Experiences of child health nurses managing malnourished children in the growth monitoring and promotion service in region D, Gauteng province
Date
2014-03-25
Authors
Magalemele, Henrietta Molelekeng
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Abstract
The World Health Organization states that childhood malnutrition remains a critical but preventable public health problem. The condition contributes to a large percentage of morbidity and mortality in children below five years of age. The health and development of this age group is monitored in the Growth Monitoring and Promotion (GMP) program. The GMP is a focus area of the Integrated Nutrition Programme, which is a nutrition strategy located within the Primary Health Care framework.
The Growth Monitoring and Promotion service implements, within the Child Health service, strategies and interventions that aim to improve the nutritional status of children below the age of five.
The identification, surveillance and monitoring of undernourished children relies heavily on information gathered at primary health care level. Factors such as difficulties in compiling statistics and in following up on malnourished children, and lack of expertise and time for counselling the caregiver, can result in the GMP service being less effective.
The aim of this study was to answer the following question: What factors, identified from the experiences of Child Health Nurses, have an effect on the quality of the GMP service? To answer this question, three objectives were formulated: these were to explore and describe the experiences of the Child Health Nurses in managing malnourished children in the GMP service, and to identify the challenges facing them in the service. Recommendations for improvement would also be found from the Child Health nurses.
To achieve the study objectives, a qualitative, exploratory and descriptive approach was used as a research design to investigate the GMP service from the perspective of Child Health Nurses who run the child health clinics.
A purposive sampling method was used to select participants for in-depth interviews. The population consisted of 14 Child Health Nurses. Interviews were conducted and data saturation was achieved after 6 interviews. Data were analysed using a thematic content analysis approach.
The study found that information exchange forms a major part of the GMP service and has the components of counselling, recoding and reporting. Another finding was that there are organisational factors which affect the effectiveness of the service, relating to human and material resources, amongst others. Emotional consequences of the factors were also found to play a part.
Conclusions reached from the findings were that the sharing of information played a major role in the GMP service, but could be hindered by challenges mainly stemming from service-related factors which could affect provision of the service. These included limited opportunity to engage appropriately with parents, inadequate record keeping, shortage of human and material supplies and factors related to parents and caregivers.
Emotional consequences – either from the poor growth of the child, or the unfavourable conditions which affect the service – could also affect both parents or service providers.
Suggestions for the improvement of the service were elicited from the study participants, as well as recommendations for further research from the researcher.