Growth monitoring (GM) is integral in child health programming. More than 73% of children under-five years in Mutasa district were missed during routine GM in 2015. We set out to evaluate the GM programme in 20 health facilities within Mutasa, Zimbabwe. A comparative process-outcome evaluation using the Logical Framework approach was used. A desk review of 20 health facility reports, 69 baby card records, 84 Village Health Worker (VHW) reports for the year 2015 and health facility GM statistics from 2014 to 2016 was done. VHW coverage was 86%. Height was being monitored in 51% of the villages. Only 7% of baby cards were completely filled for the height-for-age indicator, with the rest either partially or not filled. Discrepancies in recording GM trends present challenges in child health programming. There is need to ensure that data are captured well so as to inform appropriate health interventions.