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An assessment of the effectiveness of growth monitoring and promotion practices in the Lusaka district of Zambia

Journal Article


Abstract


  • Objective: We evaluated the effectiveness of the growth monitoring and promotion (GMP) program in Zambia.

    Methods: A 3-mo prospective study of growth outcomes was undertaken at randomly selected health facilities and community posts within the Lusaka district. Children <2 y old (n ¼ 698) were purposively sampled from three health facilities (n ¼ 459) and four community posts (n ¼ 77) where health workers had undergone training inGMP and three health facilities where staff had not received training (n ¼ 162). Qualitative data on knowledge, attitudes, and practices of GMP were collected from health facility managers (n ¼ 6), health workers (n ¼ 35), and mothers whose children attended all follow-up visits (n ¼ 27).

    Results: Anthropometric status of children in all groups deteriorated, with children at community posts having the worst outcomes (change in weight-for-age Z-score 0.860.7), followed by trained (0.560.6) and untrained (–0.360.47; P < 0.05) health facilities. A similar trend was seen for weight for length. The overall dropout rate was 74.1%. Weight-for-age Z-scores were higher at 1- and 2-mo follow-up visits for children who did not complete the study at trained health facilities and community posts compared with those who remained in the study. Mothers/caregivers identified GMP as important in attending the under-five clinic, associated their child’s weight with overall health status, and expressed a willingness to comply with health workers’ advice. However, health care providers were poorly motivated, inadequately supervised, and demonstrated poor practices.

    Conclusions: The GMP program in Lusaka is functioning suboptimally, even in facilities with trained staff.

Authors


  •   Charlton, Karen E.
  •   Kawana, Beatrice (external author)
  •   Hendricks, Michael (external author)

Publication Date


  • 2009

Citation


  • Charlton, K. E., Kawana, B. M. & Hendricks, M. K. (2009). An assessment of the effectiveness of growth monitoring and promotion practices in the Lusaka district of Zambia. Nutrition, 25 (10), 1035-1046.

Scopus Eid


  • 2-s2.0-69249216411

Ro Metadata Url


  • http://ro.uow.edu.au/hbspapers/3344

Number Of Pages


  • 11

Start Page


  • 1035

End Page


  • 1046

Volume


  • 25

Issue


  • 10

Place Of Publication


  • http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6TB0-4WXRDN3-2-1&_cdi=5128&_user=202616&_orig=search&_coverDate=10%2F31%2F2009&_sk=999749989&view=c&wchp=dGLzVlz-zSkWA&md5=6666debc23bc653390a489707905ec2e&ie=/sdarticle.pdf

Abstract


  • Objective: We evaluated the effectiveness of the growth monitoring and promotion (GMP) program in Zambia.

    Methods: A 3-mo prospective study of growth outcomes was undertaken at randomly selected health facilities and community posts within the Lusaka district. Children <2 y old (n ¼ 698) were purposively sampled from three health facilities (n ¼ 459) and four community posts (n ¼ 77) where health workers had undergone training inGMP and three health facilities where staff had not received training (n ¼ 162). Qualitative data on knowledge, attitudes, and practices of GMP were collected from health facility managers (n ¼ 6), health workers (n ¼ 35), and mothers whose children attended all follow-up visits (n ¼ 27).

    Results: Anthropometric status of children in all groups deteriorated, with children at community posts having the worst outcomes (change in weight-for-age Z-score 0.860.7), followed by trained (0.560.6) and untrained (–0.360.47; P < 0.05) health facilities. A similar trend was seen for weight for length. The overall dropout rate was 74.1%. Weight-for-age Z-scores were higher at 1- and 2-mo follow-up visits for children who did not complete the study at trained health facilities and community posts compared with those who remained in the study. Mothers/caregivers identified GMP as important in attending the under-five clinic, associated their child’s weight with overall health status, and expressed a willingness to comply with health workers’ advice. However, health care providers were poorly motivated, inadequately supervised, and demonstrated poor practices.

    Conclusions: The GMP program in Lusaka is functioning suboptimally, even in facilities with trained staff.

Authors


  •   Charlton, Karen E.
  •   Kawana, Beatrice (external author)
  •   Hendricks, Michael (external author)

Publication Date


  • 2009

Citation


  • Charlton, K. E., Kawana, B. M. & Hendricks, M. K. (2009). An assessment of the effectiveness of growth monitoring and promotion practices in the Lusaka district of Zambia. Nutrition, 25 (10), 1035-1046.

Scopus Eid


  • 2-s2.0-69249216411

Ro Metadata Url


  • http://ro.uow.edu.au/hbspapers/3344

Number Of Pages


  • 11

Start Page


  • 1035

End Page


  • 1046

Volume


  • 25

Issue


  • 10

Place Of Publication


  • http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6TB0-4WXRDN3-2-1&_cdi=5128&_user=202616&_orig=search&_coverDate=10%2F31%2F2009&_sk=999749989&view=c&wchp=dGLzVlz-zSkWA&md5=6666debc23bc653390a489707905ec2e&ie=/sdarticle.pdf