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  • Title: Growth charts only marginally improved maternal learning from nutrition education and growth monitoring in Lesotho.
    Author: Ruel MT, Habicht JP.
    Journal: J Nutr; 1992 Sep; 122(9):1772-80. PubMed ID: 1380982.
    Abstract:
    A study done in Lesotho in 1985-1986 assessed whether growth charts increased the impact of nutrition education and growth monitoring on maternal learning about weaning practices and diarrhea. Seven hundred and seventy six mothers were given three monthly sessions of group nutrition education along with growth monitoring of children and individual counseling. Growth charts, which were taught to one of two groups, fostered learning but only on issues related to diarrhea and only among new clinic attendants, mothers with less than secondary schooling and mothers of malnourished children. These benefits, however, were small (differences less than 10%) compared with the overall impact of the nutrition education and growth monitoring intervention (increases between baseline and post-intervention were greater than 50% for some questions). Our findings suggest that well-designed clinic-based nutrition education and growth monitoring can have a significant impact on maternal nutrition knowledge. Teaching growth charts to mothers may not be necessary for obtaining such results in programs conducted under ideal conditions. More research is needed to determine under what circumstances, for what purposes and for whom growth charts may be beneficial. Between December 1985 and November 1986, before and after 3 monthly sessions of group nutrition counseling and individual counseling about weaning and diarrhea management at 9 primary health clinics in Lesotho, researchers compared data on 575 mothers who received a growth chart to monitor their 2-year old children's growth with data on 201 mothers of 2-year old children who did not receive a growth chart. They wanted to learn whether growth charts promoted maternal learning and whether the growth charts better served some mothers than other mothers. Growth monitoring intervention improved knowledge of diarrhea management but not weaning practices. This improvement in learning about diarrhea management was limited to new clinic attendants, mothers with less than high school education, and mothers with malnourished children, however. Yet the differences in benefits between these 2 groups were 10% and insignificant. Nutrition education interventions had significantly improved knowledge of weaning practices and diarrhea management for both groups of mothers (range of improvement 3-119.2%; p.05). The greatest improvements occurred in correct responses to continuous feeding of solid foods during diarrhea (119.2% for mothers who did not receive charts and 85.2% for those who did) and to introduction of protein rich vegetables to children's diet (42.6% and 58.9%, respectively). Thus use of growth charts contributed only slightly to increased effectiveness of nutrition education. It appeared that the quality and specificity of educational projects and proper use of weight information during individual counseling contributed the most to improved maternal learning. Nevertheless further research is warranted to learn the circumstances, purposes, and target audience under which use of growth charts would bring the most benefits.
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