The efficacy and related factors of the growth monitoring and promotion programme in clinics of Vhembe district, South Africa.
Loading...
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Aim: To determine the growth monitoring and promotion (GMP) related knowledge,
perceptions and skills of nursing staff and mothers with IYC under five at selected clinics
in the rural areas of Vhembe district, Limpopo Province, South Africa.
Methods: The study sample included 82 randomly selected clinics from the four subdistricts
in Vhembe district, Limpopo province. In three of the four sub-districts, 24
clinics were sampled from from each, while the fourth sub-district was represented by
ten clinics. A cross-sectional exploratory descriptive survey employing quantitative and
qualitative data collection techniques was conducted to explore the variables under
investigation. The quantitative phase included 312 nursing staff with an equal number of
participants from each randomly sampled clinic. Data collection was conducted by
trained fieldworkers using a research instrument consisting of open- and closed-ended
questions, as well as an observation tool. A recording sheet was used for documenting
the prevalence of moderate- and severe acute malnutrition in the district. For the
qualitative phase, nine focus group discussions (FGDs), with a total of 83 purposively
sampled biological mothers of IYC were conducted in three of the four sub-districts using
a semi-structured interview guide.
Means and standard deviations were computed for continuous variables. A comparison
between means was conducted using the independent samples t-test, while correlations
between continuous variables were done with Pearson’s correlations. Frequency
distributions were calculated for categorical variables, followed by Chi-square tests to
determine the relationship between categorical variables. Time series analysis by means
of ANOVA was used to analyse the prevalence of SAM/MAM across the five years for
which clinic statistics were obtained.
For the qualitative phase of the study, FGDs were recorded on a digital voice recorder
with verbatim transcripts being translated into English by back translation. These
transcripts were imported into Atlas ti. version 8.4 computer software for thematic
content analysis, followed by the creation of themes and sub-themes for creating codes
and networks of responses.
Results: Participating nursing staff that worked with GMP for 12.0 ± 8.8 years, had a
mean knowledge score regarding GMP of 48.9%, with 40% having a score of ≤ 50%.
Fieldworker observations of nursing staff while conducting growth monitoring (GM),
generated evidence that the majority of participants did not follow the correct procedure
when measuring weight, length, height or mid-upper arm circumference (MUAC). The
low mean scores obtained for knowledge, as well as the ability to interpret growth
indicators, are cause for concern. In addition, 20.1% of the study sample was never
offered training and/or never attended refresher training following completion of their
formal training. A significant positive correlation was documented for knowledge
regarding GMP and the ability of participants to interpret growth indicators if both mean
values were expressed as percentages (r=0.251; p<0.000).
Based on the FGD discussions conducted with mothers, it was evident that they knew the
importance of taking their IYC to the clinic for GMP, despite the fact that some were not
familiar with the reasons for its importance.
Conclusion: Although nursing staff had positive perceptions regarding GMP, their
knowledge regarding the programme, as well as their ability to accurately conduct
anthropometric measurements was not optimal. Mothers of IYC that make use of GMP in
Vhembe district have the necessary knowledge regarding its importance. However, there
are several barriers preventing them from optimally utilising the GMP services offered
by clinics. Findings highlight the need for nursing staff, clinics and the Department of
Health to address the barriers mothers face, as it has the potential to impact on the aims
and successful implementation of GMP in the district.
Key concepts: Clinics, GMP, knowledge, mothers with IYC, nursing staff and skills.
Description
Doctoral Degree. University of KwaZulu-Natal, Pietermaritzburg.