Seeing is Believing: A Community Tool to Visualize Children's Growth

Summary:

Stunting reduction has become a centerpiece of multi-sectoral nutrition and development agendas, and the ambitious goal of preventing 20 million children from stunting is among the UN's Sustainable Development Goals (SDG). The first 1,000 days from the start of a woman's pregnancy until the child's second birthday is a critical period for healthy child growth. Yet the people who need to take action, families and communities, lack timely data and decision-making tools. Children's linear growth is not tracked routinely in health centers because height boards require time and specialized training to use or in communities due to a lack of appropriate tools. The Child Length Mat is a community tool that allows families and communities to visualize linear growth. Adapted by Indonesia and Rwanda and a pilot in Cambodia, the Child Length Mat is showing promise as an important SBC tool. Families, communities and health workers report that seeing children's growth enables them to support key behaviors in time to promote optimal child growth.

Background/Objectives

Stunting, measured as low length- or height-for-age, is a marker of chronic undernutrition. These growth impairments have life-long consequences, including cognitive impairment, a weakened immune system, and susceptibility to chronic diseases. Globally one in three children under age five are stunted a sign they will not meet their full developmental potential. The causes include inadequate diets, infections, and poor hygiene and sanitation. Children's linear growth is not tracked routinely and not communicated to parents because tools, time and specialized training are not available, leaving families not recognizing poor growth or believing that something can be done.

Description Of Intervention And/or Methods/Design

The Child Length Mat is a non-clinical, community tool developed by the Manoff Group (TMG) to help families visualize linear growth and to encourage timely action to prevent malnutrition. Made of a durable, portable material such as PVC, the colorful mat has girls' and boys' measurements side by side with markings that denote the cut-off lengths for stunting(< -2SD) using the latest World Health Organization standards at pre-determined age intervals. The use of one cut-off offers a binomial or yes/no result, omitting the need to look up a child's measurements on a growth table so that community members can use it easily. With technical assistance, national governments of Indonesia and Rwanda and a pilot in Cambodia, adapted the original mat from Bolivia to local program contexts. Adaptations included specific age categories as well as locally meaningful colors and text, and motivations to act for integration within the community program platforms.

Results/Lessons Learned

After one year of implementation in 70 communities in Cambodia, an independent consultant surveyed a random sample of 149 caregivers of children under two years and held 10 focus group discussions (FGD) with 70 community agents and caregivers. The findings suggest that the objectives of the pilot to generate demand for health services through community action and greater attention to children's linear growth were achieved. The Child Length Mat communicates to families and communities to what extent a child is on target for normal length-for-age progress over time. This enables them to address behaviors in time to promote optimal child growth. Community health volunteers shared that they integrated the length mat seamlessly into community GMP, using it with all children without adding time or task burdens. Health workers confirmed that they see more children as a result of community GMP with the Child Length Mat.

Discussion/Implications For The Field

Visualizing linear growth is a critical support to SBC for young child growth and nutrition. This community tool shows promise to integrate into on-going community programs and provide families with simple, easy-to-understand growth measurement and status.

Abstract submitted by:

Marcia Griffiths - The Manoff Group

Lisa Sherburne - The Manoff Group

Math Srales - Save the Children

Kristen LaFleche - The Manoff Group