title: Revisiting the concept of growth monitoring and its possible role in community-based nutrition programs.
abstract: BACKGROUND
  Community-based growth monitoring (GM) and growth monitoring and promotion (GMP) have been implemented worldwide. The literature provides controversial messages regarding their effectiveness. Numerous countries have GM as their main community-based activity and need guidance for future programming. The notion of GM is usually clear, but the follow-up actions include a range of activities and interventions, all under the heading of "promotion."
  
  
  OBJECTIVE
  We suggested definitions, objectives, and outcomes of the GM and GMP. By providing some clarity on these conceptual issues we attempted to provide a basis for consensus building and development of recommendations on when this activity should be promoted or discouraged.
  
  
  METHODS
  We reviewed basic concepts and global experience of GM and GMP using publications about GM and GMP, UNICEF country reports and other publications, field observations, and reports of recent expert consultations.
  
  
  RESULTS
  Realistic added benefits are suggested as compared with general counseling that could also be delivered outside the GM session. We provide a narrow definition of "promotion" in GMP, in which actions are tailored to the results of monitoring, as well as suggest quality implementation criteria.
  
  
  CONCLUSIONS
  GM, even if complemented by a promotional package, can have only a limited impact if it is not part of a comprehensive program. GMP cannot be viewed as a competitor to highly effective interventions, but may serve as a possible platform for their delivery. The decision to build community-based programs on a GMP platform should be based on consideration of benefits, feasibility of quality implementation, and capacity of human resources.
authors.affiliation: Nutrition Section, UNICEF, 3 United Nations Plaza, New York, NY 10017, USA. nmangasaryan@unicef.org
authors.forename: Nuné
authors.initials: N
authors.lastname: Mangasaryan
authors.forename: Mandana
authors.initials: M
authors.lastname: Arabi
authors.forename: Werner
authors.initials: W
authors.lastname: Schultink
mesh_terms: D000886:Anthropometry; D002657:Child Development; D002662:Child Health Services; D015362:Child Nutrition Disorders / Q000517:prevention & control; D002675:Child, Preschool; D004032:Diet; D005522:Food Services; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000517:prevention & control; D038622:Internationality; D018673:Nutrition Policy