1
|
Sato Y, Khamphithoun S, Saiyachak K, Ando H, Ishizuka T, Saeki S, Miyoshi M. Enhancing child dietary diversity through cooking demonstration and nutritional education in rural Lao PDR. Trop Med Health 2024; 52:8. [PMID: 38191472 PMCID: PMC10773088 DOI: 10.1186/s41182-023-00571-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Efforts to prevent malnutrition in children under five are crucial for both short-term and long-term impact, especially in resource-constrained low- and middle-income countries, where ensuring minimal food diversity remains an urgent challenge. Our organization implemented initiatives to improve dietary diversity among children under five in rural areas of Lao People's Democratic Republic (Lao PDR). METHODS We carried out educational and awareness programs directed at caregivers of children aged 6-59 months. These programs were delivered by healthcare professionals and trained community volunteers in specific areas of Xaybouathong District, Khammouane Province. To evaluate the impact of our interventions, we conducted surveys both at the beginning and end of the project. We designated the Individual Dietary Diversity Score IDDS as the objective variable, serving as an indicator of child dietary diversity. Using sociodemographic and economic indicators as explanatory variables, we assessed the impact of the intervention through multivariate analysis with a generalized linear model as well as a bivariate analysis. RESULTS The comparison between 210 children at baseline and 205 children at endline revealed a significant increase in IDDS among children aged 6-23 months (from 3.36 to 4.22) and children aged 24-59 months (from 3.29 to 3.83). Multivariate analysis indicated a significant association between the intervention effect (baseline vs. endline) and the village of residence. Furthermore, significant improvements were observed in each food group that constitute IDDS, including vegetables and fruits, eggs, and legumes and nuts. CONCLUSIONS Even in resource-limited settings, such as rural areas of Lao PDR, it is possible to improve child dietary diversity through educational approaches that encourage the utilization of locally available foods.
Collapse
Affiliation(s)
- Yu Sato
- Our Lady of the Snow St. Mary's Hospital, Tsubuku Honmachi 422, Kurume, Fukuoka, Japan.
- Non-Profit Organization ISAPH Tokyo Office, OWK Bld. 3F, Shimbashi 3-5-2, Minato-Ku, Tokyo, Japan.
- Aomori University of Health and Welfare, Oaza-Hamatate Mase 58-1, Aomori, Aomori, Japan.
| | | | | | - Hisao Ando
- Our Lady of the Snow St. Mary's Hospital, Tsubuku Honmachi 422, Kurume, Fukuoka, Japan
- Non-Profit Organization ISAPH Tokyo Office, OWK Bld. 3F, Shimbashi 3-5-2, Minato-Ku, Tokyo, Japan
| | - Takaaki Ishizuka
- Our Lady of the Snow St. Mary's Hospital, Tsubuku Honmachi 422, Kurume, Fukuoka, Japan
- Non-Profit Organization ISAPH Tokyo Office, OWK Bld. 3F, Shimbashi 3-5-2, Minato-Ku, Tokyo, Japan
| | | | - Miki Miyoshi
- Aomori University of Health and Welfare, Oaza-Hamatate Mase 58-1, Aomori, Aomori, Japan
| |
Collapse
|
2
|
Hojati A, Alesaeidi S, Izadi S, Nikniaz A, Farhangi MA. MyKid'sNutrition mobile application trial: a randomized controlled trial to promote mothers' nutritional knowledge and nutritional status of preschool children with undernutrition-a study protocol. Trials 2023; 24:544. [PMID: 37596662 PMCID: PMC10439575 DOI: 10.1186/s13063-023-07503-w] [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: 01/17/2023] [Accepted: 07/09/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Childhood malnutrition is a crucial public health issue in developing countries. Mothers' nutritional knowledge significantly affects children's nutritional status. It also appears that mothers with low health literacy are unable to adequately meet their children's nutritional needs because they do not clearly understand their children's nutrition and malnutrition status. METHODS This randomized controlled trial aims to describe the development and study protocol of the MyKid'sNutrition application, a smartphone-based intervention for mothers of preschool (2-6 years old) children. The application contains several contents on children's healthy eating, childhood underweight, children's loss of appetite, and child growth assessment. As part of the MyKid'sNutrition trial, a total of 116 participants will be randomized 1:1 either to (a) treatment as usual and MyKid'sNutrition or (b) treatment as usual alone. The results of this trial will be based on changes in growth indicators and mothers' nutritional knowledge, attitude, and practice within the groups and the differences between them. DISCUSSION Due to their widespread availability throughout society, smartphones can be used to deliver educational content on a large scale at a low cost. In addition, they can provide novel ways for patients to receive support. Hence, it is essential to conduct research studies on these types of interventions. MyKid'sNutrition application offers dietary solutions for such nutritional problems as underweight, loss of appetite, and malnutrition in children. Meanwhile, it provides detailed instructions on how to interact with the child. TRIAL REGISTRATION IRCT.ir IRCT20140907019082N11. Registered on February 19, 2022.
Collapse
Affiliation(s)
- Ali Hojati
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sogol Alesaeidi
- Department of Pediatric Medicine, Imam Hossein Hospital, Resident of Pediatric Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeideh Izadi
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Nikniaz
- Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
3
|
Siswati T, Iskandar S, Pramestuti N, Raharjo J, Rubaya AK, Wiratama BS. Impact of an Integrative Nutrition Package through Home Visit on Maternal and Children Outcome: Finding from Locus Stunting in Yogyakarta, Indonesia. Nutrients 2022; 14:nu14163448. [PMID: 36014954 PMCID: PMC9416237 DOI: 10.3390/nu14163448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Stunting has been a public health problem in several developing countries including Indonesia. One of the strategies to reduce stunting was family assistance. This study was aimed to estimate the effect of family assistance by using an integrative nutrition package through home visits on the growth and development of stunted children. Method: This was an experimental study using pre-test post-test with control group design, conducted in Yogyakarta, Indonesia, on March to May 2022. The intervention group was provided an integrative nutrition package (INP) including maternal education, behavioral change through home visit, as well as monitoring children’s outcome, while the control group was asked to read and follow child care procedure in the maternal and child health (MCH) book as a standard procedure. Both groups were visited by trained health volunteers and had a complementary feeding (CF) package weekly for four weeks. The outcomes of this study were the maternal outcome (knowledge and behavior on children’s growth monitoring (CGM), children’s development monitoring (CDM), and infant/young children feeding (IYCF) as well as children’s outcomes, including body weight (BW), body height (BH), and child score development (CSD). This study used generalized estimating equation (GEE) to estimate the differences in differences (DID) of the impact of intervention compared with control group and compared among three different times (baseline, fourth, and eighth week). Results: There were 60 stunted children under five years in this study, i.e., 30 in intervention group and 30 in control group. From the GEE analysis, it was found that the regression adjusted DID showed statistically significant increase of all outcomes including children’s development score (CDS). The adjusted DID effect (95% CI) on 8th week for children’s weight, height, and development score were 0.31 (0.25–0.37), 0.41 (0.13–0.68), and −0.40 (−0.59–(−0.21)), respectively, among the intervention group. Conclusions: INP through home visit successfully increased maternal and children’s outcomes compared witsh standard procedure. The effect of intervention was found to be consistently significant in the fourth and eighth weeks after intervention. We recommend the local government to apply INP through home visit especially in high-prevalence stunting areas.
Collapse
Affiliation(s)
- Tri Siswati
- Department of Nutrition, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Correspondence:
| | - Slamet Iskandar
- Department of Nutrition, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
| | - Nova Pramestuti
- Balai Litbang Kesehatan Banjarnegara, Selamanik No. 16 A, Banjarnegara 53415, Indonesia
| | - Jarohman Raharjo
- Balai Litbang Kesehatan Banjarnegara, Selamanik No. 16 A, Banjarnegara 53415, Indonesia
| | - Agus Kharmayana Rubaya
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Department of Environmental Health, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
| | - Bayu Satria Wiratama
- Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
| |
Collapse
|
4
|
Shenavar R, Sajjadi SF, Farmani A, Zarmehrparirouy M, Azadbakht L. Improvement in Anthropometric Measurements of Malnourished Children by Means of Complementary Food and Nutritional Education in Fars Province, Iran: A Community-Based Intervention. Front Nutr 2022; 9:813449. [PMID: 35308266 PMCID: PMC8924542 DOI: 10.3389/fnut.2022.813449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/21/2022] [Indexed: 11/14/2022] Open
Abstract
Background Childhood malnutrition could have adverse impacts on the growth of child and eventually on fertility and general economic growth, and still, this issue remains a worldwide priority and a concern. This study aimed to evaluate the effectiveness of the national nutritional interventions program on the improvement and nutritional status of malnourished children children aged 6–59 months. Methods This community-based intervention study was conducted with 1288 acute and moderately malnourished children aged 6–59 months referred to health centers. Children received combined nutritional education and counseling with the provision of affordable complementary food for 10 months. Anthropometric measurements were assessed monthly according to the standard protocols. Results Our results showed the reduction in the risk of malnutrition among children after nutritional interventions for weight-for-height (WHZ) (P < 0.001), height-for-age (HAZ) (P < 0.001), and weight-for-age (WAZ) (P = 0.008). Total malnourished children indicated improvement in HAZ (<-3 SD: OR = 1.10, P = 0.026), WAZ (<-2SD: OR = 1.21, P < 0.001; <-3SD: OR = 1.60, P < 0.001), and WHZ (<-3SD: OR = 1.10, P = 0.030). Controlling potential confounders (socioeconomic status, childrens' birth supine length, and weight) showed a significant amelioration in HAZ (<-2 SD: OR = 6.20, P = 0.020; <-3 SD: OR = 9, P = 0.003) and WAZ (<-2 SD: OR = 5.85, P = 0.010; <-3 SD: OR = 7.50, P = 0.004). In urban areas, significant amelioration was observed in HAZ (<-3 SD: OR = 1.22, P = 0.010) and WAZ (<-2 SD: OR = 1.24, P = 0.003; <-3 SD: OR = 1.64, P < 0.001). In rural, considerable amelioration was observed in WAZ (<-2 SD: OR = 1.20, P = 0.010; <-3 SD: OR = 1.50, P < 0.001) and WHZ (<-3 SD: OR = 1.20, P = 0.020). Conclusion Nutritional training and counseling as well as complementary food intervention among the malnourished children significantly improved the nutritional status of children. So community-based intervention is recommended to reduce the malnutrition among children.
Collapse
Affiliation(s)
- Razieh Shenavar
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Forough Sajjadi
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Farmani
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
| | - Mina Zarmehrparirouy
- Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Leila Azadbakht
| |
Collapse
|