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Factors Influencing the Utilization of Growth Monitoring and Promotion Services and Their Association with Physical Growth among Children Aged 12–23 Months in Syangja District, Nepal

Marasini NR, Zhang Z, Karki AR, Pachya U, Devkota B et al. · 16 Sept 2026

Abstract

Abstract Background Growth Monitoring and Promotion (GMP) is an essential child health strategy for the early detection and prevention of growth faltering and malnutrition. However, regular utilization of GMP services remains suboptimal in many low- and middle-income countries, including Nepal, and evidence linking GMP utilization with child growth outcomes is limited. Objective To identify factors associated with regular GMP service utilization and examine its relationship with physical growth among children aged 12–23 months in Syangja District, Nepal. Methods A facility-based cross-sectional study was conducted among 294 mother–child pairs selected using multistage sampling from four local administrative units in Syangja District. Data were collected through interviewer-administered questionnaires and standardized anthropometric measurements. Descriptive statistics, chi-square tests, multivariable logistic regression, and analysis of covariance (ANCOVA) were performed using SPSS version 27. Anthropometric Z-scores were generated in R using the WHO Anthro package. Results All caregivers had utilized GMP services at least once; however, only 25.9% attended regularly. Regular GMP utilization was independently associated with completing four postnatal care visits (AOR = 2.50, 95% CI: 1.40–4.47), good maternal knowledge of GMP (AOR = 5.04, 95% CI: 1.15–22.12), and favorable maternal attitude toward GMP (AOR = 2.06, 95% CI: 1.11–3.83). The prevalence of stunting, wasting, and underweight was 16.3%, 5.1%, and 2.0%, respectively, with higher prevalence among male children. After adjustment for potential confounders, regular GMP utilization was not significantly associated with anthropometric indicators of physical growth (all P  > 0.05). Conclusions Although GMP services were universally accessed, regular attendance remained low. Maternal knowledge, positive attitudes, and adherence to recommended postnatal care were important determinants of regular GMP utilization. Regular attendance alone did not translate into improved child growth, highlighting the need to strengthen the quality of GMP services, integrate them with postnatal care, and ensure timely nutrition counseling and follow-up to improve child nutrition outcomes in Nepal.