Caregiver knowledge and perceptions as determinants of growth monitoring and promotion service utilization in Kisumu County

Background: Growth monitoring and promotion (GMP) is globally recognized for its role in early detection of growth faltering and providing timely nutrition and health interventions. Despite its benefits, utilization remains suboptimal in many low- and middle-income countries. In Kisumu County, Kenya, evidence suggests that caregiver-related factors, particularly knowledge and perceptions, significantly influence GMP service uptake. Using cross-sectional data from caregivers of children under five years, the study examines associations between caregiver understanding of GMP objectives, perceived benefits and attendance patterns. Methods: This was a community-based descriptive cross-sectional study design. Data was collected through a structured questionnaire from a sample of 407 caregivers who participated in the survey. Study participants were identified through a multistage sampling method. Both descriptive and multivariable logistic regression analyses were performed. An adjusted odds ratio (aOR) (95% CI) was used to assess the strength of association. Results: The median (IQR) age of caregivers was 28 (22, 34) years and the under-5s was 27 (17, 40) months. Most caregivers (91.2%) had good knowledge of GMP and 84.0% had a positive perception of the services. Caregivers with good knowledge on GMP services (aOR=5.01; 95%CI=1.67-15.05); Caregiver with good perception (aOR=4.96, 95%CI=2.20-11.17. Conclusions: Caregiver knowledge and perception significantly influence GMP uptake. Tailored health education and enhanced service quality are necessary to improve attendance and ultimately child health outcomes.