The use of growth curve and growth chart in MCH centers in MOHJordan

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The use of growth curve and growth chart in MCH
centers in MOH-Jordan

• Presented by Dr. Mai Al-Hadidi

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• 385 MCH centers in MOH provide childhood
  services.
• Separate growth charts are provided for boys and
  girls from 0 to 36 months of age only.
• The types of growth charts are
• 1- Weight-for-age.
• 2- Height-for-age.
• 3- Weight-for-height.
• 4- Head circumference-for-age.

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• These growth charts are based on the NCHS /WHO
  standards ( National Center for Health Statistics
  USA )
• 7 percentile system is used as a classification
  system for all types of the child growth charts.
• The tools / techniques are used for measuring
  weight are
• 1- Infant scale for infants up to 24
  months old.
• 2- Adult scale for children older than
  24
• months.

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• The techniques for that are
• 1- The health provider must be sure that
  the scale is accurate fixed and in balanced
  position before weighing the baby.
• 2- For infant the weight should be taken
  when the baby is nude.
• 3- For older children the child may wear
  light clothing but not shoes.
• 4- If the child is uncooperative the health
  provider can weigh him while his mother is
  carrying him and subtracts the mother weight from
  the total.

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• The tools / for measuring the linear growth and
  stature are
• 1- Measuring board.
• 2- stadiometer .
• The techniques for that are -
• 1- The length for the infant taken by two
  examiners ( one to position ) with the child
  supine on a measuring board.
• 2- For older children, the measure was
  stature, taken with the child standing on
  stadiometer.

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Tools for measuring the headcircuference.

• 1- special tape , none distensible plastic
  measuring tape.
• 2- The techniques for that are the tape is
  placed over the mid forehead and is extended
  circumferentially to include the most prominent
  portion of the occiput, so that the greatest
  volume of the cranium is measured.

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• All the measurements should be plotted on the
  standard growth charts by midwife according to
  the guidelines, which are written in the infants
  fyle.
• MCH health worker were trained on that after
  developing these fyle .
• Any abnormality must be referred to MCH. G/P
  doctor .
• Any problem in infant growth chart which can't
  be managed must be refered to pediatrian .

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Existing Problems In The Use Of The Growth Charts
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• 1- Inaccurate plotting of the child
  measurements on the chart ( by supervisory visits
  ).
• 2- Difficulties in understanding the reference
  curve by MCH doctors and midwives (supervisory
  visit ).
• 3- Difficulties in interpreting the childs
  growth curve in order to take effective action.
• 4- Continue to have adequate official training
  of health personnel.
• 5- Continue to supply proper equipments in some
  distal areas.
• 6- Adequate protocols for managing growth curve
  problems .

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Recommendations To Improve The Use Of The Growth
Charts In Relation Tools/Techniques
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• Improve the monitoring systems for the growth
  chart ( for all problems including over weight
  and under nutrition).
• Training courses for health providers in
  interpretations of the growth chart.
• Develop guidelines for managing different
  problems.
• Supply proper equipments to MCH centers
  according to their needs and renew the old ones.
• Coordinate and cooperate with other health
  sectors in Jordan who provide these services to
  children

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• The information obtained from the growth
  charts should be used for the purpose of program
  planning and resource allocation.
• Expand growth charts of children aged from
  3 years to 18 in primary health care system.

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Thank you