Abstract
Achieving the optimal transition to a family diet over the first two years of life has remained a challenge in Ethiopia. The use of amylase-rich flour (ARF) can improve complementary foods. However, utilisation requires an effective delivery strategy for upskilling the community to use ARF. The aim of this study was to explore facilitators and barriers of cascading ARF skills to improve complementary foods. The study was conducted in Gale Mirga kebele of Kersa district in Eastern Ethiopia in 2016. The study utilised exploratory qualitative research that used participatory action. Focus group discussions (FGDs) were conducted with the Health Development Army (HDA) leaders, religious leaders, and observation of participatory complementary food demonstrations. Cultural acceptability and the presence of HDA structure that supports skill development were identified as key facilitators to ARF use. On the other hand, the potential barriers to expanding ARF skill were lack of sustainability of external skill support for HDA leaders, perceived time constraints, unsuitable demonstration settings, cooking method, and large group size. The indigenous community’s knowledge of germination has not been used to improve complementary foods. The universal use of ARF requires integration into the Health Extension Programme (HEP) with support and supervision for HDA leaders.
Highlights
Achieving nutrient needs for healthy growth and development during the transition to a family diet over the first two years of life has remained a challenge in low-income settings such as Ethiopia [1]
Three food processing and preparation sessions were provided for Health Development Army (HDA) leaders at the health post, and each HDA group went back to their community and redemonstrated the activities by pooling resources
The analysis revealed a range of facilitators and barriers to the use of amylase-rich flour (ARF) as follows
Summary
Achieving nutrient needs for healthy growth and development during the transition to a family diet over the first two years of life has remained a challenge in low-income settings such as Ethiopia [1]. According to the Ethiopian Demographic and Health Survey (EDHS), only 14% of children between 6 to 23 months meet the recommended diversified diet [2]. These children frequently consume foods made from fewer than four food groups, mainly local staples such as grains, roots, and tubers, followed by vitamin-A-rich fruits and vegetables, cheese, yoghurt, or other milk products [2]. The poor dietary quality is attributed to low food availability, low family income, and associated inadequate food access [3,4,5,6,7], resulting in child malnutrition. About 44% of healthcare costs associated with undernutrition occur before the child turns one year old, which is partly attributed to the quality of complementary foods [8]
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