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Effect of Infant Growth Monitoring Education on Growth Monitoring Practices among Mothers of Infants in Nigeria

Abstract

Infant growth monitoring is an important component of child health and provides an opportunity for the early identification of growth faltering, undernutrition, and other health conditions that may affect infant development. Regular monitoring of weight, length, and other appropriate growth indicators enables healthcare providers and caregivers to assess whether an infant is growing adequately and to initiate appropriate nutritional or medical interventions when abnormalities are identified. However, mothers in Nigeria may not consistently participate in growth monitoring because of inadequate knowledge, limited awareness of its importance, financial constraints, distance to healthcare facilities, competing household responsibilities, cultural beliefs, and inadequate access to child health services. Infant growth monitoring education provides an opportunity to improve mothers' understanding of child growth, appropriate monitoring schedules, interpretation of growth measurements, nutrition, and the importance of seeking healthcare when growth concerns are identified. Against this background, this study investigates the effect of infant growth monitoring education on growth monitoring practices among mothers of infants in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Andersen's Behavioral Model of Health Services Use. The Health Belief Model explains how mothers' perceptions of the importance of monitoring infant growth, perceived risks of poor growth, perceived benefits of monitoring, perceived barriers, and cues to action may influence growth monitoring practices. Social Cognitive Theory emphasizes knowledge, self-efficacy, observational learning, behavioural reinforcement, social support, and environmental influences in the adoption and maintenance of appropriate child health practices. Andersen's Behavioral Model explains how mothers' predisposing characteristics, enabling resources, and perceived healthcare needs influence their utilization of infant growth monitoring services. Collectively, these theoretical perspectives provide a suitable framework for explaining how growth monitoring education may influence growth monitoring practices among mothers of infants in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise mothers with infants aged 0–12 months attending selected primary healthcare centres, hospitals, immunization clinics, child welfare clinics, and community-based maternal and child health programmes across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible mothers. Infant growth monitoring education will be assessed using indicators such as exposure to structured education sessions, frequency and duration of education, knowledge of infant growth indicators, recommended monitoring schedules, interpretation of growth charts, appropriate infant feeding, recognition of growth faltering, importance of routine child health visits, and appropriate actions following abnormal growth findings. Growth monitoring practices will be assessed using indicators such as attendance at growth monitoring sessions, frequency of infant weight and length measurements, use of growth charts, documentation of growth measurements, attendance at scheduled child welfare clinics, interpretation of growth trends, and appropriate follow-up after abnormal findings. Data will be collected using structured questionnaires, growth monitoring cards, child health records, clinic attendance registers, growth charts, and relevant healthcare records. Descriptive statistics will be used to summarize participants' characteristics, exposure to growth monitoring education, and patterns of growth monitoring practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of infant growth monitoring education on growth monitoring practices. Where a quasi-experimental design is adopted, growth monitoring practice scores before and after the educational intervention will be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that infant growth monitoring education has a significant positive effect on growth monitoring practices among mothers of infants in Nigeria. Mothers exposed to structured and practical growth monitoring education are expected to demonstrate improved attendance at growth monitoring sessions, more consistent monitoring of infant growth, better use of growth charts, and greater ability to recognize and respond appropriately to abnormal growth patterns. Education may improve mothers' understanding of the relationship between infant nutrition, illness, and growth and encourage timely utilization of child health services when growth concerns are identified. Practical demonstrations of growth charts and individualized counselling may further strengthen mothers' confidence in monitoring their infants' growth. However, financial constraints, distance to healthcare facilities, limited availability of growth monitoring services, competing household responsibilities, low health literacy, cultural beliefs, and inadequate healthcare personnel may limit consistent participation. The study therefore expects accessible, practical, culturally appropriate, and continuous growth monitoring education to contribute significantly to improved growth monitoring practices among mothers of infants in Nigeria. The study is expected to contribute to the literature on infant growth monitoring education, growth monitoring practices, child growth, infant nutrition, maternal and child health, child welfare services, health education, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, nurses, midwives, community health workers, nutritionists, child health practitioners, development partners, and policymakers regarding strategies for improving infant growth monitoring. The study will also provide evidence-based recommendations for integrating practical growth monitoring education into immunization and child welfare services, strengthening healthcare-provider counselling, improving mothers' access to growth charts and child health records, increasing community awareness, strengthening referral and follow-up systems, and promoting regular growth monitoring among mothers of infants across Nigeria.

Keywords: Infant growth monitoring education, growth monitoring practices, mothers of infants, child growth, growth charts, infant nutrition, child health, maternal and child health, child welfare services, health education, Nigeria, public health.