Evaluation of growth monitoring and promotion services implementation at health posts of farta district south Gondar zone, Amhara -Ethiopia: single case study

Abstract

Background: Growth monitoring and promotion (GMP) is a preventive program that targets the reduction of malnutrition in children in the early period of their lives. GMP targets the caregiver and family decision for positive child growth outcomes and has great potential to contribute to improve child survival if well implemented. In Ethiopia, the practice of GMP was initiated 2008 in 39 districts as one of the key components of the community-based nutrition package. By the end of 2014, it was expanded to a total of 447 districts in six selected regions. In Ethiopia, GMP is practiced in 51% of the health facility with inadequate supervision and provision of supplies for the worker, similarly, in Farta district the implementation states of GMP service is not studied yet. Objective: The main aim of the present study was to evaluate the implementation of GMP service at health posts in Farta district south Gondar Zone, Amharic, Ethiopia 2022. Methods: A single case study design using both qualitative and quantitative method was conducted. A date was collected using semi structured questioner; caregivers attending GMP services at Health posts of Ferta District were interviewed, direct observations, six-month retrospective chart/document review and Key informant interviews with 14 health care providers were performed. Mothers were selected using consequentive sampling technique while key informants were selected purposively. Qualitative data were transcribed, translated, coded and analyzed in themes. Variables with p-value < 0.25 in bivariate logistic regression were candidate for multiple logistic regression. P-value < 0.05 and confidence interval were used to declare association. The overall process of program implementation was determined based on pre-sated criteria of judgmental cutt-off points. Results: In the present study the overall level of process of GMP program implementation was 76.5%. Resource availability was 77.6% and compliance to national GMP guideline was 81.5 %. In satisfaction dimension 61.5% of caregivers were satisfied by the GMP services they obtained. Educational status, marital status and family size were factors that affect satisfaction. Conclusion: The primary health care units in Ferta district have minimum requirement resources to provide GMP services to under- two children in the health posts and community level. Compliance of the HEWs to the national guideline was good while satisfaction of mothers towards the process of GMP services provided by HEWs was poor. Overall, the process of GMP implementation in the district needs improvement.