Abstract / Summary
Abstract BACKGROUND Child stunting remains a major public health challenge in under-resourced communities, where community programming is central to nutrition screening and follow-up. This qualitative sub-study of the CROSS (Colombia’s potential Realized: an Observational Study for Stunting) study examined how caregivers, community health workers, and NGO staff perceive child nutrition screening processes in two Colombian cities. The aim was to identify key barriers and facilitators to effective growth monitoring and outline strategies to strengthen participation, quality, and sustainability for nutrition care within community programming centers. METHODS This qualitative descriptive study employed seven focus group discussions in Cartagena and Barranquilla with 54 participants, including caregivers (n=14), community health workers (n=30), and NGO staff (n=10). Discussions were transcribed and analyzed thematically using NVivo. Thematic analysis of 760 coded references revealed consistent patterns in experiences and practices surrounding child nutrition screening. RESULTS Three overarching themes emerged: (1) Training and Implementation of Nutritional Screenings , (2) Barriers and Facilitators to Effective Practice , and (3) Integration and Sustainability . Participants emphasized that combining weight, height, and MUAC with clinical observation and culturally sensitive counseling improved accuracy and family adherence. Barriers to nutrition care programming included limited training, lack of calibrated equipment, safety concerns, and fragmented coordination. Successful programs linked diagnosis to tangible support and strong institutional collaboration, fostering caregiver trust and program continuity. CONCLUSIONS Sustainable nutrition-focused quality improvement programs require balancing technical rigor with community acceptability and replicability. Standardized anthropometric practices, logistical reliability, and culturally relevant counseling—supported by multi-sectoral coordination and community engagement—are essential for long-term impact. CLINICAL TRIAL NUMBER Clincaltrials.gov, NCT06709001, registered November 26, 2024