Growth monitoring is difficult because it involves the creation and decision making from a line graph,considered by Piaget to be one of the more difficult concepts to teach in education. It needs to be taught in a highly practical manner. One successful method involves measuring known quantities of water into a bucket hanging below the Direct Recording Scale. For this a plastic bottle cut to hold 400cc at one end and 200cc at the other end is required. As the water is poured into the bucket below the spring the mothers see the spring stretch and themselves with a ball pen create successive points on the growth curve.
Mothers appreciate being involved.
They understand what weighing and plotting a growth curve means. When shown several charts they can select the most appropriate growth curve. After 2 years the grandmothers experience with the scale, who are the decision makers, and their grand-daughters, the future mothers, also understood the growth curve. Faltering was defined as no gain in weight for two months, or a loss of 200 grams in children under 2. David Morley David Morley,Emeritus Professor of Tropical Child Health, University of London.