Non-adherence to growth monitoring and promotion sessions amongst caregivers of children under 5 years in Polokwane Municipality, Limpopo province

Abstract

Background: Child growth is crucial for nutritional and health status; poor growth may result in stunting. South Africa experiences a high prevalence of stunting, micronutrient deficiencies and late identification of growth faltering. Non-adherence to growth monitoring and promotion (GMP) sessions remains a challenge and caregivers contribute to non-adherence. Therefore, this study explores factors affecting the non-adherence of GMP services.
Methods: Qualitative approach and phenomenological exploratory study design were used. One-on-one interviews were conducted with 23 participants conveniently sampled. Sampling size was dependent on data saturation. Voice recorders were used to capture data. Tesch’s eight steps, inductive, descriptive and open coding techniques were used to analyse data. Measures of trustworthiness were ensured through credibility, transferability, dependability and confirmability.
Results: Participants indicated non-adherence to GMP sessions because of a lack of knowledge of the importance of adherence and poor service by healthcare workers, which includes long waiting hours. Inconsistent availability of GMP services at healthcare facilities and growth of the firstborn children with non-adherence to GMP sessions are factors influencing participants’ adherence. A lack of transportation and lunch money also contributed to non-adherence to sessions.
Conclusion: A lack of knowledge of the importance of adherence to GMP sessions, long waiting hours and inconsistent availability of GMP services at facilities contributed enormously to nonadherence. Therefore, the Department of Health must ensure consistent availability of GMP services to demonstrate the importance and enable adherence. Healthcare facilities should reduce waiting hours to minimise the need for lunch money, and service delivery audits should be conducted to identify other factors contributing to non-adherence to address these.
Contribution: Primary health care providers should conduct service delivery audits and internal surveys to identify factors that contribute to non-adherence in order to introduce measures to address them.