Abstract
The mothers’ nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with one intervention arm and one control arm (n = 110; 1:1 ratio) and was performed at one well-child clinic in Urmia, Iran. An educational smartphone application was delivered to the intervention group for a 6-month period while the control group received treatment-as-usual (TAU) with regular check-ups of the child’s development at the well-child centre and the provision of standard nutritional information. The primary outcome measure was change in the indicator of acute undernourishment (i.e., wasting) which is the weight-for-height z-score (WHZ). Children in the smartphone group showed greater wasting status improvement (WHZ +0.65 (95% Confidence Interval (CI) ± 0.16)) than children in the TAU group (WHZ +0.31 (95% CI ± 0.21); p = 0.011) and greater reduction (89.6% vs. 51.5%; p = 0.016) of wasting caseness (i.e., WHZ < −2; yes/no). We conclude that smartphone-based maternal nutritional education in complementary feeding is more effective than TAU for reducing undernourishment among children under 3 years of age in food-secure communities.
Highlights
Every country in the world is affected by one or more forms of child malnourishment, with undernourishment being more prevalent in low- and middle-income countries [1]
The World Health Assembly has committed to decreasing the global prevalence of wasting (measured with weight-for-height z score (WHZ) < −2) among preschool children to less than 5%, and the number of stunted (height-for-age z score (HAZ) < −2) children by 40% by the year
The secondary outcome measures were the change in wasting caseness (WHZ < −2; yes/no) and the change in the mothers’ nutritional literacy with regard to critical knowledge, feeding attitudes, and nutritional practice
Summary
Every country in the world is affected by one or more forms of child malnourishment, with undernourishment being more prevalent in low- and middle-income countries [1]. Nutrient requirements are high in this age interval and cannot be met through breast milk alone. Children are not yet developmentally ready to consume the same meals as other members of the family. Nutrients 2020, 12, 587 refers to the timely introduction of developmentally appropriate, nutrient-dense foods in addition to breast milk. The World Health Assembly has committed to decreasing the global prevalence of wasting (measured with weight-for-height z score (WHZ) < −2) among preschool children to less than 5%, and the number of stunted (height-for-age z score (HAZ) < −2) children by 40% by the year
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