Evaluation of growth monitoring care process for stunted under-five aged children in two primary health care units in Cairo- Egypt

Abstract

Growth monitoring is an essential element of child health care. Children’s healthy growth and development, and detection of variations from typical growth can be confirmed by proper growth monitoring. Objective This study aimed to evaluate detection and referral processes of cases of stunting among a sample of children aged less than 5 years attending maternal and child Healthcare centers in Cairo. Methods a quality of performance study carried out to observe children aged less than 5 years attending two primary healthcare centers during their growth monitoring process to assess the quality of documentation (14 items), body measurements (Anthropometric Measurements – 11 items for height and 8 for weight measurements), plotting (3 items), interpretation (4 items) and referral of detected cases (2 items) using observational checklist. Interviewing questionnaire for healthcare workers to assess their knowledge and skills in the process of detection of stunting. Results Observed growth monitoring process was undertaken for 300 children, 51% boys and 49% girls, 44% were breastfed. Out of the sample 27 (9.3%) were < -2 Z-score height for age, 5 (1.7%) were < -2 Z-score weight for age, 5 (1.7%) were < -2 Z-score weight for height and 4 (1.3%) were < -2 Z-score body mass index for age. By Observational checklist results for growth monitoring process for documentation (28.5%) of items were not done, (53.7%) were good done and (17.8%) were satisfactory done. For measuring height (9%) of items were not done, (45.5%) were poor done, (9%) were satisfactory done and (36.5%) were good done. For measuring weight (25%) of items were not done, (6.2%) were poorly done, (12.5%) were satisfactory done and (56.3%) were good done. For plotting on growth chart (66.7%) of items were not done and (33.3%) were good done. For Interpretation of the growth pattern and referral (100%) of items not done. Conclusion Growth monitoring shows areas in need for improvement as the detection process including documentation and follow standardized anthropometric measurements, up-to-date and periodic staff training. Developing formal and well organized referral of detected stunted is a mandate.

Effect of Educational Program on Mothers’ Knowledge and Reported Practices regarding their Children Suffering from Short Stature

“…Globally, the affected children under five account for over 162 million. In Egypt, one child in five under five years old has short stature, while one in ten has very short stature [10] Short stature is an important issue that needs to be addressed. Short stature is even regarded as a disability as children suffer from impairments in cognitive, motor and language development.…”

Effect of Instructional Guidelines on Mothers' Knowledge and practices regarding Early Stunting Detection among Children under five years

“…In Egypt, one out of every five children under the age of five is stunted, with one out of every ten being severely stunted. If current trends continue, 127 million children under the age of five would be stunted by 2025 in the world (Haidar et al, 2019).…”