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Ebroshe M, Oljira L, Mengiste B, Adem HA, Alemu A, Fekadu G. Complementary feeding practices and associated factors among children aged 6-23 months in rural Haramaya district, Eastern Ethiopia: A community-based cross-sectional study. Nutr Health 2023; 29:523-530. [PMID: 35234106 DOI: 10.1177/02601060221082373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The age of children up to 59 months is a critical period for children's growth and development and the age when optimal complementary feeding is crucial. Aim: To assess optimal complementary feeding practices and associated factors among children aged 6-23 months in rural Haramaya district, Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted. Statistical Package for Social Science (SPSS) version 24 was used for the analyses. Bivariable and multivariable logistic regression analysis were conducted at p-value < 0.05 and an Adjusted Odd Ratio (AOR) with a 95% Confidence Interval (CI). Results: The percentage of mothers that practiced optimal complementary feeding practices was 53.5% (95% CI: 49.2%, 57.6%). Average monthly income of the family, $37.5 to $75 (AOR = 0.52, 95% CI: 0.28, 0.98), institutional delivery (AOR = 1.61, 95% CI: 1.06, 2.46), postnatal care follow-up (AOR = 2.53, 95% CI: 1.67, 3.82), having an awareness about IYCF (AOR = 3.05, 95% CI: 1.85, 5.02), less than 30 min foot-walking to reach health facility (AOR = 2.61,95% CI: 1.65, 4.09), separate child's feeding plate (AOR = 1.75, 95% CI: 1.16, 2.64), and attendance of Infant and Young Child Feeding demonstration (AOR = 2.02, 95% CI: 1.33, 3.07) were significantly associated with optimal complementary feeding practices. Conclusion: The magnitude of optimal complementary feeding practices was below the minimum recommended level for the growth and development of children in the study area. Lack of access to and underutilization of maternal and child healthcare services were significant risk factors for suboptimal complementary feeding practices. Maternal and child health services would be essential to mitigate suboptimal feeding practices for children aged 6-23 months.
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Affiliation(s)
- Mahdi Ebroshe
- Public Health Expert, Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bezatu Mengiste
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hassen Abdi Adem
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gelana Fekadu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Herman H, Mansur AR, Chang YJ. Factors associated with appropriate complementary feeding: A scoping review. J Pediatr Nurs 2023:S0882-5963(23)00107-0. [PMID: 37150632 DOI: 10.1016/j.pedn.2023.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/09/2023]
Abstract
PROBLEM Childhood stunting becomes a vital point of an underlying problem in early life. Appropriate and adequate complementary feeding is necessary for children to prevent malnutrition and introduce healthy eating habits. Knowledge of factors related to complementary feeding practices is needed to design strategies that improve optimal complementary feeding and avoid malnutrition in children. However, factors related to appropriate complementary feeding practices have not been systematically examined; hence, the present study aims to synthesize the available evidence on factors associated with proper complementary feeding practices. METHODS A scoping review was conducted. Five databases were searched for relevant studies, including Medline, Embase, Cochrane, CINAHL, and Web of Science. The studies selected for review were those published in English from 2009 to 2022 on complementary feeding practices and related factors, measuring at least three complementary feeding indicators, and available in full text. The criteria resulted in 30 eligible articles that were selected, extracted, and then analyzed using descriptive and content analysis. FINDING Factors associated with complementary feeding practice include maternal factors (knowledge, attitude, self-efficacy, parity, antenatal care visit, place of delivery, and postnatal check-up), socio-environmental factors (age, educational level, income, employment status, residence, household size, mother's ethnicity, and support) and informational factors (exposure to media, source of information and intervention). CONCLUSION AND IMPLICATION Maternal, socio-environmental, and informational factors are associated with appropriate complementary feeding in infants and young children. Further research is necessary to identify causal relationships between the three groups of factors and complementary feeding practices.
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Affiliation(s)
- Hermalinda Herman
- Maternal and Child Health Nursing Department, Faculty of Nursing Andalas University, Padang, West Sumatera, Indonesia; PhD Candidate, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Arif Rohman Mansur
- Maternal and Child Health Nursing Department, Faculty of Nursing Andalas University, Padang, West Sumatera, Indonesia
| | - Ying-Ju Chang
- Professor, Institution of Allied Health Science & Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Director of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Determinants of Child Stunting, Wasting, and Underweight: Evidence from 2017 to 2018 Pakistan Demographic and Health Survey. J Nutr Metab 2023; 2023:2845133. [PMID: 36915292 PMCID: PMC10008110 DOI: 10.1155/2023/2845133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 12/23/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban and rural areas were used for this study consisting of 4,226 children less than 5 years of age. Univariate and multivariable analyses using logistic regression models were conducted. Over 23% of the children were underweight, 8.0% suffered wasting, and 37.7% were stunted. Children with small size at birth (<45.7 cm), those who were average in size (45.7 to 60 cm) at birth were less likely to be stunted (AOR, 0.4890) and underweight (AOR, 0.538). Children with large size at birth (>60 cm) were also less likely to be stunted (AOR, 0.288) and underweight (AOR, 0.538). Children who consumed fresh milk were less likely to be classified as wasted (AOR, 0.524) than those children who did not consume fresh milk. The children in high- and middle-economic status families were less likely to be stunted, underweight, or wasted. Children of mothers who had secondary and higher education were less likely to be stunted (AOR, 0.584) and were less likely to be underweight (AOR, 0.668) than illiterate mothers' children. Children of working mothers were less likely to be wasted compared to children of nonworking mothers (AOR, 0.287). Maternal BMI is also inversely associated with being underweight because overweight and obese mothers were less likely to have underweight children (AOR, 0.585). Our findings reflect a need to design targeted public health policies and community-based education that emphasize the mother's education on nutrition health and provide socioeconomic resources that enable mothers to provide dietary needs that prevent malnutrition.
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Sebai I, Decelles S, Batal M. Determinants of dietary diversity among children 6-23 months: a cross-sectional study in three regions of Haiti. J Hum Nutr Diet 2022; 36:833-847. [PMID: 36514214 DOI: 10.1111/jhn.13128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prenatal, perinatal, postnatal and nutritional (A3PN) support study was a 4-year initiative aimed to reduce maternal mortality in Haiti. A cross-sectional study was developed to collect the baseline data for evaluation purposes of the A3PN. This study aimed to determine the factors contributing to dietary diversity (DD) in Haitian children aged 6-23 months. METHODS A cross-sectional study during two seasons (the lean season and the harvest season) was carried out in Haiti to assess the DD of children and their mothers using non-quantitative 24-h recalls. Indicators of DD were minimum dietary diversity for children (MDD-C) and minimum dietary diversity for women (MDD-W). Mid-upper arm circumference was measured in women and children, and food security was assessed using the Household Hunger Scale. Focus groups were also conducted to gain a better understanding of the quantitative findings. RESULTS Only 7.3% of the children included in this study met the MDD-C. Factors associated with MDD-C were the season (odds ratio [OR]: 0.141 [0.039-0.513]), land ownership or rental (OR: 4.603 [1.233-17.188]), maternal education (OR: 0.092 [0.011-0.749]), the mother's responsibility for the main or secondary source of income for the household (OR: 2.883 [1.030-8.069]) and her DD (OR: 5.690 [1.916-16.892]). Focus groups revealed the existence of various food restrictions. CONCLUSIONS The results indicated that the low prevalence of MDD-C in three regions of study in Haiti is indicative of a serious public health concern that might be further aggravated by local food taboos. They also suggest that to fight against hunger, it is necessary to focus on women's well-being.
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Affiliation(s)
- Ines Sebai
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Ottawa, Ontario, Canada.,TRANSNUT, Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Stéphane Decelles
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Ottawa, Ontario, Canada.,TRANSNUT, Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Malek Batal
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Ottawa, Ontario, Canada.,TRANSNUT, Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
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Cavalcanti AUA, Boccolini CS. Desigualdades sociais e alimentação complementar na América Latina e no Caribe. CIENCIA & SAUDE COLETIVA 2022; 27:619-630. [DOI: 10.1590/1413-81232022272.31862020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/07/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Este artigo tem como objetivo avaliar o papel das desigualdades sociais nos padrões de alimentação complementar nos países da América Latina e do Caribe. Trata-se de um estudo ecológico que utilizou dados agregados de inquéritos de base populacional. A unidade de análise da pesquisa foram 16 países da América Latina e do Caribe com informações disponíveis. Foram selecionados como desfechos a prevalência dos seguintes indicadores de alimentação complementar: introdução alimentar de alimentos sólidos, semissólidos e pastosos” (IASSP), “diversidade alimentar mínima” (DAM), “frequência alimentar mínima” (FAM) e “alimentação mínima aceitável” (AMA). As diferenças da prevalência dos indicadores entre os quintis de riqueza mais ricos e mais pobres foram calculadas de forma absoluta e relativa. Comparando os quatro indicadores de alimentação complementar, o IASSP teve o melhor desempenho, com 10 países, entre os 11 avaliados, apresentando prevalência acima de 80%. O indicador com pior desempenho foi o AMA, com apenas um país, entre os oito avaliados, com prevalências acima de 60%. Na quase totalidade dos países, a população mais pobre possuía prevalências de indicadores de alimentação complementar menores que os mais ricos.
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Donkor WES, Adu-Afarwuah S, Wegmüller R, Bentil H, Petry N, Rohner F, Wirth JP. Complementary Feeding Indicators in Relation to Micronutrient Status of Ghanaian Children Aged 6-23 Months: Results from a National Survey. Life (Basel) 2021; 11:969. [PMID: 34575118 PMCID: PMC8468967 DOI: 10.3390/life11090969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Optimal complementary feeding is critical for adequate growth and development in infants and young children. The associations between complementary feeding and growth have been studied well, but less is known about the relationship between complementary feeding and micronutrient status. METHODS Using data from a national cross-sectional survey conducted in Ghana in 2017, we examined how multiple WHO-recommended complementary feeding indicators relate to anemia and the micronutrient status of children aged 6-23 months. RESULTS In total, 42%, 38%, and 14% of the children met the criteria for minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. In addition, 71% and 52% of the children consumed iron-rich foods and vitamin A-rich foods, respectively. The prevalence of anemia, iron deficiency (ID), iron deficiency anemia (IDA) and vitamin A deficiency (VAD) was 46%, 45%, 27%, and 10%, respectively. Inverse associations between MMF and socio-economic status were found, and MMF was associated with an increased risk of ID (55%; p < 0.013) and IDA (38%; p < 0.002). CONCLUSION The pathways connecting complementary feeding and micronutrient status are complex. Findings related to MMF should be further investigated to ensure that complementary feeding programs account for the potential practice of frequent feeding with nutrient-poor foods.
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Affiliation(s)
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon P.O. Box LG 25, Ghana; (S.A.-A.); (H.B.)
| | - Rita Wegmüller
- GroundWork, 7306 Fläsch, Switzerland; (R.W.); (N.P.); (F.R.); (J.P.W.)
| | - Helena Bentil
- Department of Nutrition and Food Science, University of Ghana, Legon P.O. Box LG 25, Ghana; (S.A.-A.); (H.B.)
| | - Nicolai Petry
- GroundWork, 7306 Fläsch, Switzerland; (R.W.); (N.P.); (F.R.); (J.P.W.)
| | - Fabian Rohner
- GroundWork, 7306 Fläsch, Switzerland; (R.W.); (N.P.); (F.R.); (J.P.W.)
| | - James P. Wirth
- GroundWork, 7306 Fläsch, Switzerland; (R.W.); (N.P.); (F.R.); (J.P.W.)
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A scoping review of research on policies to address child undernutrition in the Millennium Development Goals era. Public Health Nutr 2021; 24:4346-4357. [PMID: 33926609 DOI: 10.1017/s1368980021001890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The breadth of research on the impact of nutrition-specific policies to address child undernutrition is not well documented. This review maps the evidence base and identifies gaps on such policies. DESIGN We systematically searched Medline, Embase, PAIS Index for public policy, Scopus and Web of Science databases to identify eligible studies. Key study characteristics, including research design, type of policy, time span of policy before impact assessment, child age at outcome assessment and types of outcomes assessed, were abstracted in duplicate. SETTING Low-, middle- and high-income countries. PARTICIPANTS Studies were eligible for inclusion if they aimed to assess the impact of population-level nutrition-specific policies on undernutrition among children under 10 years of age. RESULTS Of the 5646 abstracts screened, eighty-three studies were included. A range of policies to address child undernutrition were evaluated; the majority were related to micronutrient fortification. Most studies were observational, reported on mandatory regional or sub-national polices, were conducted in high-income countries and evaluated policies within 1 year of implementation. A narrow set of health outcomes were evaluated, most commonly iodine deficiency disorders and neural tube defects. CONCLUSIONS Nutrition policies were commonly associated with improved child nutritional status and health. However, this evidence is primarily based on limited settings and on a limited number of outcomes. Further research is needed to assess the longer-term impact of a broader range of nutrition policies on child health, particularly in low- and middle-income countries.
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Chen D, McKune SL, Singh N, Yousuf Hassen J, Gebreyes W, Manary MJ, Bardosh K, Yang Y, Diaz N, Mohammed A, Terefe Y, Roba KT, Ketema M, Ameha N, Assefa N, Rajashekara G, Deblais L, Ghanem M, Yimer G, Havelaar AH. Campylobacter Colonization, Environmental Enteric Dysfunction, Stunting, and Associated Risk Factors Among Young Children in Rural Ethiopia: A Cross-Sectional Study From the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) Project. Front Public Health 2021; 8:615793. [PMID: 33553097 PMCID: PMC7862945 DOI: 10.3389/fpubh.2020.615793] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022] Open
Abstract
Livestock farming provides a possible mechanism by which smallholder farmers can meet their household need for animal source foods (ASF), which may reduce the risk of stunting. However, direct/indirect contacts with domestic animals may increase colonization by Campylobacter spp., which has been associated with Environmental Enteric Dysfunction (EED) and stunting. A cross-sectional study involving 102 randomly selected children between 12 and 16 months of age was conducted in rural eastern Ethiopia to establish prevalence rates of Campylobacter colonization, EED, and stunting, and evaluate potential risk factors. Data were collected between September and December 2018. The prevalence of EED and stunting was 50% (95% CI: 40-60%) and 41% (95% CI: 32-51%), respectively. Among enrolled children, 56% had consumed some ASF in the previous 24 h; 47% had diarrhea and 50% had fever in the past 15 days. 54, 63, 71 or 43% of households owned at least one chicken, cow/bull, goat, or sheep; 54 (53%) households kept chickens indoors overnight and only half of these confined the animals. Sanitation was poor, with high levels of unimproved latrines and open defecation. Most households had access to an improved source of drinking water. The prevalence of Campylobacter colonization was 50% (95% CI: 41-60%) by PCR. In addition to the thermotolerant species Campylobacter jejuni, Campylobacter coli and Campylobacter upsaliensis, non-thermotolerant species related to Campylobacter hyointestinalis and Campylobacter fetus were frequently detected by Meta-total RNA sequencing (MeTRS). Current breastfeeding and ASF consumption increased the odds of Campylobacter detection by PCR, while improved drinking water supply decreased the odds of EED. No risk factors were significantly associated with stunting. Further studies are necessary to better understand reservoirs and transmission pathways of Campylobacter spp. and their potential impact on child health.
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Affiliation(s)
- Dehao Chen
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Sarah L. McKune
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Center for African Studies, University of Florida, Gainesville, FL, United States
| | - Nitya Singh
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Jemal Yousuf Hassen
- Department of Rural Development and Agricultural Extension, Haramaya University, Dire Dawa, Ethiopia
| | - Wondwossen Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Mark J. Manary
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, United States
| | - Kevin Bardosh
- Department of Anthropology, University of Florida, Gainesville, FL, United States
| | - Yang Yang
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicholas Diaz
- Center for African Studies, University of Florida, Gainesville, FL, United States
| | | | - Yitagele Terefe
- College of Veterinary Medicine, Haramaya University, Dire Dawa, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Mengistu Ketema
- School of Agricultural Economics and Agribusiness, Haramaya University, Dire Dawa, Ethiopia
| | - Negassi Ameha
- School of Animal and Range Science, Haramaya University, Dire Dawa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Gireesh Rajashekara
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Loïc Deblais
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Mostafa Ghanem
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Getnet Yimer
- Global One Health initiative, Office of International Affairs, The Ohio State University, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Arie H. Havelaar
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
- Institute for Sustainable Food Systems, University of Florida, Gainesville, FL, United States
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Ahishakiye J, Vaandrager L, Brouwer ID, Koelen M. Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda. BMC Public Health 2021; 21:103. [PMID: 33419407 PMCID: PMC7796631 DOI: 10.1186/s12889-020-10095-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/20/2020] [Indexed: 11/29/2022] Open
Abstract
Background Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life. Methods This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. Results Coping strategies included improving mothers’ own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers’ anticipatory behaviors such as preparing child’s food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role. Conclusion In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers’ capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.
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Affiliation(s)
- Jeanine Ahishakiye
- Department of Human Nutrition and Dietetics, College of Medicine and Health Sciences, University of Rwanda, P.O Box 3286, Kigali, Rwanda. .,Health and Society Chair Group, Wageningen University and Research, P.O Box 8130, 6700EW Wageningen, The Netherlands.
| | - Lenneke Vaandrager
- Health and Society Chair Group, Wageningen University and Research, P.O Box 8130, 6700EW Wageningen, The Netherlands
| | - Inge D Brouwer
- Division of Human Nutrition and Health, Wageningen University and Research, P.O Box 17, 6700AA Wageningen, The Netherlands
| | - Maria Koelen
- Health and Society Chair Group, Wageningen University and Research, P.O Box 8130, 6700EW Wageningen, The Netherlands
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Gezahegn H, Tegegne M. <p>Magnitude and Its Predictors of Minimum Dietary Diversity Feeding Practice Among Mothers Having Children Aged 6–23 Months in Goba Town, Southeast Ethiopia, 2018: A Community-Based Cross-Sectional Study</p>. NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s243521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Miller V, Webb P, Micha R, Mozaffarian D. Defining diet quality: a synthesis of dietary quality metrics and their validity for the double burden of malnutrition. Lancet Planet Health 2020; 4:e352-e370. [PMID: 32800153 PMCID: PMC7435701 DOI: 10.1016/s2542-5196(20)30162-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Achieving most of the UN Sustainable Development Goals requires a strong focus on addressing the double burden of malnutrition, which includes both diet-related maternal and child health (MCH) and non-communicable diseases (NCDs). Although, the most optimal dietary metric for assessing malnutrition remains unclear. Our aim was to review available global dietary quality metrics (hereafter referred to as dietary metrics) and evidence for their validity to assess MCH and NCD outcomes, both separately and together. A systematic search of PubMed was done to identify meta-analyses or narrative reviews evaluating validity of diet metrics in relation to nutrient adequacy or health outcomes. We identified seven dietary metrics aiming to address MCH and 12 for NCDs, no dietary metrics addressed both together. Four NCD dietary metrics (Mediterranean Diet Score, Alternative Healthy Eating Index, Healthy Eating Index, and Dietary Approaches to Stop Hypertension) had convincing evidence of protective associations with specific NCD outcomes, mainly mortality, cardiovascular disease, type 2 diabetes, and total cancer. The remaining NCD dietary metrics and all MCH dietary metrics were not convincingly validated against MCH or NCD health outcomes. None of the dietary metrics had been validated against both MCH and NCD outcomes. These findings highlight major gaps in assessing and addressing diet to achieve global targets and effective policy action.
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Affiliation(s)
- Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Ahmed KY, Page A, Arora A, Ogbo FA. Trends and factors associated with complementary feeding practices in Ethiopia from 2005 to 2016. MATERNAL AND CHILD NUTRITION 2019; 16:e12926. [PMID: 31833239 PMCID: PMC7083482 DOI: 10.1111/mcn.12926] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 12/18/2022]
Abstract
Introducing appropriate complementary feeding at 6 months of age is crucial for the optimal growth and development of an infant. In Ethiopia, however, no previous national‐level studies have examined the trends and associated factors of complementary feeding practices. The aim of this study is to investigate the trends and determinants of complementary feeding practices in Ethiopia from 2005 to 2016. The study was conducted using the Ethiopia Demographic and Health Survey (EDHS) data for 2005 (N = 2,520), 2011 (N = 2,850), and 2016 (N = 2,864). Percentage point changes in complementary feeding indicators were estimated to examine the trends over the EDHS years. Multivariate logistic regression was used to examine the association between socioeconomic, demographic, health service, and community‐level factors and (a) the introduction of complementary foods, (b) minimum dietary diversity (MDD), (c) minimum meal frequency (MMF), and (d) minimum acceptable diet (MAD). The proportion of mothers who met MDD increased from 6.3% to 13.5% (p < .001), and MAD increased from 4.1% to 7.1% (p = .003) from 2005 to 2016. Improvements in the introduction of complementary foods (from 50.3% to 59.5%, p = .051) and MMF (from 41.3% to 43.6%, p = .288) were not statistically significant. Maternal education and occupation were associated with the introduction of complementary foods, MDD, MMF, and MAD. Higher partner education and frequent antenatal visits were associated with MDD and MAD. Children whose mothers listened to the radio had higher odds of MDD, MMF, and MAD. Our analysis of the EDHS suggests that the proportion of MDD and MAD were unacceptably low. Interventions aiming to improve complementary feeding practices in Ethiopia should also target mothers with low education, antenatal service usage, and media exposure.
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Affiliation(s)
- Kedir Y Ahmed
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, New South Wales, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,General Practice Unit, Prescot Specialist Medical Centre, Makurdi, Nigeria
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Martin M, Blackwell A, Kaplan H, Gurven M. Differences in Tsimane children's growth outcomes and associated determinants as estimated by WHO standards vs. within-population references. PLoS One 2019; 14:e0214965. [PMID: 30995260 PMCID: PMC6469771 DOI: 10.1371/journal.pone.0214965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/22/2019] [Indexed: 12/15/2022] Open
Abstract
Anthropometric measures are commonly converted to age stratified z-scores to examine variation in growth outcomes in mixed-age and sex samples. For many study populations, z-scores will differ if calculated from World Health Organization (WHO) growth standards or within-population references. The specific growth reference used may influence statistical estimates of growth outcomes and their determinants, with implications for biological inference. We examined factors associated with growth outcomes in a sample of 152 Tsimane children aged 0-36 months. The Tsimane are a subsistence-scale population in the Bolivian Amazon with high rates of infectious disease and growth faltering. To examine the influence of growth reference on statistical inferences, we constructed multiple plausible models from available infant, maternal, and household attributes. We then ran identical models for height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ), with z-scores alternately calculated from WHO and robust Tsimane Lambda-Mu-Sigma growth curves. The distribution of WHO relative to Tsimane HAZ scores was negatively skewed, reflecting age-related increases in lower HAZ. Standardized coefficients and significance levels generally agreed across WHO and Tsimane models, although the strength and significance of specific terms varied in some models. Age was strongly, negatively associated with HAZ and WAZ in nearly all WHO, but not Tsimane models, resulting in consistently higher R2 estimates. Age and weaning effects were confounded in WHO models. Biased estimates of determinants associated with WHO HAZ may be more extreme in small samples and for variables that are strongly age-patterned. Additional methodological considerations may be warranted when applying WHO standards to within-population studies, particularly for populations with growth patterns known to systematically deviate from those of the WHO reference sample.
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Affiliation(s)
- Melanie Martin
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, United States of America
| | - Aaron Blackwell
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, United States of America
| | - Hillard Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque, NM, United States of America
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, United States of America
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Rosen JG, Clermont A, Kodish SR, Matar Seck A, Salifou A, Grais RF, Isanaka S. Determinants of dietary practices during pregnancy: A longitudinal qualitative study in Niger. MATERNAL & CHILD NUTRITION 2018; 14:e12629. [PMID: 29956458 PMCID: PMC6175447 DOI: 10.1111/mcn.12629] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 04/22/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Abstract
Undernutrition is associated with maternal morbidity and poor pregnancy outcomes. This qualitative study seeks to understand the multilevel factors influencing maternal dietary practices in Niger, including the impact of pregnancy illnesses on diet. Criterion-based, purposive sampling was used to select pregnant women and household members from 24 villages in a rural district of the Maradi Region in south-central Niger. Semistructured interviews (n = 153) and focus group discussions (n = 38) explored 4 primary themes: (a) perceptions of ideal diet during pregnancy, (b) barriers to consuming the ideal diet, (c) coping strategies including dietary responses related to pregnancy illnesses, and (d) changes in perceptions from early to late pregnancy. Longitudinal data collection allowed for repeated interviews of pregnant women to document changes in dietary practices throughout pregnancy. Transcripts were coded using an inductive approach informed by grounded theory methodology. Participants categorized foods into 4 primary dietary taxonomies when discussing ideal maternal diets but cited constraints related to accessibility and availability impeding routine consumption of these foods. Perceptions of "modern," urban foods as healthy, coupled with key structural barriers such as food costs, were identified. Maternal morbidity influenced food consumption, as women reported reducing food intake early in pregnancy in response to illness episodes. Although awareness of optimal foods for supporting healthy pregnancies was moderately high, some misconceptions were observed and multilevel barriers to food security restricted opportunities for consuming these foods. Nutrition-specific and nutrition-sensitive interventions could improve access and availability of acceptable foods for supporting increased dietary intake during pregnancy.
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Affiliation(s)
- Joseph G. Rosen
- Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Adrienne Clermont
- Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Stephen R. Kodish
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | | | | | | | - Sheila Isanaka
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of ResearchEpicentreParisFrance
- Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
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15
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Poda GG, Hsu CY, Chao JCJ. Factors associated with malnutrition among children <5 years old in Burkina Faso: evidence from the Demographic and Health Surveys IV 2010. Int J Qual Health Care 2018; 29:901-908. [PMID: 29045661 DOI: 10.1093/intqhc/mzx129] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 09/25/2017] [Indexed: 12/25/2022] Open
Abstract
Objective To assess the factors associated with malnutrition among children <5 years in Burkina Faso. Design This study was based on secondary analysis of cross-sectional population-based data from Burkina-Faso Demographic Health Surveys 2010. Setting This study was carried out in Burkina Faso, West Africa. Participants The participants were 6337 children <5 years and their mothers. Main outcome measures Demographic characteristics, child nutrition and health status, and maternal and household information were collected. Survey-specific SAS procedures for weighting, clustering and stratification in the survey design were used. The distribution of different nutritional status, such as underweight, stunting and wasting and the effects of risk factors on malnutrition was analyzed. Results Out of 6337 children <5 years, 51.0% of children were male and 57.8% of children had an average size at birth. There were 15.6, 21.5 and 10.6% of children who recently suffered from diarrhea, fever and acute respiratory infection, respectively. Child sex, age, size at birth, child morbidity, mother's education and body mass index and household wealth index were significantly associated with undernutrition among children <5 years in Burkina Faso. Conclusions In addition to the improvement of household wealth index, more health and nutritional education for mothers should be implemented by the government to improve health and nutritional status of children <5 years in Burkina Faso.
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Affiliation(s)
- Ghislain G Poda
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Ministry of Health, Avenue of Burkina, Ouagadougou 7035, Burkina Faso
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Taipei 112, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
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16
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Nsereko E, Mukabutera A, Iyakaremye D, Umwungerimwiza YD, Mbarushimana V, Nzayirambaho M. Early feeding practices and stunting in Rwandan children: a cross-sectional study from the 2010 Rwanda demographic and health survey. Pan Afr Med J 2018; 29:157. [PMID: 30050621 PMCID: PMC6057555 DOI: 10.11604/pamj.2018.29.157.10151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 03/06/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction in Rwanda, despite different interventions to improve child nutrition status, malnutrition in children under five years of age continue to be a public health concern. This study aimed to evaluate the factors that contribute to childhood stunting by assessing feeding practices of Rwandans in children ≤ 2 years of age. Methods A cross-sectional study with data obtained from the 2010 Rwanda Demographic and Health Survey was conducted on 1,634 children ≤ 2 years of age with complete anthropometrical measurements. Multivariable logistic regression analysis was used to assess the association between feeding practices and childhood stunting. Results The results revealed that 35.1% of 1,634 children were stunted. Breastfeeding for 1 year (OR = 2.77, 95% CI = 1.91-4.01, P < 0.001) increased the risk of childhood stunting. After controlling for confounders, solid food initiation (OR = 1.21, 95% CI = 0.47-3.16, P≥ 0.690) and early initiation to breastfeeding (OR = 1.16, CI = 0.90-1.51, P = 0.243) were not associated with childhood stunting. Conclusion There was a significant association between continued breastfeeding for 1 year and childhood stunting. We suggest supplementary feeding for children who are breastfed for ≥1 year.
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Affiliation(s)
- Etienne Nsereko
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Rwanda
| | - Assumpta Mukabutera
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Rwanda
| | - Damien Iyakaremye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Rwanda
| | | | - Valens Mbarushimana
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Rwanda
| | - Manassé Nzayirambaho
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Rwanda
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17
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Muggaga C, Ongeng D, Mugonola B, Okello-Uma I, Kaaya NA, Taylor D. Influence of Sociocultural Practices on Food and Nutrition Security in Karamoja Subregion of Uganda. Ecol Food Nutr 2017; 56:424-447. [DOI: 10.1080/03670244.2017.1366318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C. Muggaga
- Department of Food Science and Postharvest Technology, Gulu University, Gulu, Uganda
| | - D. Ongeng
- Department of Food Science and Postharvest Technology, Gulu University, Gulu, Uganda
| | - B. Mugonola
- Department of Rural Development and Agribusiness, Gulu University, Gulu, Uganda
| | - I. Okello-Uma
- Department of Food Science and Postharvest Technology, Gulu University, Gulu, Uganda
| | - N. A. Kaaya
- Department of Food technology and Nutrition, School of Food Science, Nutrition and Bio-science Engineering, College of Agricultural and Environmental Sciences, Kampala, Uganda
| | - D. Taylor
- Department of Geography, National University of Singapore, Singapore
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18
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Pauzé E, Batal M, Philizaire Y, Blanchet R, Sanou D. Determinants of diet quality among rural households in an intervention zone of Grande Anse, Haiti. Food Secur 2016. [DOI: 10.1007/s12571-016-0615-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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19
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Barman D, Vadrevu L. How is perceived community cohesion and membership in community groups associated with children's dietary adequacy in disadvantaged communities? A case of the Indian Sundarbans. BMC Health Serv Res 2016; 16:622. [PMID: 28185598 PMCID: PMC5123337 DOI: 10.1186/s12913-016-1862-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Membership in community groups and a sense of community cohesion may facilitate collective action in mobilizing resources towards better health outcomes. This paper explores the relationship of these factors, along with individual level socio-economic variables, to dietary adequacy among children below 6 years of age, a proximate determinant of child malnutrition. Methods We conducted a cross-sectional survey in Patharpratima block of the Sundarbans in West Bengal, India, using a two-stage, 30 cluster random sampling design. In 1200 sampled households, we used a structured questionnaire to interview mothers of children below 6 years of age on their child’s nutritional intake. We also interviewed household heads to assess perceived community cohesion using a nine item scale, membership in any community self-help organization, and other socio-economic determinants. We used a logistic regression model to assess their association with a minimum acceptable diet among children between 6 months to 6 years. Results Only 9.33 % children between 6 and 71 months of age received a minimum acceptable diet. With each increase in the perceived community cohesion score (scale 0-9), a child is 1.31 times more likely to have minimum acceptable diet (95 % CI 1.14, 1.50). The odds of minimum acceptable diet were also higher among children whose mothers had primary education (2.09, 95 % CI 1.03, 2.94) as compared to illiterate mothers and in households with surplus food resources (2.72, 95 % CI 1.32, 5.58) as compared to those without surplus or deficit. In contrast, registering at an Anganwadi (government early child development) centre (odds ratio 1.34 95 % CI 0.69, 2.60) and community membership (odds ratio 0.93, 95 % CI 0.59, 1.46) were not associated with minimum acceptable diet. Conclusion The results are consistent with what is known about the importance of maternal education and access to food resources in ensuring that children have a minimum acceptable diet. Perceived community cohesion seems to play a positive role in children’s diets. Further research needs to clarify which community characteristics and services are the most relevant, how they can better support children’s diets, and how interventions can strengthen these community characteristics and services.
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Agbozo F, Colecraft E, Ellahi B. Impact of type of child growth intervention program on caregivers' child feeding knowledge and practices: a comparative study in Ga West Municipality, Ghana. Food Sci Nutr 2016; 4:562-72. [PMID: 27386106 PMCID: PMC4930500 DOI: 10.1002/fsn3.318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 07/10/2015] [Accepted: 11/01/2015] [Indexed: 11/08/2022] Open
Abstract
Community-based growth promotion (CBGP) delivered by community volunteers aims at enhancing the traditional growth monitoring and promotion (GMP) program delivered by community health nurses through the promotion of optimum infant and young child feeding (IYCF) leading to improved child growth. This study compared IYCF knowledge and practices among caregiver-child pairs (0-24 months) receiving child welfare services from CBGP (n = 124) and GMP (n = 108) programs. Semistructured questionnaires were used to interview caregivers on IYCF knowledge/practices and validated food frequency questionnaire used to record infants' food intakes. Group differences were determined using Chi-square and independent samples t-tests (P < 0.05; 95% confidence interval [CI]). Mean IYCF knowledge scores were similar (CBGP: 10.84 ± 1.69 vs. GMP: 10.23 ± 1.38, P = 0.062). However, more CBGP caregivers (17%) were highly knowledgeable than their GMP counterparts (5%) (P = 0.011). Early breastfeeding initiation (CBGP: 54% vs. GMP: 28%, P < 0.0001), exclusive breastfeeding (CBGP: 73% vs. GMP: 56%, P = 0.001), and timely complementary feeding (CBGP: 72% vs. GMP: 49%, P = 0.014) were reportedly higher among CBGP caregivers. Underweight was 11% (CBGP: 8% vs. GMP: 14%, P = 0.154). Mean dietary diversity scores (10 food groups) were similar (CBGP: 4.49 ± 1.89 vs. GMP: 3.87 ± 1.89, P = 0.057) but more CBGP caregivers (77%) achieved minimum dietary diversity than their GMP counterparts (61%) (P = 0.035). Few caregivers achieved minimum meal frequency (CBGP: 31% vs. GMP: 29%, P = 0.486) and minimum acceptable diet (CBGP: 23% vs. GMP: 21%, P = 0.464) indicators. Number of children under 5 years owned by caregiver (adjusted odds ratio [AOR]: 0.405; 95% CI: 1.13-78.53, P = 0.038), her educational level (AOR: 0.112; 95% CI: 0.02-0.90, P = 0.040), and IYCF knowledge (AOR: 0.140; 95% CI: 0.03-0.79, P = 0.026) significantly predicted optimum child feeding. Nutrition education on optimum complementary feeding and birth spacing strategies should intensify.
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Affiliation(s)
- Faith Agbozo
- Department of Family and community HealthSchool of Public HealthUniversity of Health and Allied SciencesHo (Hohoe campus)Ghana
| | - Esi Colecraft
- Department of Nutrition and Food ScienceUniversity of GhanaP. O. Box LG 134LegonGhana
| | - Basma Ellahi
- Faculty of Health and Social CareUniversity of ChesterChesterCH1 4BJUnited Kingdom
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Ayoya MA, Heidkamp R, Ngnie‐Teta I, Mamadoultaibou A, Daniel EF, Durandisse EB, Saint‐Fleur JE, Beaulière JM, Koita Y, M'Mbakwa BE, Stoltzfus RJ, Pierre JM. Précis of nutrition of children and women in Haiti: analyses of data from 1995 to 2012. Ann N Y Acad Sci 2014; 1309:37-62. [DOI: 10.1111/nyas.12373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Rebecca Heidkamp
- Division of Nutritional Sciences Cornell University Ithaca New York
| | | | | | | | | | | | | | - Youssouf Koita
- Nutrition Section UNICEF Country Office Port‐au‐Prince Haiti
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Heidkamp RA, Ayoya MA, Teta IN, Stoltzfus RJ, Marhone JP. Complementary feeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys. MATERNAL AND CHILD NUTRITION 2013; 11:815-28. [PMID: 24118777 DOI: 10.1111/mcn.12090] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Haitian National Nutrition Policy identifies the promotion of optimal complementary feeding (CF) practices as a priority action to prevent childhood malnutrition. We analysed data from the nationally representative 2005-2006 Haiti Demographic Health Survey using the World Health Organization 2008 infant and young child feeding indicators to describe feeding practices among children aged 6-23 months and thus inform policy and programme planning. Multivariate regression analyses were used to identify the determinants of CF practices and to examine their association with child growth outcomes. Overall, 87.3% of 6-8-month-olds received soft, solid or semi-solid foods in the previous 24 h. Minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) were achieved in 29.2%, 45.3% and 17.1% of children aged 6-23 months, respectively. Non-breastfed children were more likely to achieve MDD than breastfed children of the same age (37.3% vs. 25.8%; P < 0.001). The proportion of children achieving MMF varied significantly by age (P < 0.001). Children with overweight mothers were more likely to achieve MDD, MMF and MAD [odds ratio (OR) 2.08, P = 0.012; OR 1.81, P = 0.02; and OR 2.4, P = 0.01, respectively] than children of normal weight mothers. Odds of achieving MDD and MMF increased with household wealth. Among mothers with secondary or more education, achieving MDD or MAD was significantly associated with lower mean weight-for-age z-score and height-for-age z-score (P-value <0.05 for infants and young child feeding indicator × maternal education interaction). CF practices were mostly inadequate and contributed to growth faltering among Haitian children 6-23 months old.
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Affiliation(s)
- Rebecca A Heidkamp
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | - Joseline Pierre Marhone
- National Food and Nutrition Program Coordination Unit, Ministry of Public Health and Population, Port-au-Prince, Haiti
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