Childhood undernutrition is a serious public health problem in South A
frica. Growth monitoring (GM) is a central tool in attempts to prevent
and detect undernutrition. Despite its widespread adoption by interna
tional and national agencies, there has been very little evidence whic
h shows that it has made an impact in reducing undernutrition. An impo
rtant problem has been the conceptual confusion as to the exact role o
f GM. This article reviews the international evidence for the effectiv
eness of GM when used in various roles and proposes some of the factor
s necessary for GM to be successful in South Africa.