ABSTRACT
Recent data shows that Nigeria has the 12th (with Niger) highest under- five mortality rate of 143 per 1,000 live births. It is estimated that 60% of under-five deaths in developing countries are attributable to malnutrition and it is a threat to the achievement of the Millennium Development Goal (MDG). In sub-Saharan Africa under nutrition poses a major challenge for child survival and development in the region. In developing countries, knowledge of growth monitoring among mothers/caregivers is generally poor and the extent of practice and attitude to its use among them varies from one community to another. In Nigeria, child mortality and malnutrition rates are far higher in the North East and North West geopolitical zones than in other parts of the country. To address this, it is important for mothers'/caregivers' of under-fives to be aware of early and regular monitoring of growth using growth chart (also known as ?road-to-health?). METHODOLOGY: A descriptive cross-sectional study of 360 mothers of under-fives, who presented in Dr Gwamna Awan General Hospital Kakuri, Kaduna in October 2012 was done. The mothers were selected using ballot sampling and interviewed using interviewer-administered pre-tested questionnaires and four (4) growth charts showing different growth curve situations were used: overweight above the upper reference curve, normal ascending within the reference curves, static within the reference curves, and dangerous below the lower reference curve. The socio-demographic characteristic of respondents: age, educational status, income, parity and number of living children were cross tabulated with the respondents' correct interpretation of the growth monitoring curves. Likert scaling was used to score the mothers'/caregivers' perception of and attitude to the growth monitoring chart and practice. The SPSS statistical software package was used in analysing the data and the results presented in frequency tables, and charts. The data was analyzed using 1(one) way Analysis of Variance (ANOVA) to investigate the influence of each factor on the mothers' ability to correctly interpret the chart. A 2-way Analysis of Variance (ANOVA) was also carried out to see if all the factors combined together would yield a different influence on the interpretation of the chart. Ap-value of <0.05 was considered as statistically significant. RESULTS: The mean age of the 360 respondents was 26.03 (SD 1.63). Majority of the respondents were Christians (67.5%) and had had some formal education (73.9%). Few of them had no formal education (23.1%). Those that had heard of and seen the growth chart were 38.1% and 59.0% respectively. Only 11.7% of those that have heard of growth chart got the information from health workers. Correct interpretation of growth charts was poor (30%) Although 67.8% of the respondents said their children had growth charts, less than half of them (41.1%) had it available as at the time of clinic attendance. About a third (38.1%) of them had been taught on how to weigh their children, 28.9% could actually conduct weighing. Age p-value=0.005, Educational status p-value=0.02, level of income p-value=0.007,and number of living children p-value=0.0003were the factors that had statistical significance to influence the mothers' ability to interpret the charts. CONCLUSION: The findings of this study clearly show that mothers'/caregivers' awareness and knowledge of the growth monitoring chart is poor. Their knowledge of the process of monitoring child's growth using the growth chart is poor; they tended to confuse the growth monitoring program with the immunization exercise. More emphasis should be on the involvement of mothers/caregivers to practice growth monitoring, interpretation of growth chart and early interventions when abnormal growth curves are noticed.