Diagnosing childhood undernutrition and accuracy of plotting growth charts in Kenya.

This study surveyed how healthcare workers (HCW) in Kenya diagnose childhood undernutrition and growth chart plotting accuracy. HCW (39) actively involved in growth monitoring completed questionnaires that included plotting of weights at ages 2, 6 and 9 months using the Kenyan road to health chart (RTH). The most commonly used measure for identifying undernutrition was weight for age collected at a single visit. Weights tended to be plotted higher than the true value, with 27 (69%) respondents plotting more than ±0.5 kg from the true value at 9 months. At 2 months 15% plotted age more than ±2 weeks from the true value, 23% at 9 months. Health workers in this local pilot study showed very poor plotting accuracy and low use of serial measurements to identify undernutrition. There is a need to improve the design of the RTH chart as well as education on chart use.