Growth monitoring and promotion utilisation among children aged 24–59 months attending an Urban Health Centre in Malawi: prevalence and associated factors

Growth monitoring and promotion (GMP) is a key strategy to prevent under nutrition in children under-five. However, GMP utilisation among children aged 24-59 months in Malawi remains low, with limited evidence on its determinants. This study assessed the prevalence and determinants of GMP utilisation among caregivers of children aged 24-59 months at Mzuzu Urban Health Centre, Malawi. A facility-based cross-sectional study was conducted from July to September 2022 among 387 caregivers attending under-five clinics at a single urban health centre in Malawi. Data were collected using an interviewer-administered questionnaire and verified using health passports. Multivariable logistic regression was used to identify factors associated with GMP utilisation. The prevalence of GMP utilisation was 39% (95% CI: 34-44%). Factors independently associated with GMP utilisation were children aged 24-35 months (AOR = 2.51; 95% CI: 1.55-4.05), caregiver age ≤ 35 years (AOR = 2.78; 95% CI: 1.33-5.79), secondary education (AOR = 1.77; 95% CI: 1.10-2.86), high GMP-related knowledge (AOR = 2.01; 95% CI: 1.23-3.27) receipt of nutrition counselling (AOR = 2.90; 95% CI: 1.70-4.98). GMP utilisation among caregivers of children aged 24-59 months attending this urban health facility was low, although general awareness of GMP was high. Utilisation was associated with child age, caregiver age, secondary education, GMP-related knowledge, and receipt of nutrition counselling. Targeted improvements in caregiver education, growth- chart interpretation support, and routine counselling may help strengthen GMP utilisation in similar facility-based settings in Malawi.