Promoting Child Growth and Development in the Sustainable Development Goals Era: Is It Time for New Thinking?

Abstract

Growth monitoring and promotion (GMP) programs have been implemented worldwide for decades. Consistent evidence of their effectiveness is lacking and complicated by design and operational differences. Nevertheless, tracking child growth and development is a fundamental component of routine preventive child health care, and governments in 178 countries implement some form of GMP. This article makes the point that despite implementation challenges, there is a compelling need for GMP. It enables a crucial dialogue with families and communities about how to support the healthy growth and development of their children and can be a powerful tool for stimulating action and accountability for child nutrition and development at household, community, subnational, and national levels. We propose that GMP deserves a fresh rethink, with a paradigm shift that tailors GMP programs and activities for different development, geographic, and cultural contexts and considers how to optimize implementation for scalability.

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

“…The lived experiences of the mothers in the study area indicated that child growth outcomes are plural, and go beyond the indicators at the child level to include factors external to the child, such as the parents' (mothers') capabilities. Our findings are useful in rethinking child growth monitoring, as has also been suggested by [5]. Based on our study findings, we advocate for a CGM paradigm shift to ensure the healthy growth and development of under-five children.…”

“…Child growth monitoring (CGM) is one of the initiatives designed to enable timely identification of (physical) growth faltering and appropriate intervention. CGM has been incorporated into the health policies of most countries, including Tanzania, and is reflected in child care practices [5]. For decades, the discourse on child growth has been dominated by the biomedical paradigm, which constructs CGM as "the process of following the growth rate of a child in comparison to a standard by periodic anthropometric measures" [1].…”

“…In this discourse, a mono-dimensional approach that focuses only on anthropometric indicators has been used not only to identify at-risk children, but also to develop interventions to promote healthy growth. It has become the norm for health workers and public health programmers to evaluate the growth of under-five children and to intervene based on information about changes in weight and height [5][6][7][8][9].…”

Barriers and facilitators to growth monitoring and promotion in Nepal: Household, health worker and female community health volunteer perceptions

“…Although GMP is largely ubiquitous in nature, it has become increasingly apparent that country-level applications of the intervention differ substantially in purpose, design, implementation and effectiveness (Bégin et al, 2019). As Nepal continues to strive for significant reductions in child undernutrition, there is a compelling need for effective and equitable GMP implementation.…”

An Ethnography of Child Growth: socio-cultural context and meanings attached to child growth in southeastern Tanzania

“…Our key findings show that healthy child growth is perceived in the community as a multi-dimensional phenomenon, as it not only includes multiple markers that are culturally bound, but is informed by the practical opportunities that mothers have in converting available resources -including food -into healthy growth in their young children. This observation points to the need for a paradigm shift in the way child growth is currently monitored, which is in line with (Bégin et al, 2020), who suggested that there is a need to rethink growth monitoring and promotion practices. The results of this thesis revealed that in their everyday lives, the mothers experienced interplay of factors that both prevented and facilitated their engagement inappropriate child care practices, ranging from the personal to the socio-cultural levels.…”