Enhancing Growth Monitoring Visits in Joshipur Rural Municipality, Kailai, Nepal

The goal of this clinical trial is to learn if health workers training on growth promotion and monitoring guideline and Female Community Health Volunteers mobilization for increasing demand for growth monitoring and promotion, GMP through growth monitoring and promotion day, GMP day) can enhance the growth monitoring and promotion practices in mothers and caretaker having under two years children. The main questions it aims to answer are:

* Does health workers training on GMP guideline enhances the growth monitoring and promotion practices in mothers and caretakers having under two years children?
* Does FCHV mobilization enhances growth monitoring and promotion practices in mothers and caretakers having under two years children? Participants will
* Health workers of the Joshipur rural municipality will have to attend Training session on GMP guideline,
* Mothers and caretakers having under two years children will have to visit to the nearest health facility for GMP visits for their children

For addressing the problem of malnutrition in the municipality, determinants of the problem have been identified through CFIR framework. Based on the identified facilitator and barriers, two strategies have been developed for solving the problem of the municipality- (a) health workers training on latest GMP guideline to update the knowledge and skills of the service providers (b) For increasing demand generation, inviting mothers and caretakers having under two years children

1. Health workers Training on GMP guideline: Mr. Ashish Timalsina will be responsible for one day training on GMP guideline to the health workers of all six health facilities who are primarily engaged in nutrition in Joshipur rural municipality.
2. FCHV mobilization for increasing demand of growth monitoring and promotion through GMP day: Particular days of the month will be specified as GMP day in the municipality. Mothers and caretakers having under two years children. Health coordinator of the Joshipur rural municipality will be responsible for monitoring and supervision of this strategy.

Objectives General Objective

● To assess the implementation outcomes of Health workers Training on GMP guidelines and FCHV mobilization for increasing demand of Growth monitoring and Promotion through GMP day.

Specific Objectives

* To assess acceptability, appropriateness, feasibility, fidelity of (a) Health workers Training on GMP guideline; and acceptability, appropriateness, feasibility of (b)FCHV mobilization for increasing demand of Growth monitoring and Promotion through GMP day by using PROCTOR's framework.
* To assess the effectiveness of interventions- Health workers Training on GMP guideline and FCHV mobilization for increasing demand of Growth monitoring and Promotion through GMP day by average number of GMP visits.

  6. Methodology

Study site and its justification:

The study site will be Joshipur rural municipality, Kailali. There are seven wards in Joshipur Rural Municipality, in which a total of six health facilities are providing services in the Municipality. Average growth monitoring visit of the municipality was only 8 visits per child out of 24 visits per child (who have completed two years) in the fiscal year 2079/80 BS (2022 AD). The practice of growth monitoring was only 43% in the fiscal year 2079/80 BS (2022 AD). (HMIS)

Eligibility Criteria:
Inclusion Criteria:

For Health Workers:

1. Nutrition focal person of the health facility having primary engagement in growth monitoring and promotion.
2. Trained on growth monitoring and promotion guideline.

For Female Community Health Volunteers 1. Active for inviting mothers and caretakers of the municipality

For Mothers and caretakers having under two years children

1. Any mothers and caretakers having under two years children residing in Joshipur Rural Municipality during intervention.

Exclusion Criteria:

Who not available during the time of data collection