KNOWLEDGE ATTITUDE and PRACTICE TOWARDS FIRST 1000 DAYS NUTRITIONAL REQUIREMENT AMONG LACTATING MOTHERS IN GICUMBI DISTRICT, RWANDA

Abstract

Malnutrition is a public health problem and one of the leading causes of morbidity and mortality among children. According to 2020 Rwandan Demographic and Health Survey, 32.2% of children under the age of five suffered from stunting. The Rwandan government has made a strong commitment since 2013 to drastically reduce and eventually eliminate child stunting. However, the rate of stunting in children is still stubbornly high. The study found that mothers need to be aware that children's nutritional needs increase during the first 1000 days of life and that addressing these needs would help to reduce child malnutrition. Therefore, the main aim of this study is to assess the knowledge, attitude, and practice of breastfeeding mothers' nutritional needs in the first 1000 days. Cross-sectional study design with a quantitative approach was used. A sample size of 384 were obtained using Fischer sample size calculation from 10,193 breastfeeding mothers in Gicumbi district. The results were analyzed using SPSS version 22. Modified Blooms cutoff was used for percentage categorization of the data as high or low level. The Likert scale was also used for positive and negative attitude. A bivariate and multivariate analysis was used to identify factors affecting nutrient requirements over the first 1000 days. Statistical significance was defined with a P value bellow 0.05 with 95%CI. The Overall findings of this study revealed that 52.6% of mothers with children between 0 to 24 months had high level of knowledge while 70.6% had good attitude towards the first 1000 days’ nutritional requirement in Gicumbi district. Additionally, the overall practice results showed that 44% had high level of practice towards the first 1000 days’ nutritional requirement in Gicumbi district. Multivariate analysis showed that knowledge, attitude, and education were significantly associated with good practice towards the first 1000 days’ nutritional requirement among lactating mothers with (AoR= 3.724 ,95% CI =.107-12.204, p≤0.001); (AoR =2.561,95%CI=1.702-4.524, p≤0.03); (AoR=4.530, 95%CI=2.210-7.450, p0≤.007) respectively. This study concluded that knowledge, attitude, and education were pivotal in improving nutritional practices of first 1000 days’ nutritional requirement of children and encourage Rwandan government and Ministry of health and other partners to strengthen existing policy as aligned in Rwanda fourth health sector strategic plan targets.