ABSTRACT
BACKGROUND: Child growth is crucial for nutritional and health status; poor growth may result in stunting. South Africa experiences a high prevalence of stunting, micronutrient deficiencies and late identification of growth faltering. Non-adherence to growth monitoring and promotion (GMP) sessions remains a challenge and caregivers contribute to non-adherence. Therefore, this study explores factors affecting the non-adherence of GMP services. METHODS: Qualitative approach and phenomenological exploratory study design were used. One-on-one interviews were conducted with 23 participants conveniently sampled. Sampling size was dependent on data saturation. Voice recorders were used to capture data. Tesch's eight steps, inductive, descriptive and open coding techniques were used to analyse data. Measures of trustworthiness were ensured through credibility, transferability, dependability and confirmability. RESULTS: Participants indicated non-adherence to GMP sessions because of a lack of knowledge of the importance of adherence and poor service by healthcare workers, which includes long waiting hours. Inconsistent availability of GMP services at healthcare facilities and growth of the firstborn children with non-adherence to GMP sessions are factors influencing participants' adherence. A lack of transportation and lunch money also contributed to non-adherence to sessions. CONCLUSION: A lack of knowledge of the importance of adherence to GMP sessions, long waiting hours and inconsistent availability of GMP services at facilities contributed enormously to non-adherence. Therefore, the Department of Health must ensure consistent availability of GMP services to demonstrate the importance and enable adherence. Healthcare facilities should reduce waiting hours to minimise the need for lunch money, and service delivery audits should be conducted to identify other factors contributing to non-adherence to address these.Contribution: Primary health care providers should conduct service delivery audits and internal surveys to identify factors that contribute to non-adherence in order to introduce measures to address them.
Subject(s)
Caregivers , Health Personnel , Humans , Child , Child, Preschool , Growth Disorders , Health Facilities , Health StatusABSTRACT
Growth monitoring and promotion (GMP) is critical in tracking child growth to address widespread malnutrition and health status. Attitudes influence behaviour change, including attendance of GMP, and negative attitudes are linked to non-attendance. Moreover, negative attitudes correlate with low socioeconomic position. South Africa is characterized by inequality, which may lead to negative attitudes towards GMP among caregivers with a poor socioeconomic status. Hence, this study seeks to explore the attitudes of caregivers of children under five towards GMP. A qualitative exploratory study design was used. Caregivers of children under five were purposively sampled. Twenty-three participants were interviewed one-on-one, and the data were recorded using voice recorders and field notes. Tesch's eight steps and inductive, descriptive, and open coding techniques were used to analyse the data. Participants understood the significance of GMP and were confident their children would benefit from it; hence, they attended sessions out of love for their children. The inconsistent availability of GMP services and the behaviour of health workers affected participants' attitude. Despite these challenges, participants felt good about GMP. Caregivers' love for their children/grandchildren helped them overcome challenges experienced at the health facilities. Good feelings about GMP boosted caregivers' attitudes and aided in adherence. An intervention to address element impacting attitudes of caregivers is recommended.
