Effectiveness of Growth Monitoring and Promotion Activities at Child Welfare Clinics in Imo State, South East Nigeria

Growth monitoring and promotion (GMP) represents a key strategy for early identification of undernutrition and timely nutritional intervention in young children. Despite its inclusion in Nigeria's child health policy, GMP quality at the community level is frequently compromised. This evaluative study assesses the effectiveness of GMP activities at selected child welfare clinics (CWCs) in Imo State, South East Nigeria. A mixed-methods approach was used, combining structured observations at 16 CWCs, record reviews covering 480 child health cards, and in-depth interviews with 20 clinic nurses in Owerri North, Ahiazu Mbaise, and Ezinihitte local government areas. Correct weighing technique was observed in 61.3% of sessions. Growth charts were plotted accurately in 49.2% of card reviews, with trend interpretation communicated to caregivers in only 34.6% of cases. Nutritional counselling linked to growth faltering was delivered in 27.1% of identified cases. Attendance regularity beyond three visits was achieved by only 43.8% of enrolled children. Staff cited inadequate training on growth chart interpretation, equipment calibration deficiencies, and caregiver drop-out as primary challenges. The study recommends structured on-the-job training for CWC staff in growth assessment and counselling, scale calibration protocols, and community mobilisation to sustain clinic attendance. Keywords: growth monitoring, child welfare clinic, malnutrition, Imo State, South East Nigeria.