A Systematic Review of Growth Monitoring as a Tool for Early Detection of Malnutrition in Infants in Nigeria
Chapter One
OBJECTIVE OF THE STUDY
The objective of this study is to systematically review existing literature on the use of growth monitoring as a tool for the early detection of malnutrition in infants in Nigeria.
Specifically, the study seeks to:
- Identify and analyze common growth monitoring practices used for infants in various regions of Nigeria.
- Evaluate the effectiveness of growth monitoring in facilitating early detection and intervention for malnutrition among Nigerian infants.
- Examine the challenges and barriers affecting the implementation and utilization of growth monitoring programs in Nigeria.
- Assess the role of caregivers, health workers, and community factors in the success or failure of growth monitoring practices.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
The Concept of Growth Monitoring (GM)
Growth Monitoring (GM) refers to the regular measurement and assessment of a child’s growth over time to detect deviations from expected growth patterns and facilitate early interventions. It involves the periodic measurement of parameters such as weight, height/length, and mid-upper arm circumference (MUAC) and the plotting of these measurements on standardized growth charts to compare with reference standards (WHO, 2008; Ashworth et al., 2021).
According to the World Health Organization (WHO, 2017), growth monitoring is an essential component of primary health care and child health services because it allows health workers and caregivers to track a child’s nutritional status and development. It serves as both a preventive and promotive tool, enabling early detection of growth faltering, malnutrition, or underlying health conditions before they become severe (Cogill, 2013; Onyango et al., 2019).
The process of GM typically involves three core elements:
Measurement – Accurate and regular collection of anthropometric data such as weight and height/length (WHO, 2008).
Interpretation – Comparison of the child’s growth trajectory with standardized reference curves, such as the WHO Child Growth Standards (de Onis et al., 2010).
Action – Communication of the results to caregivers, coupled with appropriate counseling, referral, or intervention when growth faltering is detected (Ashworth & Ferguson, 2009).
The conceptual framework of GM is rooted in the principle that consistent monitoring, combined with timely counseling and intervention, improves child survival, reduces the prevalence of undernutrition, and promotes overall health and development (Leroy et al., 2020). GM also serves as an entry point for broader child health programs, including immunization, deworming, and maternal nutrition education (Ruel et al., 2013).
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CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
This study adopted a systematic review research design. A systematic review involves a structured, transparent, and reproducible process of identifying, selecting, appraising, and synthesizing existing research evidence on a specific topic (Moher et al., 2009). This design was deemed appropriate because it allows for the integration of findings from multiple peer-reviewed and credible sources to provide a comprehensive understanding of growth monitoring as a tool for the early detection of malnutrition in infants in Nigeria.
Sources of Data
The data for this study were obtained from secondary sources, specifically published journal articles, conference papers, governmental and non-governmental reports, and relevant grey literature. Priority was given to studies conducted between 2014 and 2024 to ensure currency and relevance of the findings.
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS, AND DISCUSSION
Research Question 1:
What is the current state of growth monitoring practices for infants in Nigeria?
Growth monitoring practices in Nigeria are largely based on the use of growth charts and Mid-Upper Arm Circumference (MUAC) measurements at primary healthcare facilities (Olofin et al., 2020). Most states in Nigeria have adopted the WHO child growth standards, and these are implemented through Routine Immunization and Child Welfare Clinics (NPHCDA, 2021).
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
This systematic review examined the effectiveness of growth monitoring (GM) as a tool for the early detection of malnutrition in infants in Nigeria. The review synthesized findings from multiple peer-reviewed studies, governmental reports, and grey literature spanning the last decade. The focus was on two key research questions: the current state of growth monitoring practices and the effectiveness of these practices in detecting malnutrition early.
The review revealed that growth monitoring practices in Nigeria are unevenly implemented, with significant disparities between urban and rural health facilities. While some primary healthcare centres maintain regular anthropometric assessments (e.g., weight-for-age, height-for-age, weight-for-height, and mid-upper arm circumference measurements), others face resource constraints, such as a lack of trained health workers, inadequate equipment, and poor record-keeping systems.
In terms of effectiveness, the review found that growth monitoring is a reliable tool for the early detection of malnutrition when correctly implemented. Early identification allows for timely nutritional interventions, which can significantly reduce infant morbidity and mortality. However, the tool’s effectiveness is hindered by irregular follow-up visits, low caregiver awareness, inadequate community engagement, and poor referral systems.
The evidence also indicates that while many healthcare workers are aware of the importance of GM, gaps in training, motivation, and supervision limit the quality and consistency of data collection. Moreover, cultural beliefs, economic barriers, and limited health-seeking behaviours among caregivers reduce attendance at GM sessions, undermining its full potential.
Conclusion
Growth monitoring remains an essential component of Nigeria’s child health strategy, with strong potential to serve as an early warning system for malnutrition in infants. However, its current implementation faces significant challenges that limit its coverage, accuracy, and overall impact. The findings highlight that effectiveness depends not only on the technical aspects of measurement but also on the broader health system’s capacity, including training, supervision, equipment availability, community participation, and data use for decision-making.
Therefore, while GM is proven to be an effective tool for early detection, its benefits will only be maximized if Nigeria strengthens the operational framework supporting its delivery at both the community and facility levels.
Recommendations
Based on the findings of this review, the following recommendations are proposed:
Regularly train healthcare workers and community health extension workers on anthropometric measurement techniques, interpretation of growth charts, and counselling skills.
Ensure all primary healthcare centres are equipped with calibrated weighing scales, height/length boards, MUAC tapes, and standardized growth charts.
Conduct targeted awareness campaigns to educate caregivers on the importance of regular GM visits and follow-up checks.
REFEERENCES
- Abiodun, O., Oloruntoba, E., & Oladele, E. (2021). Health system challenges in delivering maternal and child health services in Nigeria. African Journal of Primary Health Care & Family Medicine, 13(1), e1–e8.
- Adebayo, A. M., & Olayemi, O. O. (2019). Utilization of child growth monitoring services in rural communities of South-West Nigeria. Nigerian Journal of Paediatrics, 46(3), 145–152.
- Adedokun, S. T., Adekanmbi, V. T., & Uthman, O. A. (2020). Rural-urban disparities in maternal and child health care utilization in Nigeria. BMC Public Health, 20(1), 111–123.
- Akinyemi, O. O., Owoaje, E. T., & Cadmus, E. O. (2020). Knowledge and perception of growth monitoring among mothers in Ibadan, Nigeria. Annals of Ibadan Postgraduate Medicine, 18(1), 12–19.
- Ekpo, O., Akinola, M., & Lawal, T. (2018). Assessing the capacity of frontline health workers in child growth monitoring in Nigeria. Nigerian Medical Journal, 59(2), 74–80.
- Eze, E., Agu, N., & Nwokedi, C. (2021). Community participation in child health promotion: The Nigerian experience. Journal of Community Medicine & Primary Health Care, 33(2), 44–53.
- Olatona, F. A., Aderibigbe, S. A., & Sekoni, A. O. (2018). Awareness and utilization of growth monitoring services among mothers in Lagos, Nigeria. Nigerian Postgraduate Medical Journal, 25(2), 93–98.
- Olusanya, B. O., Wright, S. M., & Nair, M. K. (2020). Improving child health through growth monitoring: The role of health workers. Lancet Child & Adolescent Health, 4(1), 7–9.
