Child Nutrition Research Articles

Nutrition of children up to one year of age what public health topic

Abstract Background Nutrition is one of the most important factors for a person that affects the quality and length of life. Nutrition has a fundamental influence on the maintenance of health or the development of disease and participates in the correct growth and development of an individual. Nutrition is especially important in the early stages of life, when a child’s organism develops dramatically. Mothers have the greatest influence on a child’s nutrition, and therefore it is advisable to educate them appropriately and also educate them early, from child birth or before. And early nutrition is provided through breastfeeding. Objectives To improve the knowledge of healthcare workers in the field of breastfeeding and nutrition of children up to one year of age. To strengthen the breastfeeding skills of mothers. To motivate healthcare workers to educate mothers in maternity wards and GP offices. Results Using a questionnaire, we analyzed the knowledge of 716 mothers of children under two years of age. 91 % of female respondents knew that the child should be breastfed according to his/her needs. Only 66 % of women were educated and informed about the importance and technique of breastfeeding. Educational material was prepared and distributed for midwives, nurses and doctors on breastfeeding and feeding children up to one year of age. Conclusions The level of awareness of health professionals about breastfeeding and nutrition is still insufficient. There is a need to continue to educate and support healthcare workers in this area and to motivate them in providing information to mothers. Key messages • Breastfeeding and feeding children up to one year of age are important for a child’s health. • The advisory activity of healthcare workers is key to improving public health. Health workers should help mothers not only with advice but also with practical help with breastfeeding.

Nutritional status of tribal and non-tribal school-going children in rural Bangladesh: A comparative study

BackgroundInadequate nutrition of school-going children is a major concern in Bangladesh, and it can negatively affect their productivity. It is important to consider the food pattern, socio-cultural, and economic differences between tribal (T) and non-tribal (NT) communities in Bangladesh when evaluating their nutritional status. This study aimed to investigate the nutritional status of school-going children in the rural area of Rajshahi district’s High Barind Tract (HBT) region of Bangladesh. Additionally, we compared the nutritional status between T and NT school-going children in the same area.MethodsThis was a cross sectional household study. Data were collected from T and NT households in the HBT region in the Rajshahi district of Bangladesh, from January to June of 2019. A total of 500 (T 81, NT 419) school-going children aged 6–13 years were selected as samples using mixed sampling, including convenience sampling (non-probability) and simple random sampling (probability) methods. Nutritional status was assessed using body mass index-for-age z-score (BAZ) and height-for-age z-score (HAZ) according to WHO guidelines. Thinness was defined as BAZ < -2SD and stunting as HAZ < -2SD. Descriptive statistics, Z-proportional test, and logistic regression model were used to analyze the effect of selected independent variables on nutritional status of T and NT children.ResultsAmong school-going children, 15.20% were suffering from thinness (T 12.30% and NT 15.80%) and 17.80% stunting (T 13.60% and NT 18.60%), respectively. The difference in thinness (p > 0.05) and stunting (p > 0.05) were not significant between T and NT. The distribution of BAZ and HAZ of T and NT children were normally distributed, and were positioned negatively compared to the WHO standards. The logistic model identified the following factors for thinness: (i) mother with non-or-primary education (aOR = 1.89, 95% CI: 1.05–3.43, p < 0.05), (ii) underweight mother (aOR = 3.86, 95% CI: 1.48–10.06, p < 0.01), and (iii) underweight father (aOR = 4.12, 95% CI: 1.50-11.29, p < 0.01). For stunting, the factors were: (i) mother as a housewife (aOR = 2.79, 95% CI: 1.16–6.71, p < 0.05), (ii) father working as labour (aOR = 1.77, 95% CI: 1.01–3.278, p < 0.05), (iii) severe food insecurity in the household (aOR = 2.37, 95% CI: 1.23–4.54, p < 0.05), and (iv) children playing outside regularly more than 2 h (aOR = 2.19, 95% CI: 1.31–3.67, p < 0.01).ConclusionIn rural Bangladesh, the nutritional status of T and NT school-going children did not show significant defferences. However, the mean z-score values for both groups of children were lower than the WHO standard, indicating that both communities have poor nutritional status.

Breastfeeding duration, children’s diet and physical activity in immigrant children living in Lisbon

Abstract Background In 2023, 25% of children born in the Lisbon metropolitan area were from foreign mothers. Children of immigrant parents often face an unbalanced diet and unhealthy lifestyle, preventing them from reaching their full potential. The aim of this study was to analyse the associations between migrant status and breastfeeding duration, fruit and vegetable consumption and physical activity in children living in the Lisbon metropolitan area, Portugal. Methods Cross-sequential cohort study in Lisbon Region. Between May 2022 and April 2024, 729 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected in a face-to-face interview with the parents using a structured questionnaire with information on children’s diet (fruit and vegetable consumption) and physical activity. We used X2, Mann-Whitney U and t-tests to compare immigrant and non-immigrant children. Adjusted odds ratios (aOR) with a 5% level were estimated by logistic regression. Results Immigrant children (49.4%) live in socio-economically disadvantaged families. Breastfeeding practices are more common among migrant mothers with a higher median duration of exclusive breastfeeding (6 versus 4 months, p &amp;lt; 0.001) and a higher median duration of breastfeeding (14 versus 8 months, p &amp;lt; 0.001). Parental migration background is associated with the frequency of fruit (p = 0.039) and vegetable (p &amp;lt; 0.01) consumption and with the practice of physical activity (p &amp;lt; 0.01). The odds of consuming three or more portions of fruit are 1.37 times higher for non-immigrant children, and the odds of consuming two portions of vegetables are higher for non-immigrants than immigrants (aOR=2.04, p &amp;lt; 0.01). Practicing sports is most frequent in non-immigrants (aOR =2.25; p &amp;lt; 0.01). Conclusions Migrant status was associated with a less healthy lifestyle in childhood for children living in the Lisbon metropolitan area. Key messages • Breastfeeding is an essential source of nutrition for children, especially in socio-economically disadvantaged families. • The migrant status is often associated with inequalities in childhood, challenging immigrant children to achieve their full potential.

Food purchase diversity is associated with market food diversity and diets of children and their mothers but not fathers in rural Tanzania: Results from the EFFECTS baseline survey.

Rural households in East Africa rely on local markets, but the influence of market food diversity and household food purchase diversity on diets has not been well-characterized. We quantify the associations among market food diversity, household food purchase diversity and dietary diversity of mothers, fathers and children in rural Tanzania. This study uses baseline data from a randomized controlled trial, Engaging Fathers for Effective Child Nutrition and Development in Tanzania. We used the 10 food groups for women's dietary diversity to assess the seasonal availability of nutritious foods in 79 markets. Using data from 957 rural households in two districts in Mara, Tanzania, we measured household food purchase diversity over the previous month and dietary diversity among children (6-23 months), mothers and fathers. Overall, 63% of markets sold all 10 food groups throughout the year, indicating high-market food diversity and minimal seasonality. However, only 33% of women and 35% of children met dietary diversity recommendations. Households that reported higher purchasing power (0.14, p < 0.001), lived within 30 min of a market (0.36, p = 0.001) and had access to a highly diverse market (0.37, p = 0.01) purchased a higher diversity of foods. In turn, food purchase diversity was positively associated with the dietary diversity of mothers (p < 0.001) and children 9-23 months (p < 0.001) but not fathers (p = 0.56). Interventions must account for food availability and access in local markets, and promoting diverse food purchases may be an effective strategy to improve women's and children's diets in rural areas.

Genetic aspects of taste formation

The article discusses the molecular genetic basis of taste development which determines the peculiarity of perception of sweet, salty, sour, bitter and high-protein food (umami). The genes TAS1R3, FTO, GLUT2, FGF21, GNAT3 are responsible for individual perception of sugar volume. Serum FGF21 levels are significantly elevated in obese patients and in patients with type 2 diabetes mellitus which presumably indicates a state of resistance to FGF21. Given the role of refined sugars in the development of diseases, the use of foods with a reduced content or complete absence of added sugar is a worldwide trend, especially necessary in the nutrition of children. During genome-wide sequencing for 39 patients aged 15-18 years, FGF21 gene polymorphism was detected in 27 adolescents (69 %) without gender identity. Almost all patients with FGF21 gene polymorphism showed a high addiction to sweet foods. Currently, the existence of a sixth taste is being debated, it is ammonium chloride, whose receptors are regulated by the Otop1 gene which is also responsible for the identification of sour taste.

Prevalence of Bottle‐Feeding Practice and Associated Factors Among Mothers of Children Under Five in the World, 2024: Systematic Review and Meta‐Analysis

ABSTRACTBackgroundChild‐feeding practices, particularly breastfeeding, significantly impact children's health and survival. However, bottle feeding, although historically practiced, presents numerous disadvantages affecting optimal child nutrition and health. Despite World Health Organisation and The United Nations Children's Fund recommendations against bottle feeding, it remains prevalent globally, affecting roughly 59% of infants worldwide and 85% in Australia by 5 months of age.ObjectiveThis study aims to assess the prevalence and determinants of bottle feeding among mothers of children under five globally.MethodsThis systematic review and meta‐analysis adhered to the Preferred Reporting Items for Systematic Review and Meta‐Analysis guidelines. We comprehensively searched electronic databases for English‐language articles published between 2014 and 2024. The quality of studies was assessed using the Joanna Briggs Institute critical appraisal checklist. Data were analysed in STATA version 17, including summary tables, narrative descriptions, forest plots, and statistical heterogeneity and publication bias assessment.ResultsThe pooled prevalence of bottle feeding among mothers was 57%. Subgroup analysis revealed higher prevalence in larger sample sizes (&gt; 2151) and lower prevalence in smaller ones. Factors significantly associated with bottle feeding included mode of delivery (OR = 1.953; 95%, CI: 1.272, 2.635), child hospitalisation (OR = 1.984, CI: 1.593, 2.376), mother's occupation (OR = 1.579; CI: 1.467, 1.690), post‐natal care (OR = 2.965; CI: (1.358, 4.571), age of children (OR = 2.836; CI: 1.895, 3.777), place of residence (OR = 1.423; CI: 0.994, 1.852), and mother's education (OR = 3.366, CI: 1.949, 4.783).ConclusionEfforts to promote optimal child‐feeding practices should address the identified determinants, emphasising the importance of breastfeeding and providing support to mothers, especially those facing challenges such as cesarean delivery, child hospitalisation, and maternal employment.

Evaluation of Complementary Feeding Indicators Among Children Aged 6–23 Months According to the Health Literacy Status of Their Mothers

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition.

An Inventory of Proposed and Enacted Sugar-Sweetened Beverage Policies at the State, Local, and Tribal Levels in the United States, 2014‒2023.

Objectives. To inventory and describe trends in proposal and enactment of US sugar-sweetened beverage (SSB) policies at state, local, and Tribal levels, 2014-2023. Methods. We systematically searched 6 policy databases in 2021 (updated May 2023) using SSB-related search terms, identifying additional policies through snowball and online searches and a survey of food-policy experts. We reviewed 10 821 policies for inclusion and quantitatively coded included policies. Results. The inventory included 400 (321 unique [i.e., excluding companion]) policies meeting criteria: 335 (256 unique) state-, 63 local-, and 2 Tribal-level policies. From 2014 to 2023, 11% of unique state-, 92% of local-, and 100% of Tribal-level proposed policies were enacted. Across jurisdictions, the most frequently proposed policies related to excise taxes, restaurant children's meals, nutrition standards, and the Supplemental Nutrition Assistance Program, while the largest proportions of enacted policies related to restaurant children's meals, nutrition standards, education, and procurement. More policies were proposed and enacted in California and New York than other states, and in 2017 (proposed) and 2016 (enacted). Conclusions. This comprehensive inventory of US SSB policies provides information to inform future SSB policy development and diffusion. (Am J Public Health. Published online ahead of print October 17, 2024:e1-e10. https://doi.org/10.2105/AJPH.2024.307855).

Historical aspects of the use of goat’s milk as a food product for young children: a review

Goat milk (GM) has been a valuable food product for children and adults all over the world for thousands of years and has been used as an important element of healthy nutrition and healing. The article provides information confirming the importance of GM, which is described in the studies of ancient greek and roman scientists (Hippocrates, Galen), in traditional chinese and arabic medicine (the works of Li Shizheng and Avicenna). The works of domestic and foreign scientists also show the possibility of using GM not only as an alternative to breast milk, but also as a highly effective means for strengthening health. The functional composition of GM makes it possible to create mixtures as close as possible to breast milk, which can be used as a source of nutrition for children in the absence of breastfeeding.

Factors associated with caregivers’ food safety knowledge, behavior, perception of food safety control, and the nutrition status of under-5 children in Nigeria

BackgroundHousehold-level food safety practices may have a long-term outcome on the nutrition and health status of under-five children. This study explores the relationships between caregivers’ self-reported food safety knowledge, behavior, perception of food safety control, and their young child’s (< 5 years) nutrition status.MethodsIn a cross-sectional study design, 664 caregivers from five Local Government Areas (LGAs) in Ibadan, Nigeria were surveyed using an interviewer-administered questionnaire on their food safety knowledge, behavior and perceived food safety control. Anthropometric measurements of the household’s index child (aged 6–59 months) were also taken. Variables for food safety knowledge and behavior score were selected using principal component analyses. The nutritional status of the children (Z-scores for weight-for-height (WAZ), height-for-age (HAZ), and weight-for-age (WHZ)) were calculated. Description statistics were run on all variables and logistic regression models examined associations between the three food safety constructs and the children’s nutritional status. Covariates such as LGAs, caregiver’s age, household size, wealth index, child’s gender, and age were adjusted.ResultsHigh-level of food safety knowledge, behavior and lots of perceived control on food safety issues were reported by 77.7%, 76.7%, and 81.1% of the caregivers. Using WAZ, HAZ and WHZ that are ≤ -2, acute malnutrition (6.0%), chronic malnutrition (42.5%), and underweight (22.0%), respectively were prevalent among the children. Perceived food safety control was the only food safety construct associated with acute malnutrition. Wealth index, caregivers’ age, number of under 5 at home, child age, and gender were associated with acute malnutrition. Caregiver’s age, child’s age, and gender were associated with chronic malnutrition. Furthermore, caregiver’s age, education and child’s age were associated with a child being underweight. The significance level was at P < 0.05.ConclusionFactors associated with food safety and children’s nutritional outcomes are multi-faceted in nature. Future studies should explore access to resources and other intermediate factors that may explain the linkage between childhood malnutrition and caregivers’ food safety awareness, knowledge, and behavior. Public health and food safety initiatives to bridge the gap between perceived food safety control and actual food safety behavior/practices.

Preventing Stunting Through Mujaer Fish Nuggets in Early Childhood Education

Background: Stunting significantly affects early childhood development, highlighting the need for effective nutritional interventions. Specific Background: The development of fish nugget products offers a novel strategy to enhance dietary diversity among young children through parental engagement. Knowledge Gap: However, there is limited understanding of how parental participation influences nutritional programs and stunting prevention in early childhood settings. Aims: This study investigates fish nugget production as a nutritional strategy and the role of parental involvement in a preschool context. Results: Through qualitative methods, including interviews and observations, the study reveals that 90.48% of parents expressed interest in preparing fish nuggets at home, leading to increased nutritional awareness and strengthened community ties. Novelty: This research presents a community-based model that utilizes local resources to address stunting while promoting parental engagement. Implications: The findings underscore the importance of collaborative efforts in nutritional education, suggesting that similar initiatives could be adopted in other communities to effectively combat stunting. Highlights : Emphasizes the role of parental involvement in improving children's nutrition. Highlights the effectiveness of community-based interventions in combating stunting. Demonstrates increased interest in healthy food preparation among parents. Keywords: Stunting, Nutritional Education, Parental Engagement, Fish Nuggets, Early Childhood

Fathers' engagement in a parenting program primarily intended for female caregivers: An early qualitative process evaluation in Western Kenya.

Parenting programs predominantly target one caregiver of the child or most commonly the child's mother. However, fathers are also important caregivers whose engagement in interventions can benefit child health, nutrition, and development. In August 2023, a qualitative process evaluation was conducted during the first quarter of implementation to assess initial fidelity, quality, and outcomes of a parenting program in rural Western Kenya. In-depth interviews were conducted with female and male caregivers along with in-depth interviews and focus group discussions with program delivery agents. This secondary analysis specifically focused on stakeholders' perceptions of father involvement in the program and aimed to identify barriers and facilitators to fathers' participation, initial program impacts when fathers were involved, and recommendations for increasing father inclusion. Thematic content analysis was conducted, and data were triangulated across stakeholder groups. Overall, relatively few fathers participated in the program. Nevertheless, for the rare cases of participating fathers, stakeholders highlighted positive changes in fathers' caregiving attitudes and practices. Key barriers to fathers' program engagement included restrictive gender norms and perceived opportunity costs. Stakeholders suggested several strategies for better reaching fathers, including providing financial incentives and flexible scheduling of sessions. Overall, we found that fathers' participation and program experiences were starkly different from those of mothers. Gender-responsive program adaptations and father-targeted implementation strategies are likely to increase the fathers' engagement in parenting programs, which in turn may facilitate greater program impacts on family caregiving and child outcomes. Future evaluations of parenting programs should combine qualitative and quantitative approaches to more comprehensively assess program impacts on fathers and over time.

Geographical variation, socioeconomic inequalities of low birth weight, and its relationship with maternal dietary diversity: Insights from the maternal infant and young child nutrition programme in Bangladesh.

Globally, every year, 20 million neonates are born with weights below 2500 g and are considered low birth weight (LBW). About 90% of these births occur in low- and middle-income countries. Information regarding the geographical variation, socioeconomic inequalities of LBW neonates, and the relationship between maternal inadequate dietary diversity and LBW is limited in rural areas of Bangladesh. We aimed to explore the geographical disparities and socioeconomic inequalities in the prevalence of LBW and its association with inadequate maternal dietary diversity. We extracted data from a large-scale evaluation programme conducted as a part of the maternal infant and young child nutrition phase two in Bangladesh, implemented by BRAC. We used the concentration index (CIX) to measure the socioeconomic inequalities of LBW. We performed a cluster-adjusted multiple logistic regression analysis to determine the association between LBW and maternal dietary diversity. A total of 4651 children aged <5 years with their mother's information were included. The overall prevalence of LBW was 13.5%. About 16% of mothers living in the poorest wealth quintile gave birth to LBW babies, whereas 10% of mothers living in the richest households gave birth to LBW babies. The CIX exhibited LBW babies were more prevalent among the socioeconomically worst-off (poorest) group (CIX = -0.08), indicating mothers of the poorest households are vulnerable to giving birth to normal-weight babies. An adjusted multiple logistic regression model indicated that mothers with inadequate dietary diversity had higher odds (adjusted odds ratio (AOR) = 1.27; 95% confidence interval (CI) = 1.04, 1.54) of giving birth to LBW babies. Notably, in the interaction of mothers' age and dietary diversity, we found that adolescent mothers (aged ≤ 19 years) with inadequate dietary diversity had 2.56 times (AOR = 2.56; 95% CI = 1.14, 5.76) higher odds of giving birth to LBW babies compared to adult mothers (aged >19 years) who consumed diversified foods. Intervention strategies for reducing LBW prevalence should target the poorest households. Also, interventions for improving the dietary diversity of adolescent pregnant mothers are expected to reduce the number of LBW babies from the rural areas of Bangladesh.

Feasibility of Employing mHealth in Delivering Preventive Nutrition Interventions Targeting the First 1000 Days of Life: Experiences from a Community-Based Cluster Randomised Trial in Rural Bangladesh.

An Android platform-based customised app and web-linked system was developed to aid in implementing selected nutrition interventions by community health workers (CHWs) in a community-based cluster randomised trial (c-RCT) in rural Bangladesh. Here, we describe the architecture of the intervention delivery system, and explore feasibility of employing mHealth as CHWs' job aid, employing a mixed-method study design covering 17 visits per mother-child dyad. We analysed CHWs' real-time visit information from monitoring and documentation data, and CHWs' qualitative interviews to explore the advantages and barriers of using mHealth as a job aid. Intervention coverage was high across the arms (>90%), except around the narrow perinatal period (51%) due to mothers' cultural practice of moving to their parents' homes and/or hospitals for childbirth. CHWs mentioned technical and functional advantages of the job aid including device portability, easy navigability of content, pictorial demonstration that improved communication, easy information entry, and automated daily scheduling of tasks. Technical challenges included charging tablets, especially in power cut-prone areas, deteriorated battery capacity over continuous device usage, unstable internet network in unsupportive weather conditions, and device safety. Nevertheless, onsite supervision and monitoring by expert supervisors remained important to ensure intervention quality. With appropriate training and supervision, CHWs utilised the tablet-based app proficiently, attaining high coverage of long-term visits. mHealth was thus useful for designing, planning, scheduling, and delivering nutrition interventions through CHWs, and for monitoring and supervision by supervisors. Therefore, this application and job aid can be adopted or replicated into the currently developing national health systems platform for improving coverage and quality of preventive maternal and child nutrition services. In addition, continuous supportive supervision by skilled supervisors must be accompanied to ensure CHWs' task quality. Finally, future studies should rigorously assess undesirable health and environmental effects of mHealth before and after mainstreaming, effective interventions addressing device-induced health hazards should be designed and scaled up, and effective e-waste management must be ensured.

A qualitative exploration of the COVID-19 pandemic on health and nutrition behaviours during the first 1000 days in Sri Lanka.

This study sought to understand reported impacts of the COVID-19 pandemic on maternal and child health and nutrition behaviours during the first 1000 days of life. This qualitative and participatory substudy was embedded within mixed methods formative research conducted during 2020-2022 across two urban, three rural and one estate sector site in Sri Lanka. Semi-structured interviews among caregivers of children aged 6-23 months (n = 34), influencers of caregivers, such as health workers (n = 37), leaders (n = 10) and pregnant women (n = 20) were conducted. Participatory workshops (n = 14) triangulated interview findings. Interview data were analyzed to identify salient themes using Dedoose. Numerical data from voting conducted in workshops were summed and triangulated with interview data. Findings suggest that the COVID-19 pandemic and imposed restrictions shaped maternal and child health and nutrition behaviours through a complex interplay of factors. Imposed restrictions and changes to the food system contributed to temporary unemployment for wage workers and reduced purchasing power to maintain food security for vulnerable households. While deciding whether to seek care, fears of infection prevented usual care-seeking decisions. Also, reduced incomes and disrupted public transportation made transport to health care facilities for antenatal care services difficult. Once women reached facilities, medical services and quality of care were negatively impacted. Implementing expanded community-based services during home visits focused on the first 1000 days and beyond was one effective strategy to maintain maternal and child health and nutrition during the early pandemic in Sri Lanka.

Clinical Data Flow in Botswana Clinics: Protocol for a Mixed-Methods Assessment.

Botswana has made significant investments in its health care information infrastructure, including vertical programs for child health and nutrition, HIV care, and tuberculosis. However, effectively integrating the more than 18 systems in place for data collection and reporting has proved to be challenging. The Botswana Health Data Collaborative Roadmap Strategy (2020-24) states that "there exists parallel reporting systems and data is not integrated into the mainstream reports at the national level," seconded by the Botswana National eLearning strategy (2020), which states that "there is inadequate information flow at all levels, proliferation of systems, reporting tools are not synthesized; hence too many systems are not communicating." The objectives of this study are to (1) create a visual representation of how data are processed and the inputs and outputs through each health care system level; (2) understand how frontline workers perceive health care data sharing across existing platforms and the impact of data on health care service delivery. The setting included a varied range of 30 health care facilities across Botswana, aiming to capture insights from multiple perspectives into data flow and system integration challenges. The study design combined qualitative and quantitative methodologies, informed by the rapid assessment process and the technology assessment model for resource limited settings. The study used a participatory research approach to ensure comprehensive stakeholder engagement from its inception. Survey instruments were designed to capture the intricacies of data processing, sharing, and integration among health care workers. A purposive sampling strategy was used to ensure a wide representation of participants across different health care roles and settings. Data collection used both digital surveys and in-depth interviews. Preliminary themes for analysis include perceptions of the value of health care data and experiences in data collection and sharing. Ethical approvals were comprehensively obtained, reflecting the commitment to uphold research integrity and participant welfare throughout the study. The study recruited almost 44 health care facilities, spanning a variety of health care facilities. Of the 44 recruited facilities, 27 responded to the surveys and participated in the interviews. A total of 75% (112/150) of health care professionals participating came from clinics, 20% (30/150) from hospitals, and 5% (8/150) from health posts and mobile clinics. As of October 10, 2023, the study had collected over 200 quantitative surveys and conducted 90 semistructured interviews. This study has so far shown enthusiastic engagement from the health care community, underscoring the relevance and necessity of this study's objectives. We believe the methodology, centered around extensive community engagement, is pivotal in capturing a nuanced understanding of the health care data ecosystem. The focus will now shift to the analysis phase of the study, with the aim of developing comprehensive recommendations for improving data flow within Botswana's health care system. DERR1-10.2196/52411.

Maternal factors promoting normal linear growth of children from impoverished Rwandan households: a cross-sectional study

BackgroundLinear growth faltering remains a pervasive public health concern that affects many children worldwide. This study aimed to investigate possible maternal factors promoting normal linear growth among children aged 6–23 months of age from impoverished Rwandan households.MethodsWe used a three-stage cluster sampling procedure. The study population consisted of children aged six to 23 months and their mothers who lived in the study districts. A structured questionnaire helped to collect data from 807 selected mother-child dyads. The primary outcome variable was height-for-age Z scores. The main predictors were maternal income-generating activity, maternal education, maternal depression, household decision making, number of ANC visits, use of family planning method, types of family planning, and mode of delivery. We used univariate analysis to establish median, frequencies, and percentages. Furthermore, we used the Kruskal-Wallis, Mann-Whitney U, and Spearman rank correlation tests for bivariate analysis. We included in the final model of robust linear regression for multivariate analysis the potential confounding variables identified as significantly associated with the outcome (child age, participation in works for both parents, good handwashing practice, owning a vegetable garden, and the total number of livestock) along with maternal factors.ResultsMaternal factors that promoted normal linear growth of children were the presence of maternal income generation activity (β= 0.640 [0.0269 1.253], p value = 0.041), the participation of the mother in the decision-making process of the household (β=0.147 [0.080 0.214], p-value < 0.001), and the higher frequency of consultations with ANC (β=0.189 [0.025 0.354], p-value = 0.024). Additionally, a combination of household decision-making with the number of ANC visits predicted an increase in the linear growth of the child (β=0.032 [0.019 0.045], p-value < 0.001).ConclusionMaternal factors such as maternal income-generating activity, maternal participation in household decision making, and increased number of ANC visits were found to promote normal child linear growth. These results contribute valuable information to the formulation of interventions and policies to improve child nutrition and growth in the community studied.

Complementary feeding and food handling practices among caregivers in a semi-urban setting in Northern Uganda

Background: Complementary feeding practices influence the nutritional status and health of children, especially in developing countries where sub-optimal infant feeding practices are the major cause of childhood undernutrition, morbidity, and mortality. This study sought to characterize the adequacy of complimentary feeding and food handling practices among caregivers of children aged 6-23 months in a semi-urban setting. Methods: Exploratory cross-sectional study was conducted in Adyel division, Lira district in Northern Uganda among 127 child-caregiver pairs randomly selected from three villages. Caregivers were interviewed about their child-feeding practices, complementary foods used, and common practices in handling and preparation of foods used as complementary feeds. Results: Overall, children’s feeding patterns met the recommended dietary intake when assessed using the child feeding index (CFI) whereby children aged 6-8, 9-11, and 12-23 months scored 8.03, 9.17, and 7.59, respectively. However, most children were complemented with foods from the household meals and dietary diversity was limited by frequent use of food leftover from the previous meals. Conclusions: Inappropriate meal patterns and food handling practices identified are likely to compromise child nutrition and health. Nutrition education is needed to improve the caregivers’ child-feeding and food handling practices within their socio-economic and cultural context. Keywords: Complementary feeding practices; food handling; diet quality; food safety; children; Uganda.

Household Food Insecurity Is Associated with Parental Perceptions of and Student Participation in School Meals.

School meals are an important source of nutrition for children and have been found to help mitigate food insecurity. This study evaluated the association between food insecurity and school meal participation and whether parental perceptions about school meals differ by food security status. In May 2022, 1110 Californian parents of K-12 students shared their perceptions about school meals, including meal quality, healthiness, stigma, and benefits, as well as their child's participation in school meals, in an online survey. Household food security was determined using the USDA 6-item module. Logistic and Poisson regression models were used for analysis. The prevalence of household food insecurity was 56.2% (69.6% in households of students eligible for free meals, 55.9% in reduced-price, and 38.3% in non-eligible). Many of the reported benefits of school meals (saving families money and time) were equally highly endorsed by parents with and without food insecurity (p > 0.05). Parents reporting food insecurity had less favorable perceptions of school meals and perceived more stigma (p < 0.05). Food insecurity was positively associated with breakfast participation, especially among elementary school students and students not eligible for free or reduced-price meals (FRPMs) (p < 0.05). Food insecurity is prevalent among California families with school-age children, even in families not eligible for federal FRPMs. Food-insecure households have more negative perceptions of school meals and experience more stigma, though they also report higher breakfast participation. Improving school meal quality and appeal, ensuring parents are familiar with meal quality and healthfulness, and reducing stigma may ease food insecurity while improving children's health.

The Role of Posyandu Cadres in Reducing Stunting in the Community

The general background stunting is a major health issue that threatens the quality of human resources in Indonesia. Specific background posyandu cadres play a crucial role in disseminating health information and educating mothers to prevent and reduce stunting in communities. Knowledge Gap: While previous research has focused on general health initiatives, there is limited evidence on the specific role of posyandu cadres in reducing stunting in rural areas. Aims this study to examine the role of posyandu cadres in reducing stunting rates in the local community. Results the findings demonstrate that posyandu cadres have successfully carried out their role by conducting regular health programs such as providing supplementary food, vitamin A, blood supplements for pregnant women, and monitoring child growth. These efforts have contributed to a steady decrease in stunting rates. Factors influencing the success of the programs include the knowledge and active participation of trained cadres, high community involvement, and support from local health workers and officials. Novelty this study highlights the importance of community-based health initiatives and posyandu programs in addressing stunting, emphasizing the need for well-trained cadres in achieving long-term health outcomes. Implication the research underscores the importance of continuing support for posyandu cadres through training and resources to further improve public health and reduce stunting rates in other regions. Highlights: Posyandu cadres are key in reducing stunting through regular health activities. Knowledgeable and trained cadres contribute to lower stunting rates. Local community and health worker support strengthen program success. Keywords: Stunting, Posyandu Cadres, Community Health, Child Nutrition, Rural Development