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Janmohamed A, Baker MM, Doledec D, Ndiaye F, Konan ACL, Leonce A, Kouadio KL, Beye M, Yattara ML, Dissieka R. Dietary diversity and associated factors among infants and young children in three West African countries. Front Public Health 2024; 12:1386664. [PMID: 39114514 PMCID: PMC11303163 DOI: 10.3389/fpubh.2024.1386664] [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] [Received: 02/15/2024] [Accepted: 05/24/2024] [Indexed: 08/10/2024] Open
Abstract
Providing children healthy diversified diets is important for their optimal growth and development. The high prevalence of under-nourishment during the critical early life period is of serious concern in West Africa. We assessed the level of dietary diversity and associated factors for children aged 6-23 months in Côte d'Ivoire, Niger and Senegal. Prior 24 h dietary intake was assessed for 3,528 children (Côte d'Ivoire: N = 118; Niger: N = 763; Senegal: N = 2,647) using the Diet Quality Questionnaire survey tool administered to primary caregivers. Cluster random sampling was conducted for urban and rural areas in Niger and Senegal and simple random sampling was used in Côte d'Ivoire, where only rural households were selected. Survey data were analyzed to determine children's intake of items from eight food groups: breast milk; grains, roots, tubers and plantains; pulses, nuts and seeds; dairy products; flesh foods; eggs; vitamin A-rich fruits and vegetables; and other fruits and vegetables. Minimum Dietary Diversity (MDD) was assessed based on the consumption of ≥5 of the 8 food groups. In all countries, the majority of children were ≥ 12 months of age and from rural households. Children from poor/very poor households ranged from 32.4 to 41.9%. MDD prevalence was 54.2% in Côte d'Ivoire, 33.3% in Niger and 30.8% in Senegal. In all three countries, children 12-23 months had significantly higher consumption of six of the food groups, compared to those 6-11 months, and children ≥12 months had a higher likelihood of MDD, compared to infants, in Niger (aOR = 4.25; 95% CI: 2.46, 7.36) and Senegal (aOR = 2.69; 95% CI: 2.15, 3.35). MDD prevalence was higher among children in urban, compared to rural, areas in Niger (p = 0.020) and Senegal (p < 0.001) and significantly higher in the wealthiest, compared to poorest, households. This study suggests most young children in Côte d'Ivoire, Niger and Senegal are not receiving an adequately diversified diet, with a reliance on starchy staples and lower intake of high-quality protein sources. Our results highlight socio-economic barriers to attaining dietary diversity in these settings and stress the urgent and continuing need for investments in strategies that support optimal complementary feeding practices.
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Affiliation(s)
- Amynah Janmohamed
- Helen Keller International, Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - Melissa M. Baker
- Helen Keller International, Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - David Doledec
- Helen Keller International, Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - Fatou Ndiaye
- Helen Keller International, Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | | | | | | | | | | | - Romance Dissieka
- Helen Keller International, Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
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Lacerda EMDA, Bertoni N, Alves-Santos NH, Carneiro LBV, Schincaglia RM, Boccolini CS, Castro IRRD, Anjos LAD, Berti TL, Kac G, Rodrigues Farias D, de Freitas MB, Normando P, Andrade PG. Minimum dietary diversity and consumption of ultra-processed foods among Brazilian children 6-23 months of age. CAD SAUDE PUBLICA 2023; 39:e00081422. [PMID: 37878864 PMCID: PMC10599228 DOI: 10.1590/0102-311xen081422] [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] [Received: 05/06/2022] [Revised: 04/03/2023] [Accepted: 05/04/2023] [Indexed: 10/27/2023] Open
Abstract
The study aimed to estimate the prevalence of minimum dietary diversity (MDD) and consumption of ultra-processed foods in children 6-23 months of age according to sociodemographic variables. Three indicators of complementary feeding of 4,354 children from the Brazilian National Survey on Child Nutrition (ENANI-2019) were built based on a questionnaire about food consumption on the day before the interview: MDD, consumption of ultra-processed foods, and MDD without the consumption of ultra-processed foods. The prevalence and 95%CI were calculated, stratified by macroregion; race/skin color, education and work status of the mother or caregiver; enrollment in the Brazilian Income Transfer Program; household food security; sanitation; and child enrollment in daycare/school. The overall prevalence of MDD was 63.4%, with lower prevalences among children who lived in the North Region (54.8%), whose mothers or caregivers had 0-7 years of education (50.6%), and lived under moderate or severe food insecurity (52.6%). Ultra-processed foods were consumed by 80.5% of the children, with the highest prevalence in the North Region (84.5%). The prevalence of MDD without ultra-processed foods was 8.4% and less prevalent among children with black mothers or caregivers (3.6%) and among those whose mother or caregiver had 8-10 years of education (3.6%). The most frequently consumed food groups from the MDD indicator were grains, roots and tubers (90.2%), dairy products (81%) and those from ultra-processed food were sweet or salty cookies/crackers (51.3%) and instant flours (41.4%). The ubiquitous presence of ultra-processed foods in the diets of Brazilian children and the low frequency of diversified foods, especially among the most vulnerable populations, indicate the need to strengthen policies and programs to ensure adequate and healthy infant nutrition.
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Affiliation(s)
| | - Neilane Bertoni
- Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | - Nadya Helena Alves-Santos
- Instituto de Estudos em Saúde e Biológicas, Universidade Federal do Sul e Sudeste do Pará, Belém, Brasil
| | | | | | - Cristiano Siqueira Boccolini
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | - Talita Lelis Berti
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Gilberto Kac
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Tessema M, Hussien S, Ayana G, Teshome B, Hussen A, Kebebe T, Mogese T, Petros A, Fikresilassie G, Wodajo B, Mokenen T, Tollera G, Whiting SJ. Effect of enhanced nutrition services with community-based nutrition services on the diet quality of young children in Ethiopia. MATERNAL & CHILD NUTRITION 2023; 19:e13525. [PMID: 37139835 PMCID: PMC10483948 DOI: 10.1111/mcn.13525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 05/05/2023]
Abstract
Poor diet quality related to inadequate complementary feeding is a major public health problem in low and middle-income countries including Ethiopia. Low dietary diversity has been linked to negative health outcomes in children. To provide a package of interventions to close nutritional gaps through agriculture, the Sustainable Undernutrition Reduction in Ethiopia (SURE) programme was set up as a multi-sectoral initiative and the results of combined effects of community-based and enhanced nutrition services, compared to community-based alone, on diet diversity and diet quality of complementary feeding of young children are presented. The study used pre- and post-intervention design. Baseline (n = 4980) data were collected from May to July 2016, and follow-up (n = 2419) data from December 2020 to January 2021. From 51 intervention districts having the SURE programme, 36 intervention districts were randomly selected for baseline and 31 for the follow-up survey. The primary outcome was diet quality: minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). Comparing endline to baseline over the 4.5-year intervention, the use of standard community-based nutrition services of growth monitoring and promotion increased (16%-46%), as did enhanced nutrition services of infant and young child feeding counselling, and agricultural advising (62%-77%). Women involved in home gardening significantly increased (73%-93%); however, household production of food decreased yet consumption of most own-grown foods increased. Importantly, MAD and MDD increased four-fold. The SURE intervention programme was associated with improvements in complementary feeding and diet quality through enhanced nutrition services. This suggests programmes targeted at nutrition-sensitive practices can improve child feeding in young children.
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Affiliation(s)
- Masresha Tessema
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Shimelis Hussien
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Girmaye Ayana
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Beza Teshome
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Alemayehu Hussen
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Tadesse Kebebe
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Tseday Mogese
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Alem Petros
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Getinet Fikresilassie
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Berhanu Wodajo
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Tadesse Mokenen
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Getachew Tollera
- Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAddis AbabaEthiopia
| | - Susan J. Whiting
- College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonSaskatoonCanada
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Garti H, Bukari M, Wemakor A. Early initiation of breastfeeding, bottle feeding, and experiencing feeding challenges are associated with malnutrition. Food Sci Nutr 2023; 11:5129-5136. [PMID: 37701229 PMCID: PMC10494642 DOI: 10.1002/fsn3.3472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 04/06/2023] [Accepted: 05/24/2023] [Indexed: 09/14/2023] Open
Abstract
Malnutrition remains a public health concern amidst low proportions of the core infant and young child feeding (IYCF) practices, yet, data on specific child feeding practices that are associated with undernutrition are rare. Hence, this study sought to assess child feeding practices and their association with undernutrition among young children. An analytical cross-sectional design was used among mothers/caregivers with children aged 6-23 months, attending child welfare clinics in Techiman municipality, Ghana. Simple random sampling was used to select 8 health facilities, and 403 participants were selected from those facilities using proportional stratification. A 24-h dietary recall based on seven food groups was used to collect data on children's dietary intake and used to derive WHO child feeding indicators. The length, weight, and age of children were taken and used to compute anthropometric z-scores. The proportions of children who met their minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were 44%, 56%, and 36% respectively. Children 6-8 months [AOR=2.24, CI (1.037-4.841); p = .04] and 9-11 months [AOR=2.47, CI (1.096-5.573); p = .029], those who were not breastfed within the first hour of delivery [AOR = 3.56, CI (1.833-6.912), p < .001], and those who were bottle fed [AOR = 2.87, CI (1.374-5.973); p = .005] were more likely to be wasted. Children 6-8 months [AOR = 0.29, CI (0.126-0.672); p = .004] and 9-11 months [AOR = 0.24, CI (0.104-0.544); p = .001] and those who experienced feeding challenges [AOR = 0.52, CI (0.301-0.905); p = 0.021] were protected against stunting. The percentages of children who met their MDD, MMF, and MAD were low and not associated with undernutrition. Early initiation of breastfeeding and bottle feeding were associated with acute malnutrition and experiencing feeding challenges was associated with chronic malnutrition. Promoting appropriate child feeding practices can reduce the risk of undernutrition.
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Affiliation(s)
- Humphrey Garti
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Mohammed Bukari
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Anthony Wemakor
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
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Locks LM, Newell KB, Imohe A, Moloney GM, Shaker-Berbari L, Paudyal N, Jefferds MED. The effect of interventions distributing home fortification products on infant and young child feeding (IYCF) practices: A systematic narrative review. MATERNAL & CHILD NUTRITION 2023:e13488. [PMID: 36842164 DOI: 10.1111/mcn.13488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/14/2022] [Accepted: 01/26/2023] [Indexed: 02/27/2023]
Abstract
Interventions distributing micronutrient powders (MNPs) and small-quantity lipid-based nutrient supplements (SQ-LNS), or home fortification products (HFPs), have the potential to improve infant and young child feeding (IYCF) practices and children's nutrition. We systematically searched for studies on the effect of interventions distributing HFP on IYCF practices. We identified 12 (8 MNP, 4 SQ-LNS) studies: seven programmes with IYCF behaviour change communications (BCC) and MNP (IYCF-MNP) and one provided MNP without IYCF BCC (MNP only). Three SQ-LNS studies came from randomised trials without an IYCF component (SQ-LNS only) and one from a programme with both IYCF BCC and SfQ-LNS (IYCF-SQ-LNS). Five IYCF-MNP programmes reported positive associations with some IYCF practices-four with minimum dietary diversity, two with minimum meal frequency, four with minimum acceptable diet, and three with the initiation of complementary foods at 6 months. Two reported no association between MNP and IYCF indicators, and one reported a decline in IYCF practices during the intervention, although it also reported significant changes to the IYCF programme during the evaluation period. Two studies from interventions that distributed SQ-LNS (one from a related set of randomised controlled trials and the sole IYCF-SQ-LNS programme) reported a positive association with IYCF practices; one trial reported no change in breast milk intake with the provision of SQ-LNS and one found no association with IYCF practices. SQ-LNS and MNP can address nutrient gaps for young children in low-resource settings; our findings indicate that programmes that combine HFP with IYCF interventions may also contribute to improved IYCF practices in some settings.
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Affiliation(s)
- Lindsey M Locks
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA.,Department of Global Health, Boston University, Boston, Massachusetts, USA
| | - Katharine B Newell
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Annette Imohe
- United Nation Children's Fund (UNICEF) Headquarters, New York City, New York, USA
| | - Grainne M Moloney
- United Nation Children's Fund (UNICEF) Headquarters, New York City, New York, USA
| | - Linda Shaker-Berbari
- United Nation Children's Fund (UNICEF) Headquarters, New York City, New York, USA
| | - Naveen Paudyal
- United Nation Children's Fund (UNICEF) Nepal Country Office, Kathmandu, Nepal
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McKune SL, Mechlowitz K, Miller LC. Dietary animal source food across the lifespan in LMIC. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Vidal L, Brunet G, Bove I, Girona A, Fuletti D, Ares G. Parents’ mental associations with ultra-processed products for their infant children: Insights to improve complementary feeding practices. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ariyo O, Aderibigbe OR, Ojo TJ, Sturm B, Hensel O. Determinants of appropriate complementary feeding practices among women with children aged 6-23 months in Iseyin, Nigeria. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Marketing of commercial foods for infant and young children in Uruguay: sugary products, health cues on packages and fun social products on Facebook. Public Health Nutr 2021; 24:5963-5975. [PMID: 34176550 DOI: 10.1017/s1368980021002780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To analyse the content of the marketing of commercial foods for infants and young children on packages and social media. DESIGN Commercial foods targeted at children, regarded as potential breast-milk substitutes according to the Uruguayan breast-feeding standard, were considered: dairy products; teas, juices and bottled waters; glucose solutions; cereals and mixtures of fruits and vegetables. All the products sold at forty-four retail outlets were purchased. A Facebook search was performed to identify accounts of these products. For each account, all the content posted by the brands between July 2017 and July 2019 was recorded. The visual and textual information included in the packages and Facebook posts was analysed using content analysis. Products were classified using the nutrient profile model of the Pan American Health Organization. SETTING Montevideo, Uruguay. RESULTS Seventy-six unique commercial foods targeted at infants and young children were identified, 96 % of which were excessive in sugar. Packages frequently included textual and visual elements to convey health-related associations, including images of fruits and vegetables, nutrient content claims and endorsement logos. Ten Facebook accounts were identified, which generated 302 posts. Parents and caregivers were the main target audience of the posts, which mainly included content related to fun and social aspects of food consumption. Additionally, the posts frequently conveyed the idea that products would contribute to children's growth and development. CONCLUSIONS Results suggest the need to implement comprehensive regulations on the marketing of commercial foods targeted at children, regarded as potential breast-milk substitutes according to the Uruguayan breast-feeding standard.
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Nikièma V, Fogny NF, Salpéteur C, Lachat C, Kangas ST. Complementary feeding practices and associated factors of dietary diversity among uncomplicated severe acute malnourished children aged 6-23 months in Burkina Faso. MATERNAL AND CHILD NUTRITION 2021; 17:e13220. [PMID: 34075726 PMCID: PMC8476442 DOI: 10.1111/mcn.13220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
Nutritional treatment of children with uncomplicated severe acute malnutrition (SAM) is based on ready‐to‐use therapeutic foods (RUTF). With treatment provided at community level, children could have access to other foods, and a reduction in the dose of RUTF could further increase dietary diversity during treatment. We assessed the dietary diversity score (DDS), the minimum dietary diversity (MDD), the minimum meal frequency (MMF) and the minimum acceptable diet (MAD) of 459 infants and young children aged 6–23 months being treated for SAM with different doses of RUTF. We also investigated the factors associated with DDS. Dietary intake was estimated using a single 24‐h multipass dietary recall, 1 month after starting treatment, from December 2016 to August 2018. The DDS was calculated on the basis of eight food groups. Differences between children receiving the reduced RUTF and the standard RUTF dose and factors associated with DDS were assessed by Poisson and logistic regression models. RUTF dose was not associated with DDS (4.07 ± 1.25 for reduced RUTF and 4.01 ± 1.26 for standard RUTF; P = 0.77). Food groups most consumed by children were grains, roots or tubers (96%) and legumes and nuts (72%). Eggs consumption was low (3%). DDS was positively associated with child's age, mother's education, household wealth index, urban residence and rainy season. The present findings show that children with SAM consumed a variety of foods during treatment in addition to the RUTF ration prescribed to them. Reducing the dose of RUTF during SAM treatment did not impact DDS.
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Affiliation(s)
- Victor Nikièma
- Nutrition and Health Department, Action contre la Faim, Ouagadougou, Burkina Faso.,School of Nutrition and Food Sciences and Technologies, Faculty of Agronomic Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin
| | - Nadia F Fogny
- School of Nutrition and Food Sciences and Technologies, Faculty of Agronomic Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin
| | - Cécile Salpéteur
- Expertise and Advocacy Department, Action contre la Faim, Paris, France
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Suvi T Kangas
- Expertise and Advocacy Department, Action contre la Faim, Paris, France
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Brunet G, Vidal L, Bove I, Girona A, Iragola V, Ceriani F, Rodríguez R, Martínez A, Fuletti D, Ares G. The social representations of complementary feeding. Appetite 2021; 165:105324. [PMID: 34029670 DOI: 10.1016/j.appet.2021.105324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
The social representations of complementary feeding are expected to shape parents' decisions and to provide justification or legitimization for their practices. The aims of the present work were: i) to explore the social representations of complementary feeding in parents and health professionals, ii) to evaluate if the onset of complementary feeding modify social representations in parents, and iii) to compare the representations of parents and pediatricians. Three groups of participants were considered: 170 parents of children who had not started complementary feeding (1-4 months old), 170 parents of children who had started complementary feeding (7-10 months old) and 212 pediatricians. Parents were recruited in health facilities in Montevideo (Uruguay), whereas pediatricians were recruited at the National Pediatrics Conference. Participants were asked to complete a word association task with "the first meals of a baby". All the responses provided by participants were grouped into categories using content analysis. The structure of the social representations was assessed considering the frequency of mention and the average rank of appearance of the categories. Results showed that the social representations of complementary feeding for both parents and pediatricians were extremely narrow and mainly focused on specific foods: puree and a small set of vegetables and fruits. None of the categories showed high frequency of mention and low rank of appearance, indicating that the structure of the social representations did not include any element in the first periphery. According to the theory of social representations, results from the present work suggest that the social representations of complementary feeding for Uruguayan parents and pediatricians are deeply rooted and resistant to change.
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Affiliation(s)
- Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay.
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 S/n, CP 91000, Pando, Canelones, Uruguay
| | - Isabel Bove
- UNICEF Uruguay, Bulevar General Artigas 1659, CP 11600, Montevideo, Uruguay
| | - Alejandra Girona
- Departamento de Nutrición Básica, Escuela de Nutrición, Universidad de la República, Av. Américo Ricaldoni S/n, CP 11600, Montevideo, Uruguay; Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Valentina Iragola
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay
| | - Florencia Ceriani
- Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Raquel Rodríguez
- Departamento de Nutrición Básica, Escuela de Nutrición, Universidad de la República, Av. Américo Ricaldoni S/n, CP 11600, Montevideo, Uruguay; Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Andrea Martínez
- Red Uruguaya de Apoyo a la Nutrición y Desarrollo Infantil, Pedro Vidal 2145, CP 11600, Montevideo, Uruguay
| | - Darío Fuletti
- UNICEF Uruguay, Bulevar General Artigas 1659, CP 11600, Montevideo, Uruguay
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 S/n, CP 91000, Pando, Canelones, Uruguay
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Vidal L, Bove I, Brunet G, Girona A, Alcaire F, Antúnez L, Ares G. Are the recommendations of paediatricians about complementary feeding aligned with current guidelines in Uruguay? Public Health Nutr 2021; 24:1-10. [PMID: 33413708 DOI: 10.1017/s1368980020005352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore Uruguayan paediatricians' personal recommendations about complementary feeding and to assess if they are aligned with current guidelines and scientific evidence. DESIGN A questionnaire composed of open-ended questions was used to explore foods recommended to start complementary feeding, foods regarded as the most important during the first meals, recommendations for delayed introduction of foods and foods that should be avoided. Reasons underlying the recommendations were also explored. SETTING Montevideo, the capital city of Uruguay (Latin America). PARTICIPANTS A total of 212 paediatricians were recruited during a National Pediatrics Conference, organised by the Uruguayan Society of Pediatrics. RESULTS The recommendations about complementary feeding provided by paediatricians to parents and caregivers in Uruguay seemed not to be fully aligned with the guidelines provided by the Ministry of Health. Paediatricians recommend a rigid food introduction sequence, characterised by the early introduction of soft pureed vegetables and fruits, followed by meat and the delayed introduction of allergenic foods. Food diversity and the concept of ultra-processed were not frequently identified in the responses. CONCLUSIONS Results stress the importance of developing educational and communication approaches targeted at paediatricians to contribute to the uptake of updated recommendations regarding complementary feeding.
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Affiliation(s)
- Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
| | | | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, Montevideo, Uruguay
| | - Alejandra Girona
- Departamento de Nutrición Básica, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
| | - Lucía Antúnez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000Pando, Canelones, Uruguay
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Wang Y, Liu Q, Chen Y, Qian Y, Pan B, Ge L, Wang Q, Ding G, Wang J. Global Trends and Future Prospects of Child Nutrition: A Bibliometric Analysis of Highly Cited Papers. Front Pediatr 2021; 9:633525. [PMID: 34568235 PMCID: PMC8459025 DOI: 10.3389/fped.2021.633525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 08/16/2021] [Indexed: 12/13/2022] Open
Abstract
Child nutrition has always been a global concern. This study performed visual analysis of 1,398 child nutrition highly cited papers (HCPs) from 2009 to 2019. The purpose of the study was to evaluate and present the performances of authors, journals, countries, institutions, top cited papers; to explore the hot topics, prospects, and to propose the future research directions on child nutrition. We used bibliometric methods to conduct in-depth statistical analysis of HCPs on child nutrition, showing research progress, trends and hot spots. We included HCPs on child nutrition from the Science Citation Index-Expanded (SCI-E) database February 7, 2020. Two tools, CiteSpace and VOSviewer, were used to conduct the bibliometric analyses. The results showed that, since 2011, the number of HCPs on child nutrition has increased rapidly. The top three contributors in this field were the USA, the UK and Canada. However, the contribution of developing countries was very limited. Intestinal microflora, food allergy, overweight and obesity were the three major research hotspots in this field. Results of this study provide valuable references for ongoing child nutrition related research, which may be interesting and noteworthy to the researchers involved.
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Affiliation(s)
- Yunhua Wang
- School of Management, Lanzhou University, Lanzhou, China.,Gansu Provincial Hospital, Lanzhou, China
| | | | - Yongcong Chen
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yaling Qian
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Bei Pan
- Gansu Provincial Hospital, Lanzhou, China
| | - Long Ge
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China.,Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Qi Wang
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China.,Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Guowu Ding
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
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Rakotomanana H, Hildebrand D, Gates GE, Thomas DG, Fawbush F, Stoecker BJ. Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study. Curr Dev Nutr 2020; 4:nzaa162. [PMID: 33274306 PMCID: PMC7695809 DOI: 10.1093/cdn/nzaa162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar. OBJECTIVES This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6-23 mo in the Vakinankaratra region of Madagascar. METHODS Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than -2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach. RESULTS Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers' workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding. CONCLUSIONS Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.
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Affiliation(s)
- Hasina Rakotomanana
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Deana Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Gail E Gates
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - David G Thomas
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Fanjaniaina Fawbush
- Department of Agricultural and Food Science and Technology, University of Antananarivo, Antananarivo, Madagascar
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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15
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Sebayang SK, Dibley MJ, Astutik E, Efendi F, Kelly PJ, Li M. Determinants of age-appropriate breastfeeding, dietary diversity, and consumption of animal source foods among Indonesian children. MATERNAL & CHILD NUTRITION 2020; 16:e12889. [PMID: 31577064 PMCID: PMC7038882 DOI: 10.1111/mcn.12889] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/15/2019] [Accepted: 08/20/2019] [Indexed: 01/01/2023]
Abstract
Global child feeding practices remain suboptimal. In this study, we assess the determinants of age-inappropriate breastfeeding, dietary diversity, and consumption of 3+ types of animal source foods (ASFs) using 11,687 observations from combined data from the Indonesian Demographic Health Survey of 2012 and 2017. We used linear and logistic regression after adjusting for the complex sampling design. Child's age and quality of antenatal care (ANC) were associated with all outcomes. Socio-economic status and labour force participation were positively associated with higher dietary diversity score, ASF consumption, and age-inappropriate breastfeeding. More ANC visits and having consultation at ANC were associated with more dietary diversity. Higher women's knowledge level was associated with more dietary diversity and consuming more ASF. Compared with western Indonesia, more children in eastern Indonesia were age-inappropriately breastfed and had lower dietary diversity. The Indonesian government needs to develop programmes to improve child feeding particularly in eastern Indonesia, focusing on improving dietary diversity and ASF consumption in poorer households and on prolonging breastfeeding in richer households. Women's labour force participation should be encouraged, but programmes for working mothers are also needed to support continued breastfeeding and to express breast milk. ANC and postnatal programmes need improved consultation sessions for child feeding.
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Affiliation(s)
- Susy K. Sebayang
- Department of Biostatistics and Population StudiesUniversitas Airlangga, Banyuwangi CampusBanyuwangiIndonesia
| | - Michael J. Dibley
- Sydney School of Public HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Erni Astutik
- Department of EpidemiologyUniversitas Airlangga, Banyuwangi CampusBanyuwangiIndonesia
| | - Ferry Efendi
- Faculty of NursingUniversitas AirlanggaSurabayaIndonesia
| | - Patrick J. Kelly
- Sydney School of Public HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Mu Li
- Sydney School of Public HealthUniversity of SydneySydneyNew South WalesAustralia
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16
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Nsiah-Asamoah C, Pereko KKA, Intiful FD. Nutritional counselling interactions between health workers and caregivers of children under two years: observations at selected child welfare clinics in Ghana. BMC Health Serv Res 2019; 19:817. [PMID: 31703681 PMCID: PMC6842228 DOI: 10.1186/s12913-019-4692-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 10/28/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. This was a cross-sectional study in which an observation checklist was used to examine Growth Monitoring and Promotion (GMP) activities and educational/counselling activities undertaken by health workers (HWs) to communicate nutrition information to caregivers, depending on the ages of the children. METHODS A total number of 528 counselling interactions between health workers and caregivers in 16 Child welfare Clinics (CWCs) in two rural districts in Ghana were observed. Frequencies were presented for the information that was obtained from each caregiver and those that were provided by the HWs during the nutritional counselling sessions. RESULTS About 95.1 and 61.8% of the caregiver-HW interactions involved mothers of children who were less than 6 months of age and those above 6 months respectively. HWs counselled the caregivers on appropriate nutrition for the child. Health talk messages that were shared with caregivers focused mainly on the importance of attending CWCs and vaccination of children and rarely included any teaching materials. In most of the interactions, HWs made of child's feeding practices the past 1 month; and also did not provide advice on specific issues of IYCF. Nutritional counselling information given for non-breastfeeding children was inadequate and in some cases absent. Little attention was given to the feeding of children with animal products during counselling. CONCLUSION Generally nutritional information given to caregivers who had children above 6 months was inadequate.
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Affiliation(s)
| | | | - Freda Dzifa Intiful
- Department of Dietetics, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
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17
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Briaux J, Fortin S, Kameli Y, Agboka Y, Romedenne M, Boko J, Martin‐Prevel Y, Becquet R, Savy M. Dissimilarities across age groups in the associations between complementary feeding practices and child growth: Evidence from rural Togo. MATERNAL & CHILD NUTRITION 2019; 15:e12843. [PMID: 31102494 PMCID: PMC6859998 DOI: 10.1111/mcn.12843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 11/27/2022]
Abstract
Adequate complementary feeding (CF) practices are essential for achieving optimal growth but challenging to measure comprehensively. This paper describes CF practices in 2,034 children aged 6-23 months and investigates their relationships with length-for-age z-score (LAZ) and stunting, using cross-sectional data collected from May to July 2014 in rural Northern Togo. The World Health Organization infant and young child feeding indicators were computed, along with ancillary indicators on feeding style and timing of introduction of complementary foods. The associations between those indicators and children's LAZ and stunting were assessed using linear and logistic regressions after stratification by age group and adjustment for children, maternal, and household characteristics. CF practices were suboptimal, and their associations with child's growth varied across indicators and age groups. In children aged 6-11 months, reaching the minimum dietary diversity and the minimum acceptable diet was associated with higher LAZ (p < .05). In 18- to 23-month-old children, only the consumption of iron-rich food was associated with both LAZ (p = .02) and stunting (p = .05). The late introduction of family foods was associated with higher odds of being stunted and lower LAZ in children aged 12-17 months (p < .001). The untimely introduction of porridge was associated with higher odds of stunting in children aged 9-23 months (p < .05). Unexpectedly, helping the child to eat was negatively associated with linear growth in all age groups. These findings nurture the ongoing process of review of the World Health Organization infant and young child feeding indicators showing that, in their current version, they hardly capture the links between CF and child's growth at different ages.
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Affiliation(s)
- Justine Briaux
- UMR 204 Nutripass, Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier SupAgroMontpellierFrance
- UMR 1219 Bordeaux Population Health Research Center, team IDLIC, Institut National de la Santé et de la Recherche Médicale (INSERM), University of BordeauxBordeauxFrance
| | - Sonia Fortin
- UMR 204 Nutripass, Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier SupAgroMontpellierFrance
| | - Yves Kameli
- UMR 204 Nutripass, Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier SupAgroMontpellierFrance
| | - Yawavi Agboka
- Projet de Développement Communautaire et Filets Sociaux, Ministère du Développement à la BaseLoméTogo
| | - Magali Romedenne
- Child Survival and Development, UNICEF, Togo country officeLoméTogo
| | - Joachim Boko
- Social Protection and Labor Global Practice, The World Bank, Benin country officeCotonouBenin
| | - Yves Martin‐Prevel
- UMR 204 Nutripass, Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier SupAgroMontpellierFrance
| | - Renaud Becquet
- UMR 1219 Bordeaux Population Health Research Center, team IDLIC, Institut National de la Santé et de la Recherche Médicale (INSERM), University of BordeauxBordeauxFrance
| | - Mathilde Savy
- UMR 204 Nutripass, Institut de Recherche pour le Développement (IRD), University of Montpellier, Montpellier SupAgroMontpellierFrance
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Borg B, Mihrshahi S, Laillou A, Sigh S, Sok D, Peters R, Chamnan C, Berger J, Prak S, Roos N, Griffin M, Wieringa FT. Development and testing of locally-produced ready-to-use therapeutic and supplementary foods (RUTFs and RUSFs) in Cambodia: lessons learned. BMC Public Health 2019; 19:1200. [PMID: 31470824 PMCID: PMC6717373 DOI: 10.1186/s12889-019-7445-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 08/06/2019] [Indexed: 11/10/2022] Open
Abstract
Background Rates of childhood undernutrition are persistently high in Cambodia. Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness. Therefore, our project developed and trialled a locally-produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) with therapeutic and supplementary versions. This ready-to-use food (RUF) is innovative in that, unlike many RUFs, it contains fish instead of milk. Development began in 2013 and the RUF was finalised in 2015. From 2015 until the present, both the RUTF and the RUSF versions were trialled for acceptability and effectiveness. Methods This paper draws on project implementation records and semi-structured interviews to describe the partnership between the Cambodian Ministries of Health and Agriculture, Forestry and Fisheries, UNICEF, the French National Research Institute for Sustainable Development (IRD), universities, and Vissot factory. It discusses the project implementation and lessons learned from the development and trialling process, and insights into positioning nutrition on the health agenda in low and middle-income countries. Results The lessons learned relate to the importance of project planning, management, and documentation in order to seize opportunities in the research, policy, advocacy, and programming environment while ensuring adequate day-to-day project administration and resourcing. Conclusions We conclude that projects such as ours, that collaborate to develop and test novel, locally-produced RUTFs and RUSFs, offer an exciting opportunity to respond to both local programmatic and broader research needs.
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Affiliation(s)
- Bindi Borg
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Seema Mihrshahi
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Arnaud Laillou
- Child Survival and Development Section, UNICEF, Phnom Penh, Cambodia
| | - Sanne Sigh
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Daream Sok
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Department of Fisheries Post-Harvest Technologies and Quality Control, Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
| | - Remco Peters
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Chhoun Chamnan
- Department of Fisheries Post-Harvest Technologies and Quality Control, Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
| | - Jacques Berger
- UMR Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, Montpellier, France
| | | | - Nanna Roos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mark Griffin
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
| | - Frank T Wieringa
- UMR Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, Montpellier, France
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19
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Potts KS, Mulugeta A, Bazzano AN. Animal Source Food Consumption in Young Children from Four Regions of Ethiopia: Association with Religion, Livelihood, and Participation in the Productive Safety Net Program. Nutrients 2019; 11:nu11020354. [PMID: 30743994 PMCID: PMC6413062 DOI: 10.3390/nu11020354] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 01/29/2023] Open
Abstract
Introduction: Child undernutrition remains a challenge globally and in the geographically diverse country of Ethiopia. Improving dietary diversity and consumption of animal source foods are important for improving child nutrition and corresponding health outcomes. Objective: The objective of the study was to identify household and community factors associated with consumption of animal source foods among 6 to 36-month-old children from four regions of Ethiopia. Methods: A cross-sectional survey using multistage probability sampling in eight geographic zones and four regions of Ethiopia took place in 2015 with parents/caretakers of 6 to 36-month-old children. Data was collected on demographic information, proxy indicators of socioeconomic status, and food consumed by the child the day before the survey. Results: Increased child age, pastoral livelihood, Muslim religion, and participation in the Productive Safety Net Program were associated with increased consumption of animal source foods. Odds of animal source foods consumption increased by 8% with each 3-month age increase. Children from pastoralist households were the most likely to have consumed animal source foods in the preceding 24 hours as compared with those in agro-pastoralist households (0.21 times as likely) or those in agriculturalist/farming households (0.15 times as likely). The odds of consumption of animal source foods for families with food aid or safety net support was 1.7 times greater among those receiving traditional support from the Productive Safety Net Program and 4.5 times greater for those in the direct support arm of the program. Conclusions: The findings illustrate the importance of accounting for local context and community characteristics, such as livelihood and religion, when undertaking programming designed to improve diversity of children’s diets through increasing animal source foods. In addition, the Productive Safety Net Program may be a critical determinant of dietary diversity for young children in these regions.
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Affiliation(s)
- Kaitlin S Potts
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
| | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle 231, Ethiopia.
| | - Alessandra N Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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20
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Ahoya B, Kavle JA, Straubinger S, Gathi CM. Accelerating progress for complementary feeding in Kenya: Key government actions and the way forward. MATERNAL & CHILD NUTRITION 2019; 15 Suppl 1:e12723. [PMID: 30748122 PMCID: PMC6594063 DOI: 10.1111/mcn.12723] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 01/01/2023]
Abstract
Optimal complementary feeding practices, a critical component of infant and young child feeding, has been demonstrated to prevent micronutrient deficiencies, stunting, overweight, and obesity. In Kenya, while impressive gains have been made in exclusive breastfeeding, progress in complementary feeding has been slow, and the country has failed to meet targets. Recent 2014 Kenya Demographic and Health Survey reveal that only 22% of Kenyan children, 6-23 months, met criteria for a minimum acceptable diet. This case study describes key actions for complementary feeding put in place by the Kenya Ministry of Health as well as approaches for improving and monitoring complementary feeding within existing health platforms. Experience from USAID's Maternal and Child Survival Program and Ministry of Health on development of 23 complementary feeding recipes through application of a national guide for recipe development and Trials of Improved Practices is described. Challenges in how to prepare, modify, and cook foods, including meat, for young children 6-23 months of age was relayed by mothers. Addressing cultural beliefs around complementary feeding meant providing reassurance to mothers that young children are developmentally able to digest fruit and vegetables and ready to consume animal-source protein. Through the Baby Friendly Community Initiative platform, cooking demonstrations and key hygiene actions were integrated with complementary feeding messages. Future programming for complementary feeding should consider development of context specific counselling messages on consumption of animal source foods, strengthen production and use of local foods through agriculture-nutrition linkages, and include complementary indicators through routine health monitoring systems to track progress.
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Affiliation(s)
- Brenda Ahoya
- USAID's Maternal and Child Survival Program/PATHKisumuKenya
| | - Justine A. Kavle
- USAID's Maternal and Child Survival Program/PATHWashingtonDistrict of ColumbiaUSA
| | - Sarah Straubinger
- USAID's Maternal and Child Survival Program/PATHWashingtonDistrict of ColumbiaUSA
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21
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Manikam L, Lingam R, Lever I, Alexander EC, Amadi C, Milner Y, Shafi T, Stephenson L, Ahmed S, Lakhanpaul M. Complementary Feeding Practices for South Asian Young Children Living in High-Income Countries: A Systematic Review. Nutrients 2018; 10:E1676. [PMID: 30400582 PMCID: PMC6266308 DOI: 10.3390/nu10111676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/25/2018] [Accepted: 11/03/2018] [Indexed: 01/13/2023] Open
Abstract
Sub-optimal nutrition among South Asian (SA) children living in high-income countries is a significant problem. High rates of obesity have been observed in this population, and differential complementary feeding practices (CFP) have been highlighted as a key influence. Our aim was to undertake a systematic review of studies assessing CFP in children under two years of age from SA communities living in high-income countries, including dietary diversity, timing, frequency and promotors/barriers. Searches covered January 1990⁻July 2018 using MEDLINE, EMBASE, Global Health, Web of Science, BanglaJOL, OVID Maternity and Infant Care, CINAHL, Cochrane Library, POPLINE and World Health Organisation (WHO) Global Health Library. Eligible studies were primary research on CFP in SA children aged 0⁻2 years. Search terms were "children", "feeding" and "South Asian", and derivatives. Quality appraisal used the Evidence for Policy and Practice Information (EPPI) Weight of Evidence scoring. From 50,713 studies, 13 were extracted with ten from the UK, and one each from the USA, Canada and Singapore. Sub-optimal CFP were found in all studies. All ten studies investigating timing reported complementary feeding (CF) being commenced before six months. Promoters/barriers influencing CFP included income, lack of knowledge, and incorrect advice. This is the first systematic review to evaluate CFP in SA children living in high-income countries and these findings should inform the development of effective interventions for SA infants in these settings.
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Affiliation(s)
- Logan Manikam
- UCL Institute of Epidemiology & Health Care, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Raghu Lingam
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Sydney 2031, Australia.
| | - Isabel Lever
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Emma C Alexander
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Chidi Amadi
- Royal Surrey County Hospital, Egerton Road, Guildford GU2 7XX, UK.
| | - Yasmin Milner
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Taimur Shafi
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Lucy Stephenson
- Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Sonia Ahmed
- Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Monica Lakhanpaul
- Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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Klassen AC, Milliron BJ, Suehiro Y, Abdulloeva S, Leonberg B, Grossman S, Chenault M, Bossert L, Maqsood J, Abduzhalilov R, Iskandari M. "Then you raise them with Shirchoy or cookies": Understanding influences on delayed dietary diversity among children in Tajikistan. MATERNAL AND CHILD NUTRITION 2018; 15:e12694. [PMID: 30231190 PMCID: PMC6587851 DOI: 10.1111/mcn.12694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/22/2018] [Accepted: 08/24/2018] [Indexed: 12/02/2022]
Abstract
Dietary diversity is a key component of infant and young child feeding (IYCF) as well as adult health. In Tajikistan, a predominantly rural, former Soviet country in Central Asia, we conducted formative research to identify barriers to dietary diversity and strategies for nutrition behaviour change. In Spring, 2016, mixed‐methods data collection took place across 13 villages in all five regions, collecting collaborative mapping; structured assessments of stores and markets; home visits for dietary recalls; food storage, preparation, and meal observations; focus groups with pregnant women, mothers of young children, fathers, and mothers‐in‐law; and in‐depth expert interviews with local nutrition and health influentials. Overall, maternal diet was adequate in terms of diversity (only 13% reported <5/10 food groups in the past 24 hr); however, only 42% of index children 6–24 months met WHO guidelines for diversity, and only 34% met minimum acceptable diet criteria. In addition to issues of poverty and food scarcity, qualitative data reveal many behavioural barriers to timely introduction of diverse complementary foods. Women's strategies focused on gradual introduction of household diet components, without regard for diversity or nutrition. Foods such as meat were seen as costly and thus inappropriate for IYCF, and food taboos (i.e., fresh vegetables) further reduced diversity. Infant food preparation methods such as grinding were seen as impractical, and many foods were withheld until children develop teeth. Possible nutrition education strategies include point‐of‐purchase campaigns to improve availability and appeal of IYCF‐friendly foods, as well as influencing other key household members through mosques, schools, and health care providers.
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Affiliation(s)
- Ann C Klassen
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Brandy Joe Milliron
- Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania
| | | | | | - Beth Leonberg
- Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania
| | - Suzanne Grossman
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Margaret Chenault
- Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania
| | - Lisa Bossert
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Jalal Maqsood
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Rauf Abduzhalilov
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Malika Iskandari
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
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The Impact of Scientific and Technical Training on Improving Routine Collection of Antenatal Care Data for Maternal and Foetal Risk Assessment: A Case Study in the Province of South Kalimantan, Indonesia. J Pregnancy 2018; 2018:9240157. [PMID: 30302290 PMCID: PMC6158931 DOI: 10.1155/2018/9240157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/11/2018] [Accepted: 07/10/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives First, to assess the impact of scientific and technical training on midwives' abilities in collecting and recording the results of routine antenatal care examinations. Second, to explore midwives' views with regard to factors affecting their abilities to successfully complete the data documentation tasks. Methods The study was conducted in South Kalimantan, Indonesia (April 2016-October 2017). Nineteen urban and rural midwives were selected. Access to antenatal care information on 4,946 women (retrospective cohort study) and 381 women (prospective cohort study) was granted. A descriptive and exploratory design was used to describe midwives' abilities and challenges pertaining to timely collection and recording of results concerning antenatal care examinations. Results Scientific and technical training has significantly improved the average amount of recorded antenatal care data (from 17.5% to 62.1%, p-value < 0.0005). Lack of awareness, high workload, and insufficient skills and facilities are the main reasons for the database gaps. Conclusions The training has equipped midwives with scientific knowledge and technical abilities to allow routine collection of antenatal care data. Provision and adequate use of this information during different stages of pregnancy is crucial as an evidence-based guideline to assess maternal and foetal risk factors to ending preventable mortality.
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Bégin F, Aguayo VM. First foods: Why improving young children's diets matter. MATERNAL AND CHILD NUTRITION 2018; 13 Suppl 2. [PMID: 29032619 DOI: 10.1111/mcn.12528] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023]
Abstract
Globally, only 52% of children aged 6-23 months meet the minimum meal frequency and a mere 29% meet the minimum dietary diversity, with large disparities across and within regions. With most of the stunting occurring during the first thousand days-from conception to age 2 years-improving complementary feeding in children 6-23 months old is an urgent priority. With this evidence in mind, UNICEF collaborated with the governments of India and Maharashtra to convene a global meeting in Mumbai, India, under the theme: First Foods: A Global Meeting to Accelerate Progress on Complementary Feeding in Young Children (November 17-18, 2015). The global meeting provided a platform that aimed to (a) synthesize the biological and implementation science on complementary feeding; (b) review the practice and experience in improving access to nutritious complementary foods and good complementary feeding practices; and (c) consolidate a strong evidence base that can inform the development of strategies and approaches to improve complementary feeding that are fit to context. This overview paper summarizes the rationale on why improving complementary foods and feeding for infants and young children matters and what it takes to improve them. It builds on the papers presented at the First Foods Global Meeting and those commissioned as a follow on to it.
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Affiliation(s)
- France Bégin
- Nutrition Section, Programme Division, United Nations Children's Fund (UNICEF), New York, New York, USA
| | - Víctor M Aguayo
- Nutrition Section, Programme Division, United Nations Children's Fund (UNICEF), New York, New York, USA
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