This study aimed to identify determinants of Growth monitoring and promotion service utilization using unmatched case control study among less than two years children and the study will generate information to the Ministry of Health and other organizations working in the child survival programs to design interventions to improve the activities of GMP.
The study pointed out that determinants of growth monitoring and promotion service utilization were index child age, maternal knowledge, maternal Attitude, utilization of ANC services, getting counseling about GMP and distance to reach the nearest health facility.
Mother who had adequate knowledge of growth monitoring was more likely utilizes GMP than mother who had inadequate knowledge. Similar finding was reported from the study done in Areka town, Butajira, Kenya, and Ghana [13, 15, 21, 22]. This can be explained by mother with adequate knowledge may able to understand the information displayed on the growth chart and that motivates to utilize GMP session.
In this study, child in the age group of 6–11 months and 12–23 months found that more likely to utilize GMP services as compared to infants in the age group of 0–5 months. This finding is similar with study done in Southern Ethiopia Mareka district[12] and Butajira[21]. This could be explained in Ethiopian culture mother perceived that taking their child to the GMP session will expose their child to “evil eye”. Exposing children in front of people until they started walking is not accepted by the mothers[24].
This study showed that mothers/caregivers who had favorable attitude were more likely to utilize than those who had unfavorable attitude. This finding was supported by Study on Areka town, southern Ethiopia[13]. The reason for this might be good attitude of mother’s leads to happy to bring their child to the GM visits and this helps to utilize GMP session and for unfavorable attitude, one qualitative study conducted Loko Abaya District, Southern Ethiopia[24] showed that Mothers mentioned that they understood GMP as being used only for unhealthy (especially wasted) children. If their children are healthy and well-fed, they did not want to attend the GMP program.
According to this study mothers who utilized ANC services were more utilize GMP services than those who had not ANC service utilization. The possible justification for this may be during Ante natal care nutritional counseling is given and most of the mothers understand the service that was get from the health institution and after delivery the mothers will be happy to attend GMP session. This result is different from study done in Mareka district[12] showed that there is no significant association between Utilization of ANC services and GMP service utilization. This difference is may be due to study design; the previous study was used cross-sectional while this study was used case-control study design and time difference, at this time the coverage of ANC is increased.
This study identified that mothers/caregivers who received counseling about growth monitoring and promotion were more likely to utilize GMP services than who did not received counseling. This study is in line with study in Kenya[15] which showed mothers/caregivers who received nutrition advice alongside GM services were more likely to participate in continued. The reason for this may be counseling has greater impact on motivating mothers to attend GMP sessions.
In this study, mothers traveled less than an hour get to the nearest health facility from their home were more likely to utilize GMP services those travel more than one hour to get to the nearest health facility. This finding is similar with study in Southern Ethiopian, Mareka district[12] and also supported by the study in Kenya[15] showed that distance from respondent’s home to the facility 5 km; return journey were significantly associated with continued GM and similarly in Ghana[22] stated that distance between care givers home and the child welfare clinic is a determining factor in child welfare clinic (CWC) attendance. The possible justification for this may be due to Long distances to the health facilities may be a hindrance to the mothers to continue with growth monitoring especially if the children are looking well because of the competing roles. Socio-economic variables included in this study (marital status, occupation of mother, family size of the house hold and wealth index) were not significantly associated with GMP service utilization. This might be due to similar nature or living standard of mother was included in the study. Majority of mothers were farmers, married and lived in similar setting. As a limitation, there might be a recall bias while assessing the growth chart knowledge of the mothers, utilization of ANC service and PNC services.