Background
Childhood stunting (i.e. linear growth failure) is recognized to be a major global health
priority with 165 million children under the age of five years affected worldwide.
Although the prevalence of stunting has decreased over the past years, the number of
stunted children is still on the rise. Children of educated mothers have a lower
prevalence of stunting in general. There are no consistent results of how well mothers
recognize their child’s growth failure.
Aims
The aim of this study is to determine whether mother’s perception of the growth of her
child is in line with the measured growth and if mother’s education affects the
perception.
Methods
This study is a part of a two-center, randomized, single-blind, parallel group controlled
trial in rural Malawi called iLiNS-DOSE. It was carried out in Mangochi District,
southern Malawi. The study population was N=1119 of 4.8-7.1-month-old infants and
their mothers. The data used in this study was collected when children entered the
iLiNS-DOSE trial and the intervention had not yet taken place. The anthropometric
measurements of children were compared to mother’s perception retrieved from a
“Knowledge, Attitudes and Practices” questionnaire where mothers were asked if their
baby is growing well currently. The association between mother’s perception and
dichotomized child growth (Not stunted, Stunted) was assessed with crosstabulation.
Sensitivity and specificity were used to examine the accuracy of detection. The mean
values of child growth as continuous length-for-age z-score for both mother’s
perception groups were compared using independent samples t-test. The association
with mother’s perception and education was evaluated using Pearson’s Chi-Square Test.
Results
28 % of the children in our study population were stunted. The prevalence differed in
relation to mothers’ schooling: 32 % of children of uneducated mothers were stunted,
29 % of children of mothers with 1-8 years of schooling and 20 % with 9-12 years of
schooling were stunted. The sensitivity of the mothers’ assessment was 12 %.
Specificity of mothers’ assessment was 95 %. There was a statistically significant
difference between the mean values of length-for-age z-scores in the two groups of
mothers’ assessments (growing well; not growing well). 6 % of mothers with no
schooling detected their stunted children weren’t growing well, whereas 2 % in mothers
with 9-12 years of schooling detected their child’s stunting.
Conclusion
The results indicate that mothers detect their child’s stunting poorly, although most
mothers are accurate when evaluating their not stunted child to grow normally. The
group of unschooled mothers detected stunted growth in their children better than the
highest education group. This implies that formal education does not significantly
improve the detection of stunted growth. The prevalence of stunting is however smaller
in children with educated mothers.