Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa
Abstract Introduction Early childhood development (ECD) centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems. This study aimed to assess the ability of trained ECD practitioners with optimal support to correctly classify the nu...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Health Care Science |
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| Online Access: | https://doi.org/10.1002/hcs2.83 |
| _version_ | 1797293824954859520 |
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| author | Shawn W. McLaren Liana Steenkamp Jessica Ronaasen |
| author_facet | Shawn W. McLaren Liana Steenkamp Jessica Ronaasen |
| author_sort | Shawn W. McLaren |
| collection | DOAJ |
| description | Abstract Introduction Early childhood development (ECD) centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems. This study aimed to assess the ability of trained ECD practitioners with optimal support to correctly classify the nutritional status of infants and young children at ECD centres in the Nelson Mandela Bay. Methods A descriptive, cross‐sectional study was used to collect data from 1645 infants and children at 88 ECD centres. Anthropometric measurements were taken by trained fieldworkers and growth monitoring and promotion infrastructure was audited at ECD centres. Results Of the sample, 4.4% (n = 72) were underweight by weight for age Z‐score (WAZ < −2) and 0.8% (n = 13) were severely underweight (WAZ < −3). Results showed that 13.1% (n = 214) were stunted by height for age Z‐score (HAZ < −2) and 4.5% (n = 74) were severely stunted (HAZ < −3). The prevalence of moderate acute malnutrition was 1.2% and severe acute malnutrition was 0.5%, while the prevalence of overweight was 9.2% and the prevalence of obesity was 4%. A significant level of agreement between the correct interpretation and the ECD practitioners' interpretation was observed across all the anthropometric indicators investigated. The true positive wasting cases had a mean mid‐upper arm circumference (MUAC) of 14.6 cm, which may explain the high false negative rate found in terms of children identified with wasting, where ECD practitioners fail to use the weight for height Z‐score (WHZ) interpretation for screening. Conclusion By using ECD centres as hub to screen for malnutrition, it may contribute to the early identification of failure to thrive among young children. Although it was concerning that trained ECD practitioners are missing some children with an unacceptably high false negative rate, it may have been due to the fact that wasting in older children cannot be identified with MUAC alone and that accurate WFH plotting is needed. Onsite mentorship by governmental health workers may provide ECD practitioners with more confidence to screen children for growth failure based on regular WFH measurements. Moreover, ECD practitioners will be more confident to monitor the Road to Health booklets for missed vaccinations, vitamin A and deworming opportunities. |
| first_indexed | 2024-03-07T21:21:27Z |
| format | Article |
| id | doaj.art-ec81eba233e94d4cb7d75b2f85a106c9 |
| institution | Directory Open Access Journal |
| issn | 2771-1757 |
| language | English |
| last_indexed | 2024-03-07T21:21:27Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Care Science |
| spelling | doaj.art-ec81eba233e94d4cb7d75b2f85a106c92024-02-27T13:14:28ZengWileyHealth Care Science2771-17572024-02-0131324010.1002/hcs2.83Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South AfricaShawn W. McLaren0Liana Steenkamp1Jessica Ronaasen2School of Human Sciences London Metropolitan University London UKDepartment of Dietetics Nelson Mandela University Gqeberha South AfricaThe Do More Foundation Westville South AfricaAbstract Introduction Early childhood development (ECD) centres are important community hubs in South Africa and act as sites for community detection of childhood nutrition problems. This study aimed to assess the ability of trained ECD practitioners with optimal support to correctly classify the nutritional status of infants and young children at ECD centres in the Nelson Mandela Bay. Methods A descriptive, cross‐sectional study was used to collect data from 1645 infants and children at 88 ECD centres. Anthropometric measurements were taken by trained fieldworkers and growth monitoring and promotion infrastructure was audited at ECD centres. Results Of the sample, 4.4% (n = 72) were underweight by weight for age Z‐score (WAZ < −2) and 0.8% (n = 13) were severely underweight (WAZ < −3). Results showed that 13.1% (n = 214) were stunted by height for age Z‐score (HAZ < −2) and 4.5% (n = 74) were severely stunted (HAZ < −3). The prevalence of moderate acute malnutrition was 1.2% and severe acute malnutrition was 0.5%, while the prevalence of overweight was 9.2% and the prevalence of obesity was 4%. A significant level of agreement between the correct interpretation and the ECD practitioners' interpretation was observed across all the anthropometric indicators investigated. The true positive wasting cases had a mean mid‐upper arm circumference (MUAC) of 14.6 cm, which may explain the high false negative rate found in terms of children identified with wasting, where ECD practitioners fail to use the weight for height Z‐score (WHZ) interpretation for screening. Conclusion By using ECD centres as hub to screen for malnutrition, it may contribute to the early identification of failure to thrive among young children. Although it was concerning that trained ECD practitioners are missing some children with an unacceptably high false negative rate, it may have been due to the fact that wasting in older children cannot be identified with MUAC alone and that accurate WFH plotting is needed. Onsite mentorship by governmental health workers may provide ECD practitioners with more confidence to screen children for growth failure based on regular WFH measurements. Moreover, ECD practitioners will be more confident to monitor the Road to Health booklets for missed vaccinations, vitamin A and deworming opportunities.https://doi.org/10.1002/hcs2.83early childhood developmentCHWsgrowth monitoringwasting |
| spellingShingle | Shawn W. McLaren Liana Steenkamp Jessica Ronaasen Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa Health Care Science early childhood development CHWs growth monitoring wasting |
| title | Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa |
| title_full | Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa |
| title_fullStr | Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa |
| title_full_unstemmed | Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa |
| title_short | Assessment of growth monitoring among children younger than 5 years at early childhood development centres in Nelson Mandela Bay, South Africa |
| title_sort | assessment of growth monitoring among children younger than 5 years at early childhood development centres in nelson mandela bay south africa |
| topic | early childhood development CHWs growth monitoring wasting |
| url | https://doi.org/10.1002/hcs2.83 |
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