Growth monitoring in rural Kenya: Experiences from a pilot project

Abstract

In most developing countries, the majority of children in rural areas suffer from growth retardation as a result of the synergism between inadequate nutrition and recurrent bouts of infection. Growth monitoring (GM) has been identified as one of the ways in which this vicious circle can be broken (Alderman et al. 1973; Siswanto et al. 1980; Cole-King 1975). The basic strategy relies heavily on the quality of work carried out by the health worker in charge of GM as well as on the full participation of the mother in the recognition of growth faltering. It also relies on the action the two take to correct the situation. Taylor emphasized the fact that faltering of child growth is the single best general indicator at an early stage of problems in child health and development (Taylor 1982). He pointed out that growth monitoring and promotion (GMP) is an hwaluable tool for assisting the health workers and parents to identify children with nutrition and health problems early enough so that timely action may be instituted. Although there seems indeed to be strong evidence supporting his view, close examination of the results from one of the early projects that is commonly being used to demonstrate the beneficial aspects of GMP, showed the real impact of GMP activities on child mortality to have been considerably less than originally claimed (Kielmann 1983). Nonetheless, based on our own experience, we do consider GMP be an extremely valuable adjunct to child care that, if properly applied under suitable conditions, will identify the child at risk and permit early intervention (Kielmann et al. 1983).