Association of maternal characteristics with child feeding indicators and nutritional status of children under-two years in Rural Ghana

Impact of a Nutrition Knowledge Intervention on Knowledge and Food Behaviour of Women Within a Rural Community

INTRODUCTION

The influence of women in shaping household dietary habits is undeniable, with their maternal nutritional knowledge significantly impacting the overall well-being of their families. The study objective was to evaluate the impact of maternal nutritional knowledge on household dietary habits, emphasising the improvement in women's nutrition knowledge and food-related behaviours.

PURPOSE

This study aimed to assess the immediate and long-term effects of a nutrition education intervention on the nutrition knowledge and food-related behaviours of women.

METHODOLOGY

A quasi-experimental research design was employed to assess the effects of a Nutrition Education Programme (NEP) on female caregivers' nutrition knowledge and food-related behaviours. This study followed a four-phase approach: baseline survey, programme formulation, implementation and evaluation. Data were collected at various stages of this study using two measurement tools: a Dietary Diversity Questionnaire and a Nutrition Knowledge Questionnaire.

RESULTS

Statistical analysis was performed to answer the research questions and to test the null hypotheses at a significance level of 0.05. The intervention positively affected nutrition knowledge, with the mean percentage increasing from 49.1% to 63.7% and reaching 64.4% at follow-up, indicating long-term knowledge retention. The findings of this study suggest a positive shift towards increased consumption of nutrient-rich food groups. There were significant improvements in the food groups' consumption of the meat group (7.15 ± 2.35), eggs (1 ± 0), dairy (3.76 ± 1.19), cereal (8.78 ± 2.09), legumes (2.86 ± 0.95) and fats and oils (2.12 ± 0.55). Additionally, the variety of food groups consumed significantly improved (p = 0.012) post-intervention, with an increasing trend in the consumption of a variety of food groups (7-9).

RECOMMENDATION

Tailored nutrition education (NE) programs, in conjunction with addressing socioeconomic barriers positively impact nutritional behaviours, promote healthier food consumption patterns and assist in long-term knowledge retention in disadvantaged communities.

Spatial distribution of inadequate meal frequency and its associated factors among children aged 6-23 months in Ethiopia: Multilevel and spatial analysis

INTRODUCTION

More than two-third of global child death is occurred due to inappropriate feeding practice that happened during early childhood period. Evidence on meal frequency status among infant and young children at national level can be used to design appropriate interventions to improve the recommended feeding frequency. Therefore, this study was aimed to explore the spatial distribution and identify associated factors of inadequate meal frequency among children aged 6-23 months in Ethiopia.

METHODS

Secondary data analysis was conducted using the 2019 mini Ethiopian Demographic and Health Survey data. A total weighted sample of 1,532 children aged 6-23 months were included. To identify significant factors associated with of inadequate meal frequency, multilevel binary logistic regression model was fitted. Variables with p-value < 0.25 from the bi-variable model were exported to multivariable analysis. In the multivariable model, variables with p-value < 0.05 were declared as significantly associated factors and adjusted odds ratio (AOR) with its 95% confidence interval were reported. Multilevel models were compared using deviance and log-likelihood. Spatial analysis tools were utilized to visualize the distribution of inadequate meal frequency. Bernoulli model was fitted using SaTScan V.9.6 to identify most likely clusters and ArcGIS V.10.8 was used to map the hotspot areas. Ordinary least square and geographic weighted regression models were used and compared using information criteria and adjusted-R2. Local coefficients of factors associated with hotspots of inadequate meal frequency were mapped.

RESULTS

The prevalence of inadequate meal frequency was 47.03% (95% CI: 44.54%, 49.53%) in Ethiopia. Age of the child, sex of the household head, timely initiation of breastfeeding, current breastfeeding status, number of antenatal care visit, maternal education, and region were significantly associated with inadequate meal frequency. The spatial distribution of inadequate meal frequency was showed significant variation across Ethiopia (Global Moran's I = 0.164, p-value <0.001). A total of 38 significant clusters were detected through SaTScan analysis, from these the 22 primary clusters were located in Somali and Harari.

CONCLUSION AND RECOMMENDATION

The prevalence of inadequate meal frequency was high in Ethiopia and had significant clustering patter. Significant hotspot clusters were located in Somali, northern Afar, Harari, Amhara, Gambela, and eastern South nation nationalities and peoples' region. Therefore, public health interventions which enhance breastfeeding practice, optimal number of antenatal care visits, educational empowerments should target hotspot areas to decrease inadequate meal frequency practice.

Maternal and household factors affecting the dietary diversity of preschool children in eastern Ethiopia: a cross-sectional study

OBJECTIVE

Investigate the association between the dietary diversity of preschool children and proximate factors including household food insecurity, maternal food choice, preferences, khat use, and levels of depressive symptoms.

DESIGN

Cross-sectional survey of randomly selected households.

SETTING

Haramaya Health and Demographic Surveillance site in Eastern Ethiopia, predominantly smallholder farming households.

PARTICIPANTS

678 preschool children (24-59 months) and their mothers.

METHODS

The key outcome, the adequacy of dietary diversity of preschool children, was calculated using a 24-hour parental dietary recall. Binary logistic regression was then used to identify maternal and household factors associated with dietary adequacy versus inadequacy.

RESULTS

The majority (80.53%) of surveyed children had low dietary diversity (mean Dietary Diversity (MDD)) score of 3.06±1.70 on a 7-point scale). Approximately 80% of households exhibited food insecurity. Households with greater food security (adjusted OR (AOR)=1.96, 95% CI 1.19 to 3.23), healthier maternal food choice (AOR=2.19, 95% CI 1.12 to 4.31) and broader maternal food preferences (AOR=4.95, 95% CI 1.11 to 21.95) were all associated with higher dietary diversity of their preschool children (p≤0.05). Other covariates associated with adequate child dietary diversity included improved household drinking water sources (AOR=1.84, 95% CI 1.16 to 2.92) and family planning use (AOR=1.69, 95% CI 1.00 to 2.86). Despite predictions, however, maternal depression and khat consumption were not identified as factors.

CONCLUSIONS

The dietary diversity of preschool children is extremely low-a pattern observed in both food-secure and food-insecure households. Key factors include maternal selection of food for convenience and ease, preferences that do not include animal protein or healthier food choices, and lack of access to improved drinking water sources. Interventions around maternal food choice and preferences could improve preschool children's nutritional health.

Appropriate feeding practices and associated factors during diarrheal disease among children aged 6 to 23 months in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey

BACKGROUND

Diarrhea is the second leading cause of morbidity and mortality for under-five children which cause about 525,000 deaths annually. Even though diarrheal diseases have decreased substantially at the global level, low-income countries are still faced with a huge number of diarrheal diseases. Thus, our aim was to assess the child feeding practices during diarrheal diseases and associated factors among children aged 6 to 23 months in Sub-Saharan African countries using the recent demographic and health survey.

METHODS

The appended and most recent demographic and health survey (DHS) dataset of 19 Sub-Saharan African countries from 2015 to 2020 was used for data analysis. A total of 64,628 living children aged 6-23 months with diarrhea were used as a weighted sample. The determinants of appropriate feeding practice were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with appropriate feeding practice in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.

RESULT

The overall prevalence of appropriate child feeding practice during diarrhea in this study was 6.24% (95% CI: 6.06, 6.43). Maternal age (15 to 19 years and 20 to 35 years) (AOR = 1.32, 95%CI: 1.12, 1.55 and AOR = 1.14, 95%CI: 1.03, 1.27), mothers education (primary and secondary level) (AOR = 1.23, 95%CI: 1.12, 1.35 and AOR = 1.28, 95%CI: 1.15, 1.43), having media exposure(AOR = 1.36, 95%CI: 1.26, 1.46), being married (AOR = 1.18, 95%CI: 1.01, 1.38), currently working (AOR = 1.08, 95%CI:1.00, 1.15), vaccinated for Rotavirus (AOR = 1.30, 95%CI:1.19, 1.43) and living in Central and eastern African countries (AOR = 1.82, 95%CI: 1.12, 2.97) and (AOR = 2.23, 95%CI: 1.37, 3.61) respectively were significantly associated with appropriate feeding practice.

CONCLUSION

The prevalence of appropriate feeding practice during child diarrheal disease aged 6-23 months of age was strictly low which implies that child diarrhea and appropriate feeding practice is still a great issue in in Sub-Saharan African countries. Enhancing maternal education, strengthening media exposure and vaccination for rotavirus, and designing interventions that address the mother's marital status, mother's work status, and country category are recommended to enhance appropriate feeding practices. Furthermore, special consideration should be given to older mothers to increase appropriate feeding practices during diarrheal disease.