Determinants of Growth Monitoring and Promotion (GMP) Services Utilisation among Caregivers in Kisumu County, Kenya DOI: https://dx.doi.org/10.4314/ajhs.v38i2.13

Abstract

Background: Growth Monitoring and Promotion (GMP) is a multifaceted healthcare program that involves tracking the growth and welfare of children under five years through regular assessment of nutritional and physical health. Despite the apparent importance, GMP uptake remains low in low- and middle-income countries. The current study aimed to determine uptake patterns of GMP services for children 0-59 months among caregivers in Nyakach sub-county.

Methodology: A community-based descriptive cross-sectional study design was employed, using a multi-stage sampling technique to select 407 caregivers. Data were collected through questionnaires and analysed using descriptive and inferential statistics in SPSS version 28. Furthermore, multivariable logistic regression analyses were performed with adjusted odds ratio (aOR) [95% CI] used to assess the strength of association.

Results: The median (IQR) age of caregivers was 28 (22, 34) years, and 27 (17, 40) months for the children aged under five years. GMP services utilisation was at 47.7%; however, the major barriers included long distances to health facilities (56.3%) and extended waiting times (47.9%). Most caregivers (91.2%) had good knowledge of GMP, and 84.0% had a positive perception of the services. Several factors were significantly associated with GMP services utilization, namley, children's age 24-35 months (aOR= 6.6; 95%CI= 2.7-16.2); Employed caregivers (aOR= 1.92; 95%CI= 1.08-3.42), Caregivers who received all GMP service components (aOR=2.27; 95%CI=1.31-3.94), Caregivers with good maternal knowledge (aOR=5.01; 95%CI= 1.67-15.05); Caregiver with good perception (aOR=4.96, 95%CI= 2.20-11.17); Waiting time for at least 60 minutes (aOR=0.11,95%CI= 0.05-0.28), and time taken to the facility for at least 60 minutes (aOR=0.03,95%CI= 0.01-0.14).

Conclusion and Recommendation: GMP services utilisation among the under-fives remains low post-immunisation completion. Several key barriers to the utilisation of GMP services included long distances to health facilities, long waiting times, a negative perception, low caregiver knowledge, and working caregivers reported difficulties in finding time to attend GMP sessions. Conversely, high caregiver education levels, a positive perception of GMP services, and shorter distances to health facilities were associated with higher utilisation rates. It is important to enhance community-based health education and strengthen routine follow-up mechanisms to improve consistent visits.