Evaluation of Growth Monitoring and Promotion Service Implementation at Health Posts of Debatie District, Benishangul Gumuz Region, Ethiopia, 2018.

Abstract

Background: Growth monitoring and promotion (GMP) is the regular measurement, recording, and interpretation of a child’s growth over time in order to counsel, act and follow up results. Despite in Ethiopia GMP used as one of the main strategies to end under nutrition and zero stunting by 2030, in Benishangul Gumuz Region the prevalence of under nutrition remains a serious challenge then stake holders suggested implementation of GMP need to be evaluated in Debatie district. Objective: To determine the implementation status of growth monitoring and promotion service in Debatie District, 2018. Methods: case study design, with both quantitative and qualitative data collection was used from March 15 to April 15, 2018. Dimension used for the evaluation were availability, compliance and utilization of GMP service. A total of 458 caregivers were included by simple random sampling. Moreover, 50 client-provider interactions were observed by consecutively, three month selected documents were reviewed and 17 key informants were interviewed purposively. Ethical clearance was obtained from (IRB) Jimma University. Quantitative data was entered in to Epi-data and Analyzed by SPSS. Binary logistic regression was used to identify determinants of adequate utilization. Qualitative data was analyzed manually and used to support the quantitative results. The overall implementation of the service was determined based on judgmental criteria. Result: Resource availability was scored 71.4 percent; out of ten health posts, all of them had weighing scale, seven of them had adequate number trained health extension worker, none of the them had GMP guideline, 30% of them had no weighing bags and 40% of them did not have a child growth charts. Compliance was scored 56.26%; Triple A approach was not practiced for 80% of observation session, Moreover, as the judgment parameter the overall utilization of the service was scored 48.2. Growth monitoring service coverage was 73.95%, full immunization coverage was65.28%, Vitamin A supplementation coverage was 53.78%. Family size, care giver knowledge, care giver attitude, distance from the service area, and having child growth chart were significantly associated with adequate utilization of GMP services. This difference are supported by a qualitative finding of HEWs use inappropriate tools in GMP, irregularity of service, lack of pro motion for regular weighing session to mothers were mentioned reason Conclusion and Recommendation: The overall level of implementation of growth monitoring and promotion program was judged to be poorly implemented. Therefore, adequate HEWS, and regular support supervision and full set of GMP materials must be present for GMP to be successfully implemented. And HEWs should follow the recommended triple-A procedures, and should cover all eligible children and required regular monitoring.