A study of the implementation of a facility-based growth monitoring programme: the Nairobi City councll
Abstract
This study was conducted to assess the implementation of the growth monitoring
programme in the City Council health facilities. This was to determine whether the
physical and structural components necessary to implement the programme were in place.
Nine out of 38 health facilities were randomly selected for inclusion into the study. This
selection ensured that a facility was selected from each of the selected divisions, and that
the three main types of health facilities were represented. From these nine facilities, the
attitudes of nine health administrators towards the programme were determined as well
as the knowledge and technical abilities of eighteen health workers in carrying out the
programme. This was done using questionnaires that had been previously pre-tested.
Using questionnaires. existing records and through observation. an assessment was done
on the adequacy of supplies in the facilities and the accuracy and condition of weighing
scales was determined. In addition. three hundred and eighty four programme users (the
mothers) were randomly selected and interviewed on their attitudes towards the
programme. Suggestions were also drawn on how they thought the programme could be
improved.
The findings indicate that the availability of physical and structural components necessary
to implement the programme efficiently were inadequate. This was quoted as the biggest
constraint by those who implemented the programme. Out of the nine facilities. eight of
them had a shortage of the child health cards and four of them did not have follow-up
registers, tally sheets and reference booklets. The health workers did not take correct
weights of the children because they did not adjust the scale to zero for every child.
During counselling, some of the health workers did not brief the mothers on their babies'
weight progress.
Despite these shortcomings, it was surpnsmg that most of the mothers (78 %) were
satisfied with the programme and the employed mothers created time to take their
children for growth monitoring. There was a significant difference between the mothers
who were satisfied with the programme as compared to those who were not, in that the
satisfied mothers: had received nutrition education from the facility (p <0.05), reported
a good rapport with the health workers (p <0.05), did not feel that the programme
interfered with their daily activities (p <0.05), and gave suggestions as to how the
programme could be improved (p < O.05). Most mothers suggested that for improvement
of the programme. the health workers should give them nutrition/health education every
morning prior to the growth monitoring sessions.
The study led to the conclusion that the implementation of the growth monitoring
programme in Nairobi's health facilities is inadequate. It is therefore recommended that
the Government and other Donor Agencies interested in the effective implementation of
the programme should supply the programme with the minimum supplies and resources
needed to implement it. For sustainability, it is recommended that the health
administrators should charge the mothers a small fee for each GM session attended, so
that the money generated can be used to maintain the machines and to photocopy the
child health cards when they run out of stock.
Citation
Mackenzie, C.N(1999). A study of the implementation of a facility-based growth monitoring programme: the Nairobi City councllSponsorhip
University of NairobiPublisher
Department of Food Science, Nutrition and Technology, University of Nairobi
Description
Msc Thesis