Knowledge Of Complementary Feeding Research Articles

Improving knowledge, attitude, and practices of complementary feeding using practical intervention training for parents living in central Lombok, Indonesia: A community-based study.

Stunting remains a major public health concern in Indonesia despite many interventions. This study aimed to assess the effectiveness of interventions in the form of education and demonstration on preparing complementary feeding (CF) to increase knowledge, attitude, and practices (KAP) of CF among parents living in villages with high stunting prevalence in Central Lombok, Indonesia. This is a quasi-experimental community-based study, conducted from June to August 2019. Three villages were divided into three groups, i.e., control group (CG), education alone (EA) group, and education-cum-demonstration (ED) group. We assessed KAP before and after intervention with a 4-week interval. A total of 205 participants were enrolled in this study, consisting of 67, 70, and 68 participants in the CG, EA, and ED groups, respectively. In within-group analysis, parents' attitudes (P = 0.015) and practices (P = 0.014) improved in the ED group while only parents' practices (P = 0.034) improved in the EA group. In between-group analysis, parental attitude (P = 0.039) and practices (P = 0.008) improved in the ED group when compared to the CG. In the EA group, only parents' practices improved when compared to the CG (P = 0.006). There was no significant difference in KAP score in the EA and ED groups. A combined approach of education and demonstration works better to promote healthy CF practices among mothers.

Evaluation of Mother's Complementary Feeding Knowledge and Occlusion.

Aim:Mothers' understanding of feeding methods and how they affect deciduous dentition were the focus of this study.Materials and Methods:This study looked at people from different parts of the population. In total, 230 moms of children aged 6 months to 5 years who completed an oral health questionnaire were included in the study. Mothers' awareness of feeding patterns and their impact on deciduous dentition were examined in the study.Results:Illiterate moms' children showed a significant difference in the quality of their occlusion compared to similarly raised children of literate mothers. Children who began supplementary feeding before the age of 6 months were more likely to have occlusion changes.Conclusion:Malocclusion prevalence was shown to be unrelated to meal behaviors. However, further research is required as there are just a few studies currently available.

A Complementary Feeding Intervention for Fathers and Mothers in Northern Nigeria Improves Children’s Minimum Meal Frequency and Consumption of Eggs and Fish

ObjectivesThe objective of this study was to measure the effects of a social behavior change communication (SBCC) intervention on fathers’ and mothers’ complementary feeding knowledge and attitudes, fathers’ support for complementary feeding, and children’s dietary diversity and meal frequency. MethodsThis study used cross-sectional surveys of cohabiting fathers and mothers with a child 6–23 months before (N = 497) and after (N = 495) the intervention in Igabi local government area, Kaduna State, Nigeria. Participants were randomly sampled within 99 clusters selected proportional to population size. Regression models weighted for the survey design, including inverse propensity weights to adjust for differences in sociodemographic characteristics of the cross-sections, were used to assess before/after differences. Alive & Thrive’s 12-month intervention engaged fathers through community meetings, religious services, and mobile phone text and voice messages. Mothers received home visits from community health extension workers (CHEWs), which fathers also could attend. SBCC materials included TV and radio messages, sermon guides, counseling cards, pamphlets, posters, and feeding bowls. ResultsExposure of fathers to CHEW visits, fathers and mothers to mass media messages, and fathers to text/voice messages increased from baseline to endline. Fathers’ and mothers’ knowledge of the timing of introduction of different foods and meal frequency shifted toward the global recommendations. Fathers’ support for child feeding by providing money for food increased (79% to 90%, P < 0.001). The percentage of children with minimum dietary diversity did not change (62% to 65%, P = 0.358). The percentage of children who consumed fish (36% to 44%, P = 0.012) and eggs (8% to 20%, P = 0.004), had minimum meal frequency (58% to 73%, P < 0.001), and had minimum acceptable diet (40% to 52%, P < 0.001) increased from baseline to endline. ConclusionsA multipronged SBCC intervention improved fathers’ and mothers’ knowledge of complementary feeding, increased fathers’ support for complementary feeding, and modified some complementary feeding practices. Funding SourcesThis research was funded by the Alive & Thrive initiative, managed by FHI Solutions, and currently funded by the Bill & Melinda Gates Foundation, Irish Aid, the Tanoto Foundation, UNICEF, and the World Bank.

Mothers' perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach.

The objective was to explore mothers’ perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. Forty-three mothers with children aged 0–48 months participated in six FGD and 547 mothers of children aged 0–23 months in KAP interviews. The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0·06), complementary feeding knowledge (P = 0·01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0·003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in Kenya.

Complementary Feeding Knowledge and Practices of Caregivers in Orphanages Improved after Nutrition Education Intervention in Ibadan, Nigeria

Malnutrition among under-5 children has been linked to inadequate complementary feeding practices. Children living without permanent parents have also been proven to have a higher risk of malnutrition, which puts their growth and development in danger. In this study, an impact evaluation of nutrition education was carried out on the knowledge and practice of complementary feeding among caregivers in orphanages. This quasi-experimental study was conducted in selected orphanage homes located within Ibadan, southwestern Nigeria. A purposive sampling technique was employed to select 50 caregivers from 8 orphanage homes. Data was collected using an adapted interviewer administered at baseline and post-intervention. The key results showed that those who had good knowledge of complementary feeding practices increased from 68.1% to 79.9% at baseline and post-intervention respectively. The WHO complementary feeding indicators that were used to measure the practice revealed that 37.5% met the minimum meal frequency (MMF), 52.5% met the minimum dietary diversity (MDD) and 35% met the minimum adequate diet (MAD) at baseline, which increased to 62.5%, 80% and 60% respectively after intervention. Conclusively, this study revealed that nutrition education improved the complementary feeding knowledge and practice of caregivers. It is recommended that such nutrition education should be introduced to new caregivers and could also be converted into policy actions at a national level.

Complementary Feeding Knowledge, Practice, Dietary Diversity and Associated Factors among Mothers of Children 6-23 Months in Guto Gida District, Oromia, Ethiopia.

The period for complementary feeding is crucial for growth, development and overall health of infants and young children. Lack of awareness in knowledge and practices towards complementary feeding among mothers will lead to improper practice of complementary feeding which may causes of children malnutrition, slower in recovery after illness and death. Hence, this study was aimed to assess complementary feeding knowledge, practice, dietary diversity and associated factors among mothers of children 6-23 months of age in Guto Gida District, Oromia, Ethiopia. Community based cross sectional study design was conducted among 410 mothers who had children aged 6-23 months in the study area. Cluster and simple random sampling techniques were used to select the required sample. A face to face interview was conducted to collect data using semi-structured and structured questionnaire. In addition, focus group discussion was also included in this study. The collected data was coded, organized and entered in to SPPSS windows version 22.0 and analyzed by using frequency, percentage and multi-logistic regression model. The result of this study revealed that about two-third (66.3%) of the respondents had good knowledge whereas nearly half (52.2%) of the mothers had good practices toward complementary feeding. The minimum dietary diversity identified from this study was 27.3%. Education levels of mothers had significant effect on mothers’ knowledge on complementary foods. In addition, age of mothers, mother occupation and wealthy index of the family had a significant effect on mothers’ complementary feeding practices. Furthermore, age of children, birth orders of children, wealthy index and educational level of mothers had a significant effect on dietary diversity of children. The overall findings were indicative of the problems of mothers’ knowledge and feeding practice toward complementary foods, and dietary diversity of 6-23 months of age children. Therefore, all possible interventions should be applied by all the concerned bodies to improve mothers’ knowledge and practice towards complementary foods, dietary diversity of children and thus to improve child survival.

Complementary Feeding Practices During COVID-19 Outbreak in Daerah Istimewa Yogyakarta, Indonesia, and Its Related Factor.

Indonesia still faces a challenge in achieving an appropriate complementary feeding (CF) practice for the child aged 6 to 24 months. However, this condition became more critical due to the COVID-19 (coronavirus disease-2019) outbreak. The social limitation policy, market disruption, and changes in income may change the state of family food security and altering child CF practices. Besides, infant age, mother education and occupation, information availability, and CF knowledge may also affect the practice. Therefore, we aimed to explore the CF practice and its related factors during the COVID-19 outbreak through an online cross-sectional study of the mothers of children aged 6 to 24 months in Daerah Istimewa Yogyakarta. The results showed that a child's age (P = .019), household food security (P = .006), and mother's CF knowledge (P = .002) had an association with CF practices. We concluded that a child's age, household food security, and mother's CF knowledge are the determinant factors for appropriate CF practices during the outbreak.

Construcción y validación de un instrumento para medir conocimientos de madres y cuidadores sobre alimentación complementaria de infantes

La nutrición adecuada durante los primeros dos años de vida es fundamental para el desarrollo pleno del potencial del ser humano. La introducción inadecuada, precoz o tardía de la alimentación complementaria trae consecuencias a corto y largo plazo. La alimentación complementaria depende en gran medida de los conocimientos del cuidador que en los países de Latinoamérica generalmente es la madre.Objetivo: construir y validar un instrumento para medir los conocimientos maternos y de cuidadores sobre alimentación complementaria.Sujetos y Método: Estudio observacional. Participaron 80 madres comunitarias y 12 pediatras expertos. Se desarrolló en dos etapas: la creación del instrumento a partir de las 7 fases propuestas por Sampieri, y la validación mediante la evaluación de validez aparente, de constructo, de contenido, consistencia interna y fiabilidad intra-observador.Resultados: Se creó un instrumento autoadministrado que incluyó inicialmente 14 preguntas sobre conocimientos maternos y de cuidadores. Durante la validación de constructo se identificaron 3 dominios y se eliminaron cuatro preguntas. En la validación de contenido, 10 preguntas del instrumento definitivo obtuvieron calificaciones superiores a 9 (en una escala de 0-10) en las características: calidad, vocabulario, relevancia y actualidad. La consistencia interna global del instrumento fue moderada (Alfa de Cronbach: 0,64) y la fiabilidad intra-observador fue aceptable (k: 0,21-0,40) para el 80% de ítems del instrumento.Conclusiones: Se presenta el primer instrumento autoadministrado validado en la región, que permite medir conocimientos de las madres y los cuidadores sobre alimentación complementaria. A futuro, permitirá diseñar y desarrollar estrategias de evaluación e intervención en relación con los conocimientos maternos y de los cuidadores sobre alimentación complementaria.

Construction and validation of an instrument to measure knowledge of mothers and caregivers on complementary feeding of infants.

Adequate nutrition during the first two years of life is crucial for the full development of human potential. Inadequate, early, or late introduction of complementary feeding has consequences in the short- and long-term. Complementary feeding depends largely on the knowledge of the caregiver who, in Latin American countries, is usually the mother. To create and validate an ins trument to measure knowledge about complementary feeding. Observational study in which 80 community mothers and 12 expert pediatricians participated. It was carried out in two stages, the creation of the instrument (following the 7 phases proposed by Sampieri) and the va lidation through the evaluation of the apparent validity, construct and content validity, internal con sistency, and intra-observer reliability. A self-administered instrument was created that ini tially included 14 questions about maternal and caregiver's knowledge. During the validation of the construct, 3 domains were identified and four questions were eliminated. In the content validation, 10 questions of the final instrument scored higher than 9 (on a scale of 0-10) in the characteristics of quality, vocabulary, relevance, and topicality. The global internal consistency of the instrument was moderate (Cronbach's alpha: 0.64) and the intra-observer reliability was acceptable (k: 0.21-0.40) for 80% of its items. the first self-administered instrument validated in the region to measure the knowledge of mothers and caregivers about complementary feeding is presented. It will allow to design and develop strategies in relation to maternal and caregiver's knowledge of comple mentary feeding.

Effects of Nutrition Education on Improving Knowledge and Practice of Complementary Feeding of Mothers with 6- to 23-Month-Old Children in Daycare Centers in Hawassa Town, Southern Ethiopia: An Institution-Based Randomized Control Trial.

Undernutrition and hidden hunger threaten the survival, growth, and development of children, young people, economies, and nations. Inappropriate complementary feeding practice due to poor maternal knowledge and awareness in combination with low income and infectious disease is the contributing factor for child undernutrition. Hence, this study was aimed at determining the effect of nutrition education on improving the knowledge and practice of complementary feeding of the mothers with 6- to 23-month old children in daycare centers of Hawassa Town, Southern Ethiopia. An institution-based randomized control trial design was employed. Daycare centers were randomly allocated for the intervention group and the control group. Among the total daycare centers in the town, five were assigned to receive nutrition education and the rest five for the control group (CG). The simple random sampling technique used to select individual participants from each daycare center. Two hundred (200) mother-child pairs (100 for each group) were recruited. Sociodemographic and economic variables were collected by the structured questionnaire. Knowledge of appropriate complementary feeding was assessed by seven knowledge questions. Appropriate complementary feeding practice was assessed by adapting Alive and Thrive Infant and Young Child Feeding (IYCF) practice guidelines. Nutrition education was given for four consecutive months by using Alive and Thrive IYCF guidelines. Data were analyzed by the SPSS software program version 20. The chi-squared test was used to test the significant differences in the proportion of good knowledge and good practice of complementary feeding and good dietary diversity between two groups. The independent t test was used to test the significant differences in mean dietary diversity between two groups. At 95% confidence interval, p < 0.05 was considered statistically significant. The results revealed that the proportion of mothers with good knowledge of appropriate complementary feeding was increased from 59% at pretest to 96% at posttest and the appropriate complementary feeding practice was improved from 54% at pretest to 86% at posttest in IG. There was no change in the knowledge and practice of complementary feeding practice in CG after four months. The proportion of mothers with good complementary knowledge was 54% both at pretest and at posttest and good complementary feeding practice was 51% and 52% at pre- and posttest in CG, respectively. There was no significant difference (p > 0.05) on complementary feeding knowledge and practice between two groups at pretest, while the difference was highly significant (p < 0.05) at the posttest. In conclusion, providing nutrition education improved the appropriate complementary feeding knowledge and practice of mothers. In recommendation, government and other partners working on sustainable child nutrition reduction should focus on the nutrition education to improve the knowledge and appropriate complementary feeding practice including daycare centers.

Community-Based Nutrition Education Improves Caregivers’ Knowledge of Complementary Feeding in Southern Ethiopia

Abstract Objectives Quality Diets for Better Health (QDBH) is a nutrition-sensitive agriculture project in southern Ethiopia that promotes vitamin A-rich orange-fleshed sweetpotato (OFSP) and community-based nutrition education to improve the quality of young child diets. The objective of this research is to examine the impact of the project and other predictors on caregiver knowledge of infant and young child feeding (IYCF) over time. Methods Communities were randomized to a control group and intervention groups receiving OFSP planting materials and community-based nutrition education. Households with infants &amp;lt;6 months completed a baseline survey in January 2018, and follow-up surveys 7 and 13 months later. Knowledge of IYCF recommendations and vitamin A was assessed at each visit; a knowledge score (range 0–100) was calculated by assigning points for accurate responses. If a caregiver was missing not more than two responses, we imputed her score with the community-mean to retain sample size and minimize bias. We used mixed effects modeling to examine the effect of QDBH and other factors, such as education and prenatal counseling, on knowledge scores over time, while controlling for covariates. Results Of the 605 households who completed the baseline survey, 548 (90.6%) and 523 (86.4%) completed the follow-up surveys. Baseline characteristics of the group lost to follow-up did not differ from those retained in the sample. Knowledge scores were highest at baseline (65.3 ± 14.4), and lower at 7 months (48.4 ± 13.8) and 13 months follow-up (46.9 ± 14.0). Baseline scores were higher among caregivers with higher education (P &amp;lt; 0.05) and who reported receiving prenatal IYCF counseling (P &amp;lt; 0.0001), but also declined faster among those who had prenatal counseling (β = −1.6, P = 0.04). Knowledge scores in intervention and control groups were similar at baseline (P = 0.49), but scores of those in the intervention group declined less rapidly than those in the control group (β = 4.0, P &amp;lt; 0.0001). Conclusions Caregivers’ knowledge of IYCF decreased in the postnatal period; decreases were fastest among those who received prenatal IYCF counseling and among those in the control group. Postnatal community-based nutrition education can help maintain knowledge of IYCF recommendations. Funding Sources This research is funded by the European Union in partnership with the International Potato Center.

Complementary Feeding Practices and Associated Factors in Children 6–23 months in Uttar Pradesh, India: Program Implications

Abstract Objectives Optimal complementary feeding (CF) practices among children 6–23 months can prevent childhood malnutrition and can improve long term development and health. Our study aimed to understand CF practices in children 6–23 months, as part of an ongoing nutrition program (with a focus on improving dietary diversity) in UP, India. Methods Mothers of children 6–23 months old were interviewed in 125 blocks across 25 districts of UP (N = 34,290). We assessed dietary intake using 24-hour dietary recalls and calculated minimum dietary diversity (MDD, 4 + food groups) and age-appropriate minimum meal frequency (MMF). We used multivariate logistic regression to test for associations between MDD and program exposure variables, such as frontline worker (FLW) CF knowledge, home visits by FLWs, and FLW counseling on age-appropriate CF practices, controlling for age, caste, religion, mother's education level, birth order and sex of the child. Results Merely 22% of children 6–8 months old received any semisolid/solid food the previous day, and even at 1 year of age, only 60% children received any CF. Fourteen % of all children and 5% of children 9–11 months received age-appropriate MMF. Children 6–23 months old had poor diets with only 11% reaching MDD. Only 3% of younger children (6–11 months) and 18% of children 12–23 months reached MDD. In children 12–23 months, starchy staples, pulses, other fruits and vegetables (F&amp;V) and dairy products were consumed in higher proportions (65%, 52%, 36% and 36% respectively) while Vitamin-A rich F&amp;V, eggs and flesh foods were rarely consumed (11%, 2% and 3.1% respectively). Higher odds of achieving MDD were associated with FLWs CF knowledge (OR: 3.2; 95% CI: 2.2–4.5), home visit by FLWs in the past month (OR: 1.2; 95% CI: 1.1–1.4) and counselling by FLWs on age-appropriate CF practices (OR: 1.4; 95% CI: 1.2–1.7) were positively associated with MDD. Conclusions CF practices in children 6–23 months old in these 25 districts in UP are suboptimal. Dietary diversity in this age group can be improved by improving FLW knowledge and quantity and quality of FLW interactions with families. Results suggest a need for targeted age-specific counselling to increase meal frequency and to introduce a greater variety of foods to younger children. Funding Sources Bill and Melinda Gates Foundation.

Complementary Feeding Practices Among Mothers of Rural Bangladesh; A Knowledge, Attitude, and Practice Study

Background. In developing countries, inadequate knowledge and cultural practice on complementary feeding (CF) is one of the main reasons for malnutrition.&#x0D; Objective: This study aimed to document the knowledge, attitude, and practices pertaining to CF among the mothers of rural area in Bangladesh.&#x0D; Materials and Methods: A communitybased cross-sectional study was conducted in upazila health complex, kachua, Chandpur from July to December, 2017. A total 408 mothers of the babies aged 6-24 months and children under six months were included. Data were collected from the mothers/caregivers of the children in a pretested semi-structured data collection sheet and analyzed by SPSS version 20. Appropriate statistical tests were done. Statistical significance was considered if p value was &lt;0.05.&#x0D; Results: Knowledge regarding recommended CF practice only 50.8% but feeding should be started at 6 months of age (52.9),thick consistency (40.2%), adequate quantity( 61.8%), and appropriate quality (62.3%) cases. Knowledge in recommended appropriate timing and consistency varied significantly with maternal education. Frequency of CF was not appropriate in many cases. Most common first complimentary food was thick dal with rice/roti, khichuri rice 166(40.7%). One hundred twenty four (30.4%) mothers did not properly clean their hands before feeding and 138(33.8%) of mother used bottle for feeding, force full feeding (56.9%) and environment during feeding playing 72.5% and roaming around 25.5%.&#x0D; Conclusion: CF knowledge and practices are far gap from ideal in our country. Awareness building in the community may change improper feeding practices need health education.&#x0D; KYAMC Journal Vol. 11, No.-1, April 2020, Page 26-31

Evaluation of complementary feeding knowledge and behavior of mothers with children between four-twenty four months

Aim: Complementary feeding is important for growth in infancy. In this study, we aimed to determine the knowledge of complementary feeding of mothers who take their children to our hospital and to evaluate the effects of mother’s and baby’s characteristics on complementary feeding. Material and Method: Between December 2018 and February 2019, 259 mothers who admitted to our hospital were included in the study. Mothers’ knowledge and behavior about complementary feeding were questioned. Results: The mean age of 259 mothers was 28.71 ± 5.09 years old. 94 (36.3%) of the participants introduced complementary feeding before six months. The mean time to introduce complementary feeding was 5.67 ± 0.84 months. Complementary feeding was introduced with 48.6% yoghurt, 17.8% fruit puree and 17% soup. The most frequent reason for early onset was the weight gain of the baby and the decrease in breast milk. A significant difference was found between the monthly income of the family, smoking and working of the mother, and early initiation of complementary feeding. The use of feeding bottles and/or pacifiers was also associated with early onset of complementary feeding. Conclusion: Mothers’ time to introduce complementary feeding varies. Mothers should be given more education about complementary feeding for healthy development of babies.

Complementary feeding: knowledge and perception of mothers attending paediatric outpatient department in a tertiary care hospital

Background: Complementary feeding refers to food which supplements breast milk and ensures that the child continues to have enough energy protein and other nutrients to grow normally. Complementary feeding is started at 6 months of age, while continuing breast feeding. After 6 months of age breast milk alone is not enough to make an infant grow well.Methods: Cross sectional study conducted among 70 mothers coming to paediatric outpatient department. Data was collected regarding their knowledge and practices of complementary feeding. Mean, frequency table and chi-square test were used.Results: 77.1% women have sufficient knowledge about complementary feeding. 77.1% of mothers give complementary food after 6 months remaining i.e. 22.9% are unaware of age of starting it. All mothers are aware of the complementary food which is to be given to babies. 82.8% mothers properly know how to start with complementary feeds. 98.5% of mothers continue to breast feed their baby’s above 6 month.Conclusions: The study concluded that inadequate complementary feeding knowledge and practices were present among some study subjects.

EFETIVIDADE DE FORMAÇÃO EM ALIMENTAÇÃO COMPLEMENTAR PARA PROFISSIONAIS DE SAÚDE SOBRE AS PRÁTICAS ALIMENTARES DE CRIANÇAS MENORES DE UM ANO ATENDIDAS NA ESTRATÉGIA DE SAÚDE DA FAMÍLIA DO RIO DE JANEIRO

Objetivo: Avaliar a efetividade da formação em alimentação complementar (AC) sobre a alimentação de crianças menores de um ano atendidas na Estratégia de Saúde da Família (ESF) do Rio de Janeiro. Método: Ensaio comunitário randomizado controlado desenvolvido em seis unidades básicas de saúde. A intervenção consistiu em formação sobre alimentação complementar dirigida aos profissionais de saúde complementada por materiais de apoio aos profissionais e materiais educativos dirigidos às famílias. A alimentação das crianças foi analisada quando elas tinham quatro, seis, nove e 12 meses de idade. A efetividade da intervenção foi avaliada segundo “intenção de tratamento” e dose-resposta. Resultados: Foram estudadas 220 crianças no Grupo Intervenção (GI) e 225 no Grupo Controle (GC). O GI apresentou proporções maiores de amamentação e menores de uso de bicos que o GC aos 12 meses. O GC apresentou menor proporção de consumo de alimentos ultraprocessados ou não recomendados aos quatro meses e maior proporção de adequado número de refeições de sal aos 12 meses. A densidade energética de alimentos e a variedade da alimentação estavam aquém do recomendado em todos os acompanhamentos. O efeito dose-resposta foi observado somente para o uso de bico aos nove meses. Discussão: O baixo nível de exposição à intervenção entre mães de crianças do GI e o fato de que a orientação fornecida pelo profissional, quando ocorria, nem sempre era correta, podem explicar em grande parte os resultados. Conclusão: Ainda que os profissionais do GI apresentassem maior conhecimento sobre AC do que os do GC, os perfis alimentares das crianças de ambos os grupos foram semelhantes e distantes das recomendações para praticamente todos os indicadores estudados.DOI: 10.12957/demetra.2019.43801

Behavior Change Interventions Delivered through Interpersonal Communication, Agricultural Activities, Community Mobilization, and Mass Media Increase Complementary Feeding Practices and Reduce Child Stunting in Ethiopia

ABSTRACTBackgroundAppropriate infant and young child feeding practices are critical for optimal child growth and development, but in Ethiopia, complementary feeding (CF) practices are very poor. Alive & Thrive (A&T) provided intensive behavior change interventions through 4 platforms: interpersonal communication (IPC), nutrition-sensitive agricultural activities (AG), community mobilization (CM), and mass media (MM).ObjectivesThe aim of this study was to evaluate the impact of A&T intensive compared with nonintensive interventions (standard nutrition counseling and agricultural extension service and less intensive CM and MM) on CF practices and knowledge and child anthropometric outcomes.MethodsWe used a cluster-randomized evaluation design with cross-sectional surveys among households with children aged 6–23.9 mo [n = 2646 at baseline (2015) and n = 2720 at endline (2017)]. We derived difference-in-difference impact estimates (DDEs) and conducted dose–response and path analyses to document plausibility of impacts.ResultsAt endline, exposure to IPC was 17.8–32.3%, exposure to AG was 22.7–36.0%, exposure to CM was 18.6–54.3%, and exposure to MM was 35.4% in the intensive group. Minimum dietary diversity and minimum acceptable diet increased significantly in the intensive group but remained low at endline (24.9% and 18.2%, respectively). Significant differential declines in stunting prevalence were observed (DDE: −5.6 percentage points; P < 0.05) in children aged 6–23.9 mo, decreasing from 36.3% to 22.8% in the intensive group. Dose–response analyses showed higher odds of minimum dietary diversity (OR: 3.3; 95% CI: 2.2, 4.8) and minimum meal frequency (OR: 1.9; 95% CI: 1.4, 2.6) and higher height-for-age z score (HAZ) (β: 0.24; 95% CI: 0.04, 0.4) among women exposed to 3 or 4 platforms. Path analyses showed a strong relation between AG and egg consumption, which led to increased child dietary diversity and HAZ.ConclusionsDelivery of social and behavior change interventions using multiple platforms was feasible and effective, resulting in improvements in CF practices and child stunting within a 2-y period. There is a need for continued efforts, however, to expand intervention coverage and to improve CF practices in Ethiopia. This trial was registered at clinicaltrials.gov as NCT02775552.

Complementary Feeding Knowledge of Mother and Nutritional Status of Infant/Young Children (6-23 Months) in Ethiopia

Improving infant and young child feeding practices in children aged 6–23 months is critical to improved nutrition, health, and development. This paper examined the complementary feeding knowledge, attitude and practice of mothers and nutritional status of infants/young children in Jima Ganati District employing the cross sectional survey data conducted among 353 mothers of children aged 6-23 months. The result from the logit regression Education levels of mothers, age of mothers and mother occupation had a significant effect on mothers’ complementary feeding knowledge, attitude and nutritional status of infants/young children. In this study 54.6%, 60.4% and 34.6% of mothers had good knowledge, attitude and practice on complementary feeding respectively. Keywords: complementary feeding; knowledge; attitude; logit model; nutritional status. DOI : 10.7176/JCSD/49-02 Publication date :June 30 th 2019

Compliance with Use of Micronutrient Powder among Caregivers of Children Aged 6-23 Months in a District of a State in North East Nigeria

Aims: To assess the knowledge and perception about micronutrient powder (MNP) use, compliance with use of the product, and determine factors influencing compliance to continual use of MNP for food fortification among caregivers of children aged 6-23 months in Konduga LGA, Borno State, Nigeria.&#x0D; Study Design: A cross-sectional study was conducted.&#x0D; Place and Duration of Study: The study was conducted in Konduga LGA, Borno State Nigeria in August 2018.&#x0D; Methodology: A total of 218 caregivers of children aged 6-23 months were selected using a multistage sampling technique. A semi-structured interviewer-administered questionnaire was used to interview respondents on socio-demographic characteristics, knowledge about complementary feeding, perception about MNP use and compliance with use of MNP for food fortification. Data were analyzed using descriptive statistics, Chi-square test and logistic regression, with the level of significance set at 0.05.&#x0D; Results: Respondents were female with 111 (50.9%) below 30 years of age (mean age: 29.3±8.0). Twenty-four (11%) of the respondents have good knowledge of complementary feeding and 77 (35.3%) have a good perception of the use of MNP. Almost two-thirds [135 (61.9%)] of the respondents used MNP. Factors that influenced respondents’ compliance with use of MNP include; being &lt;30 years of age (P= .04), having a spouse with formal education (P= .003) and is not working (P= .013) and having good knowledge of complementary feeding (P= .01). Among these factors, having a spouse that is not working determined compliance with use of MNP (AOR=3.3, 95% CI= 1.6-7.5).&#x0D; Conclusion: Although compliance with use of MNP was above average, however, there is need to improve on Infant and Young Child Feeding (IYCF) counselling focusing on the importance of MNP particularly among the older caregivers and their spouse.

Large-Scale Social and Behavior Change Communication Interventions Have Sustained Impacts on Infant and Young Child Feeding Knowledge and Practices: Results of a 2-Year Follow-Up Study in Bangladesh

BackgroundSustained improvements in infant and young child feeding (IYCF) require continued implementation of effective interventions. From 2010–2014, Alive & Thrive (A&T) provided intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM) in Bangladesh, demonstrating impact on IYCF practices. Since 2014, implementation has been continued and scaled up by national partners with support from other donors and with modifications such as added focus on maternal nutrition and reduced program intensity.ObjectiveWe assessed changes in intervention exposure and IYCF knowledge and practices in the intensive (IPC + CM + MM) compared with nonintensive areas (standard nutrition counseling + less intensive CM and MM) 2 y after termination of initial external donor support.MethodsWe used a cluster-randomized design with repeated cross-sectional surveys at baseline (2010, n = 2188), endline (2014, n = 2001), and follow-up (2016, n = 2400) in the same communities, among households with children 0–23.9 mo of age. Within-group differences over time and differences between groups in changes were tested.ResultsIn intensive areas, exposure to IPC decreased slightly between endline and follow-up (88.9% to 77.2%); exposure to CM activities decreased significantly (29.3% to 3.6%); and MM exposure was mostly unchanged (28.1–69.1% across 7 TV spots). Exposure to interventions did not expand in nonintensive areas. Most IYCF indicators in intensive areas declined from endline to follow-up, but remained higher than at baseline. Large differential improvements of 12–17 percentage points in intensive, compared with nonintensive areas, between baseline and follow-up remained for early initiation of and exclusive breastfeeding, timely introduction of foods, and consumption of iron-rich foods. Differential impact in breastfeeding knowledge remained between baseline and follow-up; complementary feeding knowledge increased similarly in both groups.ConclusionsContinued IPC exposure and sustained impacts on IYCF knowledge and practices in intensive areas indicated lasting benefits from A&T's interventions as they underwent major scale-up with reduced intensity. This trial was registered at clinicaltrials.gov as NCT02740842.