European Journal of Biomedical and Pharmaceutical Sciences

KNOWLEDGE ATTITUDE AND PRACTICE OF HEALTH EXTENSION WORKERS TOWARDS GROWTH MONITORING AND PROMOTION PROGRAM IN TIGRAY REGION, ETHIOPIA.

Mebratu Tarekegn Baraki, Addis Adera Gebru* and Gosaye Degu Belay

ABSTRACT

Background: Currently, both preventable communicable diseases and nutritional disorders are major health problems in Ethiopia. Inspite of this issue, most progresses have been made to improve the health status of the population in the last two decades. However, still continued high population growth exerts overcrowding and faced a high rate of morbidity and mortality and the health status remains relatively poor. Objectives: The main aim of this study was to assess knowledge, attitude, practice and challenges of HEWs towards the Growth Monitoring and Promotion programs in Endamohoni, Sasi- Tsada Emba, Medebay Zana woredas of Tigray Region. Growth Monitoring is a screening tool to diagnose nutritional problems and status of children at an early stage. It has been suggested that growth monitoring has the potential for significant impact on mortality even in the absence of nutrition supplementation or education. Method and Materials: A cross sectional survey through LOT Quality Assurance method assisted by FGD, observation methods. Accordingly, 114 survey questionnaires for HEWs, 30 FGD, 9 KII were conducted from March 1to April 18, 2014. A pre-coded, pre-tested and structured questionnaire was used for the quantitative method and FGD was conducted in the three woredas for the qualitative method. Results: The findings of the study indicated that the HEW’s overall knowledge of GM was found to be 96% and about 85 % of them recognized that GM was one of a child health program. The most widely used standard GPM equipment was found to be MUAC 46.9% and weight scale 35%. As to the knowledge of HEW in using these materials, 54.7% of them need additional refresher trainings and 41.1% of respondents reported that they know it very well. Besides, 86.2% faced a problem in doing GMP and the most frequent challenges were getting a result for the same child in different time was different (31%), difficulty in reading the scale (27.8%) and the result is different in time (21.1%). Subsequent in-service training was received by (84.4%) of HEW and, the content of the trainings that were given for the HEW 78(29.7%) of the trainings focused on definition of GMP, its important, 75(28.5%) on how to do GMP, 70(26.6%) how to use the result after weighing a child and only 40(15.2%) how to link the child with other programs. One third (75%) have reported that they have a good motive towards GMP while the HEWs activities were by and large being limited to the measurement of weight and MUAC of children who attended the HC. Top three reasons of HEW not giving counseling during GMP were luck of training on how to counsel 18 (60%), work burden 5(16.7%) and shortage of time 5(16.7%). Although growth charts were available in 70.5% of the selected health posts the study covered, they were used only in 51%. The main reason of not using was the lack of skills. The result of the qualitative data indicated that there was a fair knowledge GM by the HEW participated in the study yet the practice level was found to be very less due to challenges as lack of attention to the details of working conditions and to human resources management (underdeveloped environment); absence of Institutional arrangements for management of health service extension program at all levels; absence of regular supervision not doing monitoring the quality of training and soliciting cooperation of other social sectors; unavailability of contraceptives, infrastructure, vaccines in sustainable manner poor equipment and supply for GM practice. Conclusion: The study recommended that the GMP need due attention and rapid remedial intervention by joint efforts of the government, concerned NGO’s civil societies and the community itself.

Keywords: Knowledge, Attitude, Practice, Health Extension workers, Growth monitoring, Promotion program, Tigray.