Does Growth Monitoring Work as it Ought to in Countries of Low Literacy?

Abstract

The paper examines various aspects of the growth monitoring (GM) component of the Integrated Child Development Services (ICDS) programme of India. Data of 3704 rural children, 0-6 years of age revealed that growth of almost half of the children had never been monitored, and monitored inadequately in another 25 per cent of cases. While very few mothers (1 per cent) could interpret growth charts (GC) correctly, 87 per cent of the ICDS functionaries could do this. There was a significant and positive relationship between maternal knowledge and functionary knowledge of the growth chart (GC), and coverage of children for GM. Impact of mothers' GC knowledge on nutritional status of children was determined largely by their literacy status; however, only 17 per cent were literate. Analysis of covariance of the effect of GM on weight-for-age and morbidity controlling for socio-economic status and other programme services showed that GM did not have an impact on the nutritional or health status of children. It is therefore concluded that very high levels of illiteracy amongst mothers may be a major determinant to the success of GM programmes in India.

Do growth monitoring and promotion programs answer the performance criteria of a screening program? A critical analysis based on a systematic review

“…1989). Several studies raised concerns about the unsatisfactory level of precision reached by health workers (careless technique) (Gopaldas et al. 1990; Kuhn & Zwarenstein 1990; Dixon 1993; Dixon & Sutton 1994; Kapil et al.…”

“…Only one study reported that children of mothers who correctly interpreted test cards had a better nutritional status, but as stated by the authors the association could be confounded by many factors (Owen & Owen 1983). In another study, a positive association was also found but vanished after adjusting for literacy level (Gopaldas et al. 1990).…”

“…Literacy and training sessions seem to improve comprehension scores. Comprehension of growth chart features improved with the literacy level of the mother (Grant & Stone 1986; Gopaldas et al. 1990; McAuliffe et al.…”

“…A number of studies in Bangladesh, India, South Africa and Brazil show that the nutritional status of participating and non‐participating children in GMP was not significantly different. (Gopaldas et al. 1990; Ruel et al.…”

Assessment of Impact of Training on Knowledge of Anganwadi Workers of District Ludhiana, Punjab: Pre and Post Training Evaluation

“…Gopaldas et al [8] observed from their study that 87% of the ICDS functionaries could interpret growth charts. These findings were comparable with the findings of the present study.…”