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Free Content Plot and see! Maternal comprehension of growth charts worldwide

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Summary Objective  To evaluate maternal comprehension of growth charts used in growth monitoring and promotion (GMP), a worldwide programme with important budgets but contrasting results. Methods  Systematic literature review through MEDLINE, POPLINE, Global Health, ERIC and the Cochrane Library with the keywords ‘growth monitoring’ or ‘growth chart’ limited to the title/abstract field and to the 0–5 years age range. Results  Twenty studies from Asia (8), Africa (8) and Latin America/Caribbean (3) were included in the review. The results of the 14 non-intervention, cross-sectional studies provide convincing evidence that a third to three-fourths of carers in developing countries do not understand the growth charts. Literacy had a strong effect on women’s ability to interpret the cards. Appropriate training and educational activities also increased substantially maternal comprehension as demonstrated in five of the six intervention trials. Conclusions  Many carers have poor comprehension of growth charts, but their comprehension increases not only with literacy, but also with training. Activities aimed at improving communication skills of health staff and at empowering parents to practice responsive parenting could greatly improve GMP outcomes.


Evaluer la compréhension maternelle des diagrammes de croissance utilisés dans la surveillance et la promotion de la croissance, un programme mondial avec des budgets importants mais des résultats variables. Méthodes 

Revue systématique de littérature sur Medline, Popline, Global Health, ERIC, et la bibliothèque de Cochrane avec les mots-clés «surveillance de croissance» ou « diagramme de croissance», limités à la section titre/résumé et pour la tranche d’âge de zéro à 5 ans. Résultats 

20 études en Asie (8), Afrique (8) et ‘Amérique latine/Caraïbes (3) ont été incluses dans l’analyse. Les résultats de 14 études transversales sans intervention fournissent l’évidence convaincante qu’un tiers à trois-quarts des mères dans les pays en voie de développement ne comprennent pas les diagrammes de croissance. L’instruction a un effet important sur la capacité des femmes à interpréter les diagrammes. Une formation appropriée et des activités éducatives augmentent également substantiellement la compréhension maternelle comme le démontrent 5 des 6 études d’intervention. Conclusions 

Beaucoup de mères ont une compréhension faible des diagrammes de croissance, mais leur compréhension augmente non seulement avec l’instruction mais également avec la formation. Les activités visant à améliorer les aptitudes de communication des agents de la santé et l’habilitation des parents pour la pratique parentale adéquate pourrait considérablement améliorer les résultats de la surveillance et la promotion de la croissance.
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Keywords: communication; comprehension; comprensión; compréhension; comunicación; diagrammes de croissance; educación materna; growth charts; gráficas de crecimiento; maternal education; programme theory; review; revisió; revue; teoría de programa; théorie de programme; éducation maternelle

Document Type: Research Article

Affiliations: 1:  Nutrition and Child Health Unit, Department of Public Health, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium 2:  Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA

Publication date: September 1, 2007

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