Growth monitoring as a critical means to provide primary health care

Cowan, Betty

doi:10.1007/bf02810393

Cited by 2 publications

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“…Constant repetition of the same message, such as ‘feed the child more greens’ understandably exasperated some mothers (Cape 1988; Gerein & Ross 1991). Cowan (1988), working in Ludhiana, reported that 10–15 min is needed for a meaningful contact with mothers and to elicit the needs and problems of the family.…”

Section: Quality Of Implementationmentioning

confidence: 99%

Growth monitoring and promotion: review of evidence of impact

Ashworth

Shrimpton²,

Jamil

2008

Maternal & Child Nutrition

155

185

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Table of Contents Summary86 1. Background88 1.1 History and development of growth monitoring programmes88 1.2 Objectives of growth monitoring89 2. Expected benefits of growth monitoring and growth promotion90 3. Objectives of this review91 4. Methodology91 5. Evidence of effectiveness of growth monitoring programmes91 5.1 Nutritional status and mortality of young children91 5.1.1 Studies before 199091 5.1.2 Studies since 199096 5.2 Utilization of primary health services103 6. Quality of implementation104 7. Caregivers' knowledge and understanding of growth charts105 8. Empowerment and community mobilization106 9. Coverage and attendance10710. Potential consequences if withdrawn10811. Feasibility and conditions under which growth monitoring and promotion can be expected to work10812. Cost‐effectiveness10913. Potential adverse consequences10914. Policy considerations and recommendations110References113 Summary The rationale for growth monitoring and promotion is persuasive but even in the 1980s the appropriateness of growth monitoring programmes was being questioned. The concerns centred largely around low participation rates, poor health worker performance and inadequacies in health system infrastructure that constrained effective growth‐promoting action. More recently there has been a call for a general review of the impact of large‐scale growth monitoring and promotion programmes to determine if the investments are justified. The launch of the new World Health Organization growth standard and charts has been a timely reminder of this debate. It is within this context that this review has been undertaken: the main purpose is to analyse the evidence that growth monitoring programmes are effective in conferring measurable benefits to the children for whom growth charts are kept. The benefits considered here are improved nutritional status, increased utilization of health services and reductions in mortality. There is evidence from small‐scale studies in Nigeria, Jamaica, India (Narangwal and Jamkhed), and from large programmes in Tanzania (Iringa), India (Tamil Nadu Integrated Nutrition Project), Madagascar and Senegal that children whose growth is monitored and whose mothers receive nutrition and health education and have access to basic child health services have a better nutritional status and/or survival than children who do not. There is tentative evidence from a large‐scale programme in Brazil (Ceara) that participation in growth monitoring confers a significant benefit on nutritional status independent of immunization and socio‐economic status. There is evidence from India (Integrated Child Development Services) and Bangladesh (Bangladesh Rural Advancement Committee and Bangladesh Integrated Nutrition Project) that growth monitoring has little or no effect on nutritional status in large‐scale programmes with weak nutrition counselling. There is evidence from Tamil Nadu in a randomized trial that when mothers are visited fortnightly at home and have unhurried counselling, no additional benefit accrues...

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Section: Quality Of Implementationmentioning

confidence: 99%

Growth monitoring and promotion: review of evidence of impact

Ashworth

Shrimpton²,

Jamil

2008

Maternal & Child Nutrition

155

185

View full text Add to dashboard Cite

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Monitoring the growth of the world's children

Dixon

1991

Annals of Tropical Paediatrics

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Growth monitoring and promotion is a difficult operational strategy for communicating with mothers which is based on a simple technology of weighing and charting young children and an assumption that the undoubted early warning of future low nutritional status provided by monthly growth monitoring enables corrective action to be taken to avert death. Doubts have been expressed about the efficacy and cost-effectiveness of existing growth monitoring programmes. There is an urgent need for good demonstrations of programmes in which health professionals and communities cooperate in empowering mothers to promote their children's growth, while marshalling all the primary health care activities, and yielding valuable straightforward data on the growth of the world's children.

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Growth monitoring as a critical means to provide primary health care

Cited by 2 publications

References 0 publications

Growth monitoring and promotion: review of evidence of impact

Growth monitoring and promotion: review of evidence of impact

Monitoring the growth of the world's children

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