PERCEPTIONS, ATTITUDE AND PRACTICE OF GROWTH MONITORING BY CAREGIVERS OF UNDER-FIVE CHILDREN IN IBADAN SOUTH-WEST LOCAL GOVERNMENT AREA, OYO STATE.

Abstract

In different cultures, there are different methods of monitoring growth by Caregivers of under-five Children (CGOU-5). The scientific approach to monitor observable indicators of malnutrition and take timely corrective measures has been poorly understood by many of these caregivers, thus limiting opportunities for planning appropriate interventions. This study designed to explore perceptions, attitudes and practices of CGOU-5 Growth Monitoring in Ibadan South-West Local Government Area, Oyo State. Descriptive cross-sectional design was used. This involved four-staged sampling technique which included: ward stratification into high and low density area, proportionate sampling to determine the number of the target population to be assessed, systematic sampling to select houses and random selection of 410 caregivers for the study. A pre-tested questionnaire was administered in 12 randomised selected communities under the Wards. The questionnaire elicited information on socio-demographic characteristics, GM perceptions, knowledge, practices and future intentions. Knowledge of scientific modem GM methods was measured on 21-point scale. Perceptions were measured on 16-point scale; categorised into "negative" (<8) and "positive" (>8). Knowledge scores were classified as "high" (>15), "average" (8-15) and "poor" (<8). Attitude was measured on 11-point scale, (-<6) and (>6) categorised as negative and positive attitude respectively. This was complimented with six Focus Group Discussion (FGD) sessions. Descriptive statistics and Chi-square tests were used to analyse the quantitative data while the FGD data were analysed using thematic approach. Mean age of the CGOU-5 was 31.6±6.5 years, 46.8% had secondary education and 56.8% were traders. Majority (88.3%) had received information on GM and 66.6% heard from the health workers. Almost all the respondents (90.0%) had positive perception towards GM (10.8± 2.9), Most (76.1%) respondents' knowledge on GM was average and mean knowledge score was 9.3± 2.7. Respondents with secondary education and above (78.8%) had average knowledge of GM, compared with those who had primary (16.7%) and non-formal education (4.5%) (p<0.05). Most (98.3%) had positive attitude to GM agreeing that it should be compulsory for CGOU-5. About two thirds (65.2%) weighed their U-5 occasionally. Although, 59.3% of the respondents stated that they were capable of correctly using the weighing scale to measure children's weight, only 43.7% correctly demonstrated its use. Only 39.0% and 14.4% could correctly read and interpret growth charts respectively. Respondents' educational level was significantly associated with the ability to validate weighing scale (p<0.05). Majority of FGD participants felt GM could be done by caregivers both at home and at health facilities. The CGOU-5 expressed their concern towards non-involvement in growth monitoring. Traditional GM methods comprising daily observation of children's physical size, malnutrition indicators such as weight loss, deep eye sockets and the periodic comparison of clothing sizes, bead use and wall marking for detecting slow and upward growth trajectory were mentioned for integration with the conventional methods. Most caregivers were willing to practice growth monitoring for their under-five children. However, knowledge and skills to do so were low. This emphasizes the need to develop community-based training programmes for caregivers of under-five children to interpret both traditional and newer modern methods.