Perceptions and Practices of Mothers Regarding Child Growth Monitoring at Rusape General Hospital, Zimbabwe: A Qualitative Study (2025–2026)

Abstract

Child growth monitoring is a key component of maternal and child healthcare, particularly in low- and middle-income countries where undernutrition and growth faltering remain major public health concerns. Despite the availability of growth monitoring services in Zimbabwe, utilisation and meaningful caregiver participation remain suboptimal. This study explored maternal knowledge and practices regarding child growth monitoring at Rusape General Hospital, Zimbabwe, guided by the Health Belief Model (HBM). A qualitative exploratory-descriptive research design was employed to gain an in-depth understanding of mothers’ experiences, perceptions, and practices related to child growth monitoring. The study was conducted at the Family and Child Health (FCH) department of Rusape General Hospital. Purposive sampling was used to recruit 26 mothers/caregivers of children under five years and 4 healthcare workers who participated in in-depth interviews. Data were collected using semi-structured interview guides and supported by an observation checklist. Interviews lasted approximately 30–45 minutes and were audio-recorded with participants’ consent. Data were analysed using thematic analysis following Braun and Clarke’s framework, with themes aligned to the constructs of the Health Belief Model. The findings revealed that maternal knowledge regarding growth monitoring was generally limited and largely superficial. Many mothers associated growth monitoring mainly with immunisation or weighing rather than understanding its preventive role in detecting growth faltering. Most participants demonstrated difficulty interpreting growth charts, including understanding plotted lines and curves, indicating low self-efficacy. Although mothers expressed positive attitudes towards growth monitoring and recognised its importance, their participation remained largely passive, with heavy dependence on healthcare workers for interpretation and decision-making. The study further identified inconsistent attendance at growth monitoring sessions due to socio-economic and health system barriers such as transport costs, long distances, competing household responsibilities, long waiting times, and inadequate counselling. Healthcare workers also acknowledged workload pressures that limited effective communication and health education during clinic visits. Despite these challenges, mothers expressed a strong willingness to learn and actively participate if provided with appropriate education and support. The study concluded that while growth monitoring services are generally accepted, their effectiveness is constrained by inadequate maternal knowledge, passive participation, and systemic barriers. Strengthening caregiver education, improving communication between healthcare workers and mothers, and addressing structural barriers may enhance maternal empowerment and improve child health outcomes. The study recommends targeted health education programmes, improved counselling practices, community-based support interventions, and strengthened policy implementation to enhance growth monitoring services in Zimbabwe.