Growth Monitoring

Eric Macharia
Aggrey Amwoga
Objectives
 To discuss the roles of the following people
in growth monitoring:
 Health worker
 Community Health Worker
 Mother/Caretaker
 Mother and child booklet
 Counseling the mother on Anthropometry
Definition of Key terms
 Growth- Increase in the physical size of the body and
organs.
 Monitoring- Keeping a regular track of something.

 Growth monitoring- Regular recording of a child’s

weight coupled with some specified remedial actions

if the weight is abnormal.
 WHO launched the new child growth standard in 2006,

which has been adopted by over 140 countries.

 The anthropometric measurements of the child is

taken at regular intervals and plotted on the growth

chart to observe the changes and advise the mother
accordingly based on the weight change.
Growth Chart
Normal Growth
 Growth occurs most rapidly during the first year of life.
 Normally, in the first three months, a baby gains about
500 grams of weight monthly. By five months, the
weight of the baby is twice that at birth and three times
by one year.
 The normal growth values help in determining the
degree to which physiological needs for growth and
development are met during the childhood period
(WHO).
 Monitoring of growth helps in assessing the nutritional
status of children and in measuring the general well
being of the population for the purposes of planning.
Roles of Health workers
 According to a WHO report (2006), health workers are
people whose job is to protect and improve the health
of the community.
 Some of their roles in growth monitoring of children

include:
I. Educating mothers on good nutrition and health
practices.
II. Taking the anthropometric measurements accurately.
III. Monitoring of the actual growth by observing the
anthropometric measurements.
IV. Teaching the mother how to use the MCH booklet by
understanding they are plotted and interpreted.
Role of community health workers
 These are the people selected from communities to receive
training to some extent, but without a formal professional
certificate in order to expand health care and coverage. In
our local set-up, most of them are unpaid.
 Some of their responsibilities include:

I. Educating mothers on the best practices regarding the

children’s nutrition.
II. They may assist the mother in the interpretation of the
growth charts and how to implement the
recommendations by the health workers.
III. Identifying cases in the community, which require
intervention by the health workers.
IV. Following up on children with cases of malnutrition.
Continued
 Community health workers are important in
ensuring more efficient detection and
forwarding of children with poor growth
given their proximity to the homesteads.
 Therefore, they require adequate training to

for efficiency in delivering care to the people.

 Have also been trained to assess and treat

pneumonia and neonatal sepsis in some

settings.
DOCTORS ROLE
 The doctor plays an important role in helping
the mother interpret the growth curve in the
mother and child booklet.
 During visits, the doctor also assesses the

health status and growth of the child and

offers appropriate interventions.
 It is also the role of the doctor to pick up

signs and symptoms of growth faltering that

the mother may miss.
Role of the Mother
I. The mother is the direct provider of the child’s
nutrition through breastfeeding and giving
other complementary feeds.
II. Implementation of the nutritional
recommendations by the health worker
according to the MCH booklet.
III. Detection of any growth abnormality and
seeking health care.
 The mother’s closeness to the child offers an

advantage of a more effective monitoring of the

child.
Roles of the MCH Booklet
 Contains vital background information
regarding the mother’s and the child’s health
in the antenatal and post-natal life. This can
help in explaining some aspects of growth
such as SGA and LGA.
 Contains standard growth charts for recording
the growth specific for age and sex of the
child.
 Contains the appropriate recommendations on
feeding and other interventions to facilitate
normal growth.
 Contains and outline of the developmental
milestones, which helps in monitoring growth.
Continued
 The advantages of the MCH booklet is that it
is standardized, allows long-term
monitoring, and can be used for educational
purposes. (ask class for the other advantages)
 However, the book requires skilled personnel

for plotting and interpretation.

Counseling the Mother on
anthropometry
 Educating the mother about the
anthropometric measures helps in early
detection of faltering growth even at home.
 It also helps in involving the mother in

growth monitoring by making her understand

the importance of the measurements.
Steps in counselling
 Check page 39 of WHO young infant feeding
 Discuss it then
 The two of you will do role play in counselling

– one will be the mother and the other will be

the doctor. – 5 minutes
References
 WHO Healthy Growth Project
 WHO Child Growth Standards
 WHO Policy Brief on Community Health

Workers.
 Mother and Child Health Booklet (MoH)