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Diagnosing childhood undernutrition and accuracy of plotting growth charts in Kenya

Antonina N Mutoro1, Charlotte M Wright

  • 1PEACH Unit, School of Medicine, MVLS College, University of Glasgow, Glasgow G3 8SJ, UK.

Journal of Tropical Pediatrics
|June 14, 2013
PubMed

Insights

Healthcare workers in Kenya showed poor accuracy in plotting child growth data on the Road to Health chart. This impacts the accurate diagnosis of childhood undernutrition and highlights a need for improved training and chart design.

Area of Science:

  • Pediatrics
  • Public Health
  • Nutrition Science

Background:

  • Childhood undernutrition remains a significant global health challenge.
  • Accurate growth monitoring is crucial for early detection and intervention.
  • The Road to Health (RTH) chart is a key tool for tracking child growth in Kenya.

Purpose of the Study:

  • To assess healthcare worker (HCW) accuracy in diagnosing childhood undernutrition using the Kenyan RTH chart.
  • To evaluate the precision of HCW in plotting child weight and age data on the RTH chart.
  • To identify potential areas for improvement in RTH chart utilization and design.

Main Methods:

  • A survey was conducted with 39 healthcare workers actively involved in growth monitoring in Kenya.
  • Participants completed questionnaires involving plotting child weights at 2, 6, and 9 months on the RTH chart.
  • Accuracy was assessed by comparing plotted values to true values for weight and age.

Main Results:

  • The primary method for identifying undernutrition was weight-for-age at a single visit.
  • Significant plotting inaccuracies were observed: 69% of HCW plotted weights with >±0.5 kg error at 9 months.
  • Age plotting errors exceeded ±2 weeks for 15% of HCW at 2 months and 23% at 9 months.

Conclusions:

  • HCW in this pilot study demonstrated poor plotting accuracy on the RTH chart.
  • There is underutilization of serial measurements for diagnosing undernutrition.
  • Improvements are needed in RTH chart design and HCW education on its correct use.

Keywords:
Growth chartschildhealth personnelnutrition assessmentundernutrition

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