Implementation of WHO, 2006 Child Growth Standards: Health Workers Knowledge, Attitudes and Practices in Kasarani, Kenya

Abstract

Introduction: In the populous Nairobi peri-urban setting, growth assessment of children, under five years of age is wanting (20%). Stunting, wasting and underweight were 17.2%, 2.5% and 3.8% respectively against the national statistics of 27%, 11% and 4%. A study was undertaken to assess health workers current levels of knowledge about WHO 2006 child growth standards, their attitudes, and practices. Methodology: The study was undertaken in Kasarani using a facility based cross-sectional survey in 45 health facilities. Purposive sampling was used to recruit 129 participants. The data were collected using an interviewer-administered questionnaire adopted and modified from the previous studies. Data were entered and analysed using the Statistical Package for Social Science     version 25.  Results: The study revealed that the calibration of the weighing instrument was more pronounced in private (66.7%) than in faith-based (28.6%) and public facilities (4.8%). Health workers with moderate knowledge were five times more likely (OR: 4.886, 95% CI 1.565-15.250) to implement WHO, 2006. Respondents who perceived growth assessment using the WHO growth standards as an effective method to detect malnutrition were thirteen times (OR=12.900; 95% CI 0.427 – 389.372) more likely to plot the child’s measurements.  Similarly, those who considered malnutrition as dangerous to child growth and development were three times (OR=2.671; 95% CI 1.042 – 6.573) more likely to be practitioners of the WHO growth standards. Significant positive correlations were found between knowledge with attitude (r=0.227), attitude with practice (r=0.226), as well as knowledge with practice (r=0.250). Conclusion: The study revealed that informed health workers may eventually develop a positive attitude and good practice towards the WHO 2006 child growth standards. Training interventions on the importance of adherence of growth monitoring guidelines may improve growth assessment.