Abstract:
Background: United Nations International Children Emergency Fund (UNICEF) defines Growth Monitoring and Promotion (GMP) is a prevention activity comprised of growth monitoring linked with promotion (usually counseling) that increases awareness about child growth; improves caring practices; increases demand for other services, as needed; and serves as the core activity in an integrated child health and nutrition program, when appropriate. This would help parents keep their young children healthy and well nourished. GMP has been implemented in Ethiopia since 2008 as nutrition specific intervention to prevent malnutrition. Objective: To assess knowledge and utilization of growth monitoring and promotion and identify factor associated with knowledge and utilization of GMP for children under two years in Butajira, SNNPR, Ethiopia. Method: Community based cross sectional study was conducted from April-May 2017. A total of 548 child mother pair less than 2 years old who resides in Butajira were selected by simple random sampling method. Qualitative study (in depth interview and observation) were also conducted to supplement the quantitative study and to assess the skill and knowledge of health extension workers working in selected heath post. The data was entered using Epidata version 3.1 and analyzed using STATA version 14 software. Multivariable logistic regression model was fitted to predict the association between knowledge and utilization of GMP and their determinants. All statistical analysis was set at 5% level of significance (i.e. p < 0.05. The results were reported as Odds Ratio and 95% CI). Appropriate tables and diagram were used to present findings. Result: Among 507 mother-child pair participates utilization of GMP was fifty five 11% [95%CI=8.4%-13.8%] while three hundred twenty five 64% [95%CI= 60%-68%] of the mothers had adequate child feeding and growth chart knowledge. The result showed that mothers gave birth in the health facility were 1.60 times more likely to be knowledgeable about child feeding and growth chart than those mother gave birth at home [AOR=1.60; (95% CI=1.06, 2.44)]. Whereas those child-mother pair traveled less than one hour to reach to the nearest health facility from their house were 2.06 times more likely to be knowledgeable about child feeding and growth chart than those mother travel more than an hour to reach to their nearest health facility [AOR= 2.06; (95%CI=1.35, 3.13)]. Mothers with elementary educational level were 3.31 time xii more likely utilize GMP [AOR=3.31(95%CI=1.50, 6.02)] while mothers with secondary and above education level were 3.33 times more likely utilize GMP than illiterate mothers [AOR=3.33(95%CI=1.30,8.50)]. Regarding occupation of the mother, framers were 4.03 times more likely utilize GMP than house wives [AOR=4.03(95%CI=1.32, 8.50)]. Mothers with child feeding and growth monitoring adequate knowledge were about 5 times more likely utilize GMP than those mother with inadequate knowledge [AOR=4.87(95%CI=1.80,13.16)]. Qualitatively, irregularity of GMP session due to health extension work load, not recording the age and weight of the child accurately, mother wrong belief and skill gap of heath extension workers were challenges of GMP utilization. Conclusion: growth monitoring and promotion is not implemented as it was supposed to be. More than half of the respondents had adequate child feeding and growth chart knowledge and utilization of GMP is very low in rural kebeles of Butajira. Monitoring implementation of growth monitoring and promotion should be needed throughout different weredas and kebeles that are expected to implement growth monitoring and promotion program.