of increasing caregiver knowledge about child development and increasing caregiver skills in providing nutritional intake and providing stimulation to children so that children's health and growth and development improve better.

Designing Android Based Software for Anthropometry, Hearing test, and Visual Test to Monitor Children Developmental Status

The World Health Organization (WHO) in 2018 reported that the prevalence for children under five with growth and development disorders was 28.7%, and Indonesia was included in the third country with the highest prevalence in the Southeast Asia region. As such, monitoring child growth and development is pivotal to determine necessary intervention and prevention. With technological advancement, monitoring child growth and development has become more accessible. The main objective of this paper is to explain the process of designing an Android software application for anthropometry, hearing test, and visual test to monitor children's developmental status. We employed to research and development methods, including need analysis, data collection, application design, user trial, and evaluation. The findings showed that the application could monitor growth and development in children from the age of zero to 72 months based on anthropometric testing related to auditory and visual stimulation in children. The application is useful in detecting the growth and development of children based on the results of the child's stimulation response. Based on the results of user trials by medical experts, parents, technological experts, it can be concluded that the software is applicable in monitoring the status of children's growth and development.

Training On Growth Monitoring Of Children In The Work Area Of Kayuwou Health Center

Growth monitoring is part of the health service activities carried out for infants and toddlers. It aims to improve the quality of early childhood growth and development and the readiness of children to enter formal education which is directed at improving the nutritional, cognitive, mental and psychological health status of children. 
 The population and sample in this study were 13 Posyandu located in the working area of the Kayuwou Public Health Center, Sindue Tobata District, Donggala Regency. The results show that the correct Posyandu in measuring body weight is only 15.3%, incorrect as much as 84.7%, the measurement of body length and height is only FOUR Posyandu that take measurements of body length and height and in their use fall into the category not exactly. For the correct Posyandu in filling out the KMS and Determining Growth Status, there is only ONE Posyandu (7.7%).
 The conclusion of this community service shows an increase in cadres in anthropometric measurements, filling KMS and determining growth status. This community service is important to provide knowledge and improve the skills needed by cadres to be able to determine the nutritional status of toddlers properly and correctly

The impact of growth monitoring and promotion on health indicators in children under five years of age in low- and middle-income countries

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the role of child growth monitoring and promotion (GMP) in identifying and addressing faltering growth, improving infant and child feeding practices, and promoting contact and use of health services in children under five years of age living in the community in low‐ and middle‐income countries.

Evaluation of an mHealth tool to improve nutritional assessment among infants under 6 months in paediatric development clinics in rural Rwanda: Quasi-experimental study.

Infants born preterm, low birthweight or with other perinatal complications require frequent and accurate growth monitoring for optimal nutrition and growth. We implemented an mHealth tool to improve growth monitoring and nutritional status assessment of high risk infants. We conducted a pre–post quasi‐experimental study with a concurrent control group among infants enrolled in paediatric development clinics in two rural Rwandan districts. During the pre‐intervention period (August 2017–January 2018), all clinics used standard paper‐based World Health Organization (WHO) growth charts. During the intervention period (August 2018–January 2019), Kirehe district adopted an mHealth tool for child growth monitoring and nutritional status assessment. Data on length/height; weight; length/height‐for‐age (L/HFA), weight‐for‐length/height (WFL/H) and weight‐for‐age (WFA) z‐scores; and interval growth were tracked at each visit. We conducted a ‘difference‐in‐difference’ analysis to assess whether the mHealth tool was associated with greater improvements in completion and accuracy of nutritional assessments and nutritional status at 2 and 6 months of age. We observed 3529 visits. mHealth intervention clinics showed significantly greater improvements on completeness for corrected age (endline: 65% vs. 55%; p = 0.036), L/HFA (endline: 82% vs. 57%; p ≤ 0.001), WFA (endline: 93% vs. 67%; p ≤ 0.001) and WFL/H (endline: 90% vs. 59%; p ≤ 0.001) z‐scores compared with control sites. Accuracy of growth monitoring did not improve. Prevalence of stunting, underweight and inadequate interval growth at 6‐months corrected age decreased significantly more in the intervention clinics than in control clinics. Results suggest that integrating mHealth nutrition interventions is feasible and can improve child nutrition outcomes. Improved tool design may better promote accuracy.

Minimum acceptable diet and associated factors among infants and young children aged 6–23 months in Amhara region, Central Ethiopia: community-based cross-sectional study

ObjectiveThe main objective of this study was to assess the prevalence of a minimum acceptable diet (MAD) and associated factors.DesignCommunity-based cross-sectional studySettingDebre Berhan Town, Ethiopia.ParticipantsAn aggregate of 531 infants and...

Effect of a home-based health, nutrition and responsive stimulation intervention and conditional cash transfers on child development and growth: a cluster-randomised controlled trial in Tanzania

IntroductionEvidence on the effects of community health worker (CHW) interventions and conditional cash transfers (CCTs) on child growth and development in sub-Saharan Africa remains sparse.MethodsWe conducted a single-blind, cluster-randomised controlled...

Empowerment of Posyandu Cadres in Early Detection of Child Growth Problems: Optimization of KIA Books

Posyandu (integrated health center) as a health information center for the community is expected to be the spearhead of early detection of developmental disorders in children under five. Posyandu activities are driven by cadres. Cadres monitor the growth of children under five through anthropometric measurements: body weight, height, head circumference and development milestones. Knowing how to measure anthropometric parameters, data plotting on a growth chart in the Maternal and Child Health (Kesehatan Ibu dan Anak=KIA) book, and interpret the results are very important. Cadres with good understanding and skills will greatly assist in monitoring child growth and development. This activity is expected to increase the knowledge and skills of cadres in monitoring child development. This activity was carried out through counseling, training, case study, and discussion. Pre-tests and post-tests were conducted to evaluate this activity. The mean pre-test was 40.00 ± 11.69, with the lowest value being 10.00 and the highest value being 60.00. The mean post-test was 54.10 ± 12.08, the lowest value was 30.00 and the highest was 90.00. The Wilcoxon test found p=000, where 20.5% participants' knowledge did not change while 69.23% had better knowledge compared to before the activity. Conclusion: This training can significantly improve cadres' knowledge and skills about the use of the KIA book.

HUBUNGAN BERAT BAYI LAHIR DENGAN PERTUMBUHAN PADA BATITA DI PRAKTIK MANDIRI BIDAN NURVITA SARI DESA SIMPANG CAMPANG OKU SELATAN TAHUN 2020

Basic growth that takes place from toddler to preschool will affect the development and growth of the child then. LBW babies can affect growth because since the womb, they have experienced intrauterine growth retardation. The purpose of this study was to determine the relationship between birth weight and growth in toddlers at PMB Nurvita Sari, South OKU Simpang Campang Village in 2020. This study used a cross sectional research design. The researcher used total sampling to take a sample. The results obtained from 50 respondents who were born normally as many as 42 respondents (84%), and LBW by 8 respondents (16%). And of the 50 baby respondents who experienced normal growth as many as 34 respondents (68%) and not normal as many as 16 respondents (32%). The results of the study on the relationship between birth weight and body weight / height (BB/TB) showed a p value of 0.900> 0.05, it means that there was no significant relationship between birth weight and body weight / height (BB/TB). The relationship between birth weight and height / age (TB/U) showed a p value of 0.079> 0.05, meaning that there was no significant relationship between birth weight and height for age (height / age). And the relationship between birth weight and growth shows a p value of 0.716> 0.05, which means that there was no significant relationship between birth weight and growth in toddlers. So the conclusion of this study is there was no relationship between birth weight and growth in toddlers. In this study, the secondary data did not contain head circumference data, so it is hoped that the health workers at PMB Nurvita Sari will better understand the importance of the head circumference indicator, so that growth monitoring in children can be monitored effectively.

Environmental and behavioural factors influencing the effectiveness of counselling on the feeding of infants and young children in two extremely poor Peruvian districts

ABSTRACT Background Inadequate feeding practices contribute to poor nutrition among Peruvian children. In response, Peru’s Lambayeque Regional Government funded an initiative in its four poorest districts to improve nutrition counselling skills of health-service professionals (HP). The study aimed to identify factors associated with successful communication of optimal nutrition practices to caregivers. Method Counselling data were collected in six health establishments in two of the four poorest Lambayeque districts. A thematic content analysis was completed for 30 direct observations of counselling by staff in the national child growth and development monitoring programme, 26 exit interviews with caregivers, 12 in-depth interviews (5 HP and 7 caregivers), and 5 home observations. Results Type and training of HP influenced messages given. Nurses focussed on multi-micronutrient powders and iron-rich foods; nutritionists targeted dietary diversity, food consistency, and frequency of feedings. Caregivers reported feeling more comfortable when HP used positive verbal communication and non-verbal cues. Language was a barrier (non-Quechua speaking HP), as were high HP turnover, remoteness of villages, and limited attending hours, all of which reduced opportunities for nutrition education. Learning materials and group demonstrations facilitated comprehension, but cultural beliefs prevented the adoption of some messages. Conclusions Both HP and caregivers were invested in improving infant and young child feeding practices. Trained HP demonstrated skills for effective nutrition counselling. Inclusion of nutrition education and counselling training in all HP’s curriculum, as well as in-service refresher training, is recommended to ensure all HP possess the knowledge and communication skills needed in the health services.

Infant and Child Feeding Index and nutritional status of children aged 6 to 24 months in a Metropolitan city.

Background:The nutritional status of children is influenced by feeding practices. Infant and Child Feeding Index (ICFI) is an age-specific composite index to assess the feeding practices of children.Objectives:To determine the association between ICFI and the nutritional status of children aged 6 to 24 months. To find whether ICFI has value as a tool for detecting poor nutritional status. To determine the association of ICFI and nutritional status with sociodemographic and other factors.Methods:A cross-sectional study was conducted in the urban field practice area of a tertiary care institute among 149 children aged 6 to 24 months and their mothers. Data on feeding practices were obtained and ICFI scores were calculated. The weight and length of the children were measured and Z scores (WAZ, LAZ, and WLZ) were calculated. A Chi-square test was used to find the association between the categorical variables.Results:We found no association between ICFI and any of the three nutritional indicators such as WAZ, LAZ, and WLZ. The sensitivity of the ICFI was low for detecting underweight (10.0%), stunting (29.4%), and wasting (11.1%). ICFI was significantly associated with the growth monitoring of children and mothers' education. WAZ was significantly associated with mother's education and socioeconomic class.Conclusions:There is no association between ICFI and the nutritional status of children. ICFI has limited value in detecting the poor nutritional status of children in this urban setting. Maternal education and growth monitoring of children play an important role in infant and child feeding practices.

Comparison of Nutritional Status of Under-Five Indian Children (NFHS 4 Data) Using WHO 2006 Charts and 2019 Indian Synthetic Charts.

Introduction:There is a growing body of evidence against using World Health Organization (WHO) charts for developing nations. Our objectives were: 1) To compare nutritional status of <5-year-old Indian children using WHO charts and synthetic Indian charts (SC) 2019. 2) To study nutritional status across wealth index categories. 3) To study nutritional status of predominantly breast-fed infants <6 months of age using both charts.Materials and Methods:Data from 4th National Family Health Survey (n ~ 236117, 0--59-month-old children) were used for assessing nutritional status using the WHO charts and SC. Z-scores were calculated for length/height, weight, and weight-for-height (WAZ) using both charts. Children were classified into degrees of malnutrition using appropriate cutoffs.Results:Stunting, wasting, and underweight were significantly higher using WHO charts. The prevalence of stunting (height for age) and wasting (WHZ) changed from high to medium and critical to poor when the reference changed from WHO to SC. All Z-scores showed an improving trend with increasing wealth index. On SC, almost all WHZ (wasting) from the richest to poorer were >-0.5 (clinically significant), whereas on WHO charts all wealth classes had WHZ <-0.5. For children under the age of 6 months, WHZ from richest to poorest was between -0.97 and -0.89 by WHO and 0.27 and 0.38 by SC.Conclusions:Use of Indian synthetic growth charts for growth monitoring of under-five children may be more appropriate; infants under 6 months and children from well off families performed well on these charts.

Effective coverage of nutrition interventions across the continuum of care in Bangladesh: insights from nationwide cross-sectional household and health facility surveys

IntroductionImproving the impact of nutrition interventions requires adequate measurement of both reach and quality of interventions, but limited evidence exists on advancing coverage measurement. We adjusted contact-based coverage estimates, taking...

Effects of a community health worker delivered intervention on maternal depressive symptoms in rural Tanzania.

Maternal depression affects one in four women in sub-Saharan Africa, yet evidence on effective and scalable interventions is limited. Our objective was to evaluate the effect of a community health worker (CHW) delivered home visit responsive stimulation, health and nutrition intervention, and conditional cash transfers (CCTs) for antenatal care and child growth monitoring attendance on maternal depressive symptoms. We conducted a cluster-randomized controlled trial in 12 villages in rural Ifakara, Tanzania (September 2017 to May 2019). Study villages were randomly assigned to one of three arms: (1) CHW, (2) CHW + CCT and (3) Control. Pregnant women and mothers with a child <12 months were enrolled. Maternal depressive symptoms were assessed using a Tanzanian-adapted version of the Hopkins Symptoms Checklist-25 (HSCL-25) after 18 months of follow-up. We used linear mixed-effects models to estimate intervention effects on HSCL-25 scores. Results showed that the CHW intervention significantly reduced HSCL-25 scores as compared with control [unadjusted mean difference (MD) −0.31, 95% confidence interval (CI) −0.47, −0.15]. The CHW + CCT intervention also appeared to lower HSCL-25 scores (MD −0.17, 95% CI −0.33, −0.01), but results were not statistically significant. Our findings showed that a low-intensity CHW-delivered home visit responsive stimulation, health and nutrition intervention, which did not explicitly aim to improve mental health, reduced maternal depressive symptoms, though the precise mechanisms of action remain unknown. CCTs for antenatal care and child growth monitoring appeared to provide limited to no additional benefit. Community-based integrated interventions that broadly consider maternal and child health, development and well-being have the potential to promote maternal mental health in rural Tanzania and similar settings.

Double-Duty Actions to Reduce the Double Burden of Malnutrition in Indonesia

Background: : Indonesia is facing a double burden of malnutrition (DBM). Double-duty action was promoted by WHO in 2017 which aims to tackle the double burden of malnutrition simultaneously. Objectives: This study analyzed factors associated with the double burden of malnutrition and potential of double-duty action (DDA) that is suitable for Indonesia Methods: This study is a provincial-level aggregate data set from Indonesia Basic Health Survey 2018 and National Socio-Economic Survey 2018 which covered 34 provinces. A serious DBM characterized by persistent stunting (children under five) ≥30% and coexisting overweight and obesity in adults ≥30% at the same time. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to analyze factors associated with DBM.Results: High prevalence of stunting and overweight and obesity in almost all provinces di Indonesia. Seventeen provinces were having a serious DBM. Health care access, exclusive breastfeeding and socio-economic associated with DBM. There were 4 potential DDA for Indonesia: health care which consist of antenatal care, maternal and child care, exclusive breastfeeding, child growth monitoring, and social safety net. Conclusions: Addressing the DBM through four potential DDA can be a new paradigm, mindset, and critical importance in achieving Indonesia’s target in reducing under and over nutrition simultaneously.

Growth Monitoring in Under-Three Children Using the Mother Child Protection Card

Right from its inception, ICDS programme envisaged monthly weighing and monitoring of growth in under-three children for early detection of under-nutrition. Currently accurate portable digital balances are available in anganwadi and Mother Child Production Card (MCPC) with child growth charts has been provided to children. A community based mixed longitudinal study was taken up in under-three children from urban low middle income families to assess feasibility and impact of growth monitoring and appropriate nutrition education using MCPC. Monthly weighing of children and plotting the weight-for-age in the MCPC was carried out by the research staff. A total of 5708 children were enrolled and followed up over 32879 visits between 2015 and 2019. Plotting the weight-for-age of the child in growth chart enabled identification of underweight children at the time of the visit so that appropriate nutrition and health education and care can be provided. Monthly weighing and plotting weight-for-age in growth chart enabled identification of small children growing along their own trajectory and prevented them from being mislabelled as under-nourished. Children showing deterioration in Weight for age Z score (WAZ) as compared to earlier visit(s) were readily identified and given needed advice. Personalised nutrition and health education provided at each visit taking into account current nutritional status, morbidity and Infant and Young Child Feeding Practices (IYCF) helped in preventing rise in underweight rates in the first 18 months and brought about some improvement in nutritional status of moderate and severely underweight children. It is feasible to operationalize growth monitoring as envisaged in Poshan Abhiyaan and accelerate the pace of reduction in under-nutrition in under three children.

Ethnic Disparities in Utilization of Maternal and Child Health Services in Rural Southwest China.

Background: Studies in China on ethnic disparities in access to health care in remote and rural population remain insufficient. This study aimed to assess the disparities in utilization of maternal and child health (MCH) services, including antenatal care (ANC), hospital birth, child growth monitoring, and immunization compliance between Han and ethnic minority women in Yunnan Province. Methods: A multi-stage sampling scheme was used to randomly recruit women from 40 townships in 14 remote prefectures of extremely remote areas in Yunnan. From birth records, we identified and recruited 303 Han women and 222 ethnic minority women who had given birth to a child within 3 years for an interview. Results: Overall, 96% of women used the ANC checkups and more than 95% had infants born in hospitals. However, the proportion of women compliant with early ANC visits (having antenatal care in the first trimester) was 22.5% lower in minority women than in Han women (61.3% vs. 83.8%, p < 0.001) with an adjusted odds ratio (aOR) of 2.04 (95% confidence interval (CI) of 1.13–3.66) for the minority group. The proportion of children under one year old with immunizations completed in a timely manner was also lower in minority families than in Han families (80.2% vs. 86.8%, p < 0.05) with an aOR of 1.99 (95% CI = 1.16–3.40). Conclusions: Ethnic disparities remain in utilization of early ANC visits and timely immunization completion for newborns. Ethnic minority women tended to lag behind for both. Further intervention should focus on assisting minority women living in extremely rural areas to comply with the MCH policy. Culturally-sensitive policies and skills are needed, and priority should be given to improve utilization of early ANC and timely immunization completion.

Peningkatan Kapasitas Kader Posyandu Melalui Pelatihan Pemantauan Pertumbuhan dan Perkembangan Balita di Wilayah Kerja Puskesmas Kereng Bangkirai Kecamatan Sebangau Palangka Raya

Monitoring the development of early childhood is a family task, but not all families can carry out this task optimally. Busyness, lack of knowledge, and the socio-economic condition of the family are factors that do not support this effort. Therefore, monitoring children's growth is coordinated through the role of the community through the Posyandu program. Posyandu, as one of the community-based health efforts, has a vital role in providing convenience to the community in obtaining essential services. To achieve this goal requires the role of a Posyandu cadre who has the knowledge and skills in monitoring child growth and development. The method of activity is carried out by providing material for child development and practicum on how to assess and measure children's growth and development. The results of activities were measured through differences in the results of the pre-test and post-test, as well as the results of observations when cadres provided services during Posyandu implementation. The results of the activity showed that the training in monitoring the growth and development of children under five given to Posyandu cadres could increase the knowledge and skills of cadres in providing services at Posyandu related to monitoring the growth and development of children under five.

Improving assessment of child growth in a pediatric hospital setting

BackgroundAccurate anthropometric measurements are essential for assessing nutritional status, monitoring child growth, and informing clinical care. We aimed to improve height measurements of hospitalized pediatrics patients through implementation of gold standard measurement techniques.MethodsA quality improvement project implemented computerized training modules on anthropometry and standardized wooden boards for height measurements in a tertiary children’s hospital. Heights were collected pre- and post-intervention on general pediatric inpatients under 5 years of age. Accuracy of height measurements was determined by analyzing the variance and by comparing to World Health Organization’s defined biologically plausible height-for-age z-scores. Qualitative interviews assessed staff attitudes.ResultsNinety-six hospital staff completed the anthropometry training. Data were available on 632 children pre- and 933 post-intervention. Training did not increase the proportion of patients measured for height (78.6% pre-intervention vs. 75.8% post-intervention, p = 0.19). Post-intervention, wooden height boards were used to measure height of 34.8% patients, while tape measures and wingspan accounted for 42.0% and 3.5% of measurements, respectively. There was no improvement in the quality of height measurements based on plausibility (approximately 3% height-for-age z-scores measurements flagged out of range pre- and post-intervention), digit preference (13.4% of digits pre- and 12.3% post-intervention requiring reclassification), or dispersion of measurements (height-for-age z-scores standard deviation 1.9 pre- and post-intervention). Staff reported that using the wooden board was too labor consuming and cumbersome.ConclusionsOur findings suggest that efforts to improve anthropometric measurements of hospitalized children have multiple obstacles, and further investigation of less cumbersome methods of measurements may be warranted.

"When I Breastfeed, It Feels as if my Soul Leaves the Body": Maternal Capabilities for Healthy Child Growth in Rural Southeastern Tanzania.

The burden of childhood stunting in Tanzania is persistently high, even in high food-producing regions. This calls for a paradigm shift in Child Growth Monitoring (CGM) to a multi-dimensional approach that also includes the contextual information of an individual child and her/his caregivers. To contribute to the further development of CGM to reflect local contexts, we engaged the Capability Framework for Child Growth (CFCG) to identify maternal capabilities for ensuring healthy child growth. Ethnographic fieldwork was conducted in Southeastern Tanzania using in-depth interviews, key informant interviews, participant observation, and focus group discussions with caregivers for under-fives. Three maternal capabilities for healthy child growth emerged: (1) being able to feed children, (2) being able to control and make decisions on farm products and income, and (3) being able to ensure access to medical care. Mothers’ capability to feed children was challenged by being overburdened by farm and domestic work, and gendered patterns in childcare. Patriarchal cultural norms restricted women’s control of farm products and decision-making on household purchases. The CFCG could give direction to the paradigm shift needed for child growth monitoring, as it goes beyond biometric measures, and considers mothers’ real opportunities for achieving healthy child growth.