Comparison of mothers' understanding of two child growth charts in Lesotho.

ABSTRACT

PIP: In Lesotho the Ministry of Health uses the World Health Organization (WHO) version of the road-to-health (RTH) growth chart, while the Catholic Relief Services, which administer approximately 2/3 of the primary health care (PHC) clinics in the country, use the growth surveillance (GS) system. Maternal knowledge of the charts before and after 3 months' participation in a growth monitoring program was compared. A total of 1221 mothers from 9 PHC clinics situated in the lowland and foothills of Mafeteng and Mohale's Hoek districts of Lesotho were enrolled in the study from December 1985 to April 1986. With the exception of one clinic that used the RTH chart, all the others employed the GS chart. Mothers were selected if they had a child under 2 years old and if their level of exposure to clinic activities was low. In each participating clinic, mothers were assigned sequentially to the GS group (367 mothers who received a GS chart); the RTH group (389 mothers who received an RTH chart); and the control group (465 mothers who received no growth monitoring chart). A total of 335 (27.4%) of the 1221 mothers did not complete 4 visits to the clinics. Of these drop-outs, 82 were visited at home and were administered the final questionnaire. Improvements in scores were 1.72 points for the GS group and 1.77 for the RTH group, and were significantly higher than that of the control group. Analysis of covariance indicated that there was a significantly greater improvement for the group of mothers who received instruction on the RTH chart (2.28) compared with those who were instructed on the GS chart (1.54). Relative to the results for the control mothers, the mean adjusted improvement score was several times higher for mothers who had been given instruction on the charts, while that for the controls was similar to the unadjusted improvement score.