Nutritional counselling interactions between health workers and caregivers of children under two years: observations at selected child welfare clinics in Ghana

Christiana Nsiah-Asamoah,Kingsley Kwadwo Asare Pereko,Freda Dzifa Intiful

doi:10.1186/s12913-019-4692-y

Christiana Nsiah-Asamoah, Kingsley Kwadwo Asare Pereko + Show 1 more

Open Access

https://doi.org/10.1186/s12913-019-4692-y

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Abstract

BackgroundThis 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.MethodsA 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.ResultsAbout 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.ConclusionGenerally nutritional information given to caregivers who had children above 6 months was inadequate.

Highlights

This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers
It is important to note that in 14 of the Child welfare Clinics (CWCs) only one health workers (HWs) interacted with all the caregivers on one-on-one basis after their children had been weighed
In two CWCs, which were located at the district capital towns and were the only referral health facilities, two HWs at these CWCs took turns to interact with caregivers because of the large number of children who accessed the facility for Growth Monitoring and Promotion (GMP) services

Summary

Introduction

This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. IYCF counselling was introduced as an integral part of child welfare services following the global challenge of inadequate and poor child feeding practices. In the case of children under 2 years, the need to offer nutritional counselling services especially to their caregivers has received much attention. This stage of life has been described as a critical window of opportunity for ensuring appropriate growth and development through optimal feeding, that reduces the risk of undernutrition and give children the best start in life [6,7,8]. If nutritional needs are not met and undernutrition is not addressed at this stage, it leaves long-lasting damages which are largely irreversible [11]

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