Roberfroid Dominique, Lefèvre Pierre, Hoerée Tom, Kolsteren Patrick
Department of Public Health, Nutrition Unit, Institute of Tropical Medicine, 2000 Antwerp, Belgium.
J Health Popul Nutr. 2005 Sep;23(3):207-14.
The growth chart has been proposed as an educational tool to make the child's growth visible to both health workers and caregivers and to enhance communication between them. In the case of growth faltering, this would trigger timely corrective measures. Although the relevance of growth monitoring and promotion (GMP) has often been questioned in the literature, opinions of District Medical Officers responsible for local implementation of GMP are unknown. The aim of this qualitative research was to explore the perceptions and difficulties of an international panel of District Medical Officers regarding GMP. As an exploratory study, in-depth interviews of an international panel of District Medical Officers (n=19) were conducted. Data were coded using the QSR Nudist 5.0 software. A discrepancy between intended purposes and practice of GMP was detected at two levels. First, lack of participation of care-givers was reported. Second, the District Medical Officers expressed a restrictive interpretation of the concept of growth monitoring. The communication with parents was never reported as a means or a result of GMP, neither as an evaluation criterion of programme efficiency. The growth chart was mainly considered a tool intended to be used by health services for the purpose of diagnosis. This two-fold discrepancy between the intention of international policy-planners and practice of local programme implementers could be a crucial factor affecting the performance of GMP. More emphasis should be put on social communication and involvement of caregivers.
生长图表已被提议作为一种教育工具，使卫生工作者和照顾者都能看到儿童的生长情况，并加强他们之间的沟通。对于生长发育迟缓的情况，这将促使及时采取纠正措施。尽管生长监测与促进（GMP）的相关性在文献中经常受到质疑，但负责当地实施GMP的地区医务官员的看法尚不清楚。这项定性研究的目的是探讨一个由地区医务官员组成的国际小组对GMP的看法和困难。作为一项探索性研究，对一个由地区医务官员组成的国际小组（n = 19）进行了深入访谈。数据使用QSR Nudist 5.0软件进行编码。在两个层面上发现了GMP预期目的与实践之间的差异。首先，据报告照顾者参与不足。其次，地区医务官员对生长监测概念的解释较为狭隘。从未将与家长的沟通报告为GMP的一种手段或结果，也未将其作为项目效率的评估标准。生长图表主要被视为卫生服务机构用于诊断目的的工具。国际政策制定者的意图与地方项目实施者的实践之间的这种双重差异可能是影响GMP绩效的一个关键因素。应更加重视社会沟通和照顾者的参与。
