Gebremichael, Bereket (MSc,Ass’t Professor)Wondwossen, Kalkidan(MSc )Ahmed, Fuad2020-11-262023-11-062020-11-262023-11-062020-09http://etd.aau.edu.et/handle/123456789/23610Background: Growth monitoring and promotion is a prevention activity comprised of growth monitoring, linked with promotion that increases awareness about child growth and serves as the core activity in an integrated child health and nutrition program. Even though growth monitoring and promotion would appear to be a prerequisite for a good child health, several studies have shown that there is a “know-do gap” among caregivers. Objective This study was aimed to assess caregiver‟s knowledge and utilization of Growth monitoring and promotion services for children under two years old in Debre Berhan, Ethiopia 2020. Method Community based cross sectional study supplemented with qualitative design was conducted in Debre Berhan from February- May2020. Quantitative and qualitative methods were used. For quantitative part, from the 421 estimated sample size 402caregivers were selected by using a single population proportion formula with simple random sampling and data was collected using adopted, structured and pretested interviewer administered questionnaire. For qualitative 6 purposively selected health extension workers were interviewed (in depth interview) to supplement the quantitative study to find out the challenges. Quantitative data was entered into Epi data version 4.0.2 then exported to a Statistical Package for Social Sciences version 21.0for analysis. Bivariate and multivariable logistic regressions were computed to see the association of independent with the dependent variables. The results were reported as Odds Ratio and 95% Confidence interval. Qualitative data was analyzed using thematic analysis. Result with 402(95.4%) response rate, only 35% of the care givers were found to have adequate knowledge about GMP while utilization of GMP services was 13.4%.Illiterate caregivers were 3 times less likely to know about Growth monitoring and promotion than those with secondary or above level of education [AOR=3.54; (95% CI=1.22, 10.72)].Caregivers who didn‟t get an explanation about the weight status of their child were 5 times less likely to have adequate knowledge about Growth monitoring and promotion than their counterparts [AOR=5.02; (95% CI=2.626, 9.597)].Additionally, those who said there was no nutritional counseling and education sessions at the health facility were 2.4 times less likely to be knowledgeable about Growth monitoring and promotion than those that attended the session [AOR=2,4; (95% CI=1.356, 4.359)].Residents at rural area were more likely to utilize growth monitoring and promotion than urban area [AOR=0.128; (95% CI=0.035, 0.474)]. The odds of young child age group (0-5 and 6-11month) not to utilize Growth monitoring and promotion were lower by 87.7% and 80.7% respectively compared to the 18-23 months of age [AOR=0.123 and 0.193;(95% CI=0.029, 0.517 and 0.049,0.764)]. Children‟s with more than 5 family members were 3 times less likely to utilize Growth monitoring and promotion than those with less[AOR=2.97; (95% CI =1.171,7.536)].The odds of not utilizing the service were lower by 94% for those who travel less than an hour to reach the health facility [AOR=0.06 ; (95% CI=0.014,0.261))]. Care givers with poor knowledge were 2.4 times more likely not to utilize Growth monitoring and promotion than those who had good knowledge [AOR= 2.45 ;( 95% CI=1.125-5.332)].Qualitatively, workload, lack of materials, lack of training and supervision were among the major challenges faced by health extension workers. Conclusion and recommendation Both Knowledge and utilization of Growth monitoring and promotion were low. Thus, efforts should be made to deliver supportive supervision, trainings and materials to health posts. Additionally, promotional campaigns must be initiated to create awareness in both the rural and urban side of the city.en-USCaregiver, Growth monitoring, Children, Knowledge, Utilization, EthiopiaThesis