Nutritional Quality of Diets fed to Young Children in Urban Slums can be Improved by Intensive Nutrition Education

Palwala, Misba; Sharma, Shweta; Udipi, Shobha; Ghugre, Padmini; Kothari, G; Sawardekar, Pradeep

doi:10.1177/156482650903000402

Cited by 24 publications

(34 citation statements)

References 10 publications

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“…The level of education may determine nutrition knowledge [59]. When caregivers are given such knowledge, they improve feeding practices, including feeding frequency and dietary diversity, of their children [3], [58], [60], [61].…”

Section: Discussionmentioning

confidence: 99%

Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training

et al. 2014

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Undernutrition among HIV-positive children can be ameliorated if they are given adequate foods in the right frequency and diversity. Food insecurity is known to undermine such efforts, but even in food rich areas, people have undernutrition. As yet no study has examined feeding practices and their associations with nutrition status among as HIV-positive children in regions with high food production. We therefore examined the magnitude of undernutrition and its association with feeding practices among HIV-positive children in a high food production region in Tanzania.MethodsWe conducted this mixed-method study among 748 children aged 6 months-14 years attending 9 of a total of 32 care and treatment centers in Tanga region, Tanzania. We collected quantitative data using a standard questionnaire and qualitative data through seven focus group discussions (FGDs).ResultsHIV-positive children had high magnitudes of undernutrition. Stunting, underweight, wasting, and thinness were prevalent among 61.9%, 38.7%, 26.0%, and 21.1% of HIV-positive children, respectively. They also had poor feeding practices: 88.1% were fed at a frequency below the recommendations, and 62.3% had a low level of dietary diversity. Lower feeding frequency was associated with stunting (β = 0.11, p = 0.016); underweight (β = 0.12, p = 0.029); and thinness (β = 0.11, p = 0.026). Lower feeding frequency was associated with low wealth index (β = 0.06, p<0.001), food insecurity (β = −0.05, p<0.001), and caregiver's education. In the FGDs, participants discussed the causal relationships among the key associations; undernutrition was mainly due to low feeding frequency and dietary diversity. Such poor feeding practices resulted from poor nutrition knowledge, food insecurity, low income, and poverty.ConclusionFeeding practices and nutrition status were poor among HIV-positive children even in food rich areas. Improving feeding frequency may help to ameliorate undernutrition. To improve it, tailored interventions should target children of poor households, the food insecure, and caregivers who have received only a low level of education.

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Section: Discussionmentioning

confidence: 99%

Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training

et al. 2014

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“…Among mothers who met with health professionals, those who received nutritional advice were more likely to follow better IYCF practices when compared with those who met them but did not receive advice. Some earlier studies have failed to show a significant improvement in IYCF practices following nutritional education due to a small sample size, the content of the education or the design of the intervention (39)(40)(41) . Other nutritional intervention studies that coupled nutritional education with provision of complementary food, fortification of complementary food or food supplements have found nutritional education to be effective in improving feeding practices (41,42) .…”

Section: Discussionmentioning

confidence: 99%

“…Ultimately, extensive intervention is needed to educate families about proper infant feeding practices. Traditional and cultural beliefs related to early childhood feeding are also a strong barrier to eradicating malnutrition (40,43,44) that needs to be addressed at the local level. Advice and counselling by health workers should not only educate mothers about their child's nutritional needs, but also address the restricted traditional beliefs that might be acting as a barrier to sound feeding practices.…”

Section: Discussionmentioning

confidence: 99%

Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability?

Malhotra

2012

Public Health Nutr.

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Objective: Despite a rapidly growing economy and rising income levels in India, improvements in child malnutrition have lagged. Data from the most recent National Family Health Survey reveal that the infant and young child feeding (IYCF) practices recommended by the WHO and the Indian Government, including the timely introduction of solid food, are not being followed by a majority of mothers in India. It is puzzling that even among rich households children are not being fed adequately. The present study analyses the socioeconomic factors that contribute to this phenomenon, including the role of nutritional information. Design: IYCF practices from the latest National Family Health Survey (2005)(2006) were analysed. Multivariate logistic regression analyses were performed to establish the determinants of poor feeding practices. The indicators recommended by the WHO were used to assess the IYCF practices. Setting: India. Subjects: Children (n 9241) aged 6-18 months. Results: Wealth was shown to have only a small effect on feeding practices. For children aged 6-8 months, the mother's wealth status was not found to be a significant determinant of sound feeding practices. Strikingly, nutritional advice on infant feeding practices provided by health professionals (including anganwadi workers) was strongly correlated with improved practices across all age groups. Exposure to the media was also found to be a significant determinant. Conclusions: Providing appropriate information may be a crucial determinant of sound feeding practices. Efforts to eradicate malnutrition should include the broader goals of improving knowledge related to childhood nutrition and IYCF practices. In India, an alarming 43 % of children less than 3 years of age are stunted, 48 % are underweight and 17 % are wasted, according to the latest National Family Health Survey (NFHS; (1) Keywords

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“…Nutrition knowledge among caregivers improved in turn when they were frequently counseled by health workers who received nutrition training [19]. Nutrition counseling also improved caregivers’ knowledge in food preparation [28,29] and healthy feeding behaviors [30]. As a result, caregivers were more likely to improve their children’s feeding frequency [31], dietary diversity [32], protein, and energy intake [28,33].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of nutrition training of health workers toward improving caregivers’ feeding practices for children aged six months to two years: a systematic review

Sunguya

Poudel

Mlunde

et al. 2013

Nutr J

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BackgroundNutrition training of health workers can help to reduce child undernutrition. Specifically, trained health workers might contribute to this end through frequent nutrition counseling of caregivers. This may improve child-feeding practices and thus reduce the risk of undernutrition among children of counseled caregivers. Although studies have shown varied impacts of health workers’ nutrition training on child feeding practices, no systematic review of the effectiveness of such intervention has yet been reported. Therefore, we conducted this study to examine the effectiveness of nutrition training for health workers on child feeding practices including feeding frequency, energy intake, and dietary diversity among children aged six months to two years.MethodsWe searched the literature for published randomized controlled trials (RCTs) and cluster RCTs using medical databases including PubMed/MEDLINE, CINAHL, EMBASE, and ISI Web of Knowledge, and through WHO regional databases. Our intervention of interest was nutrition training of health workers. We pooled the results of the selected trials, evaluated them using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria, and calculated the overall effect size of the intervention in meta-analyses.ResultsTen RCTs and cluster RCTs out of 4757 retrieved articles were eligible for final analyses. Overall, health workers’ nutrition training improved daily energy intake of children between six months and two years of age. The pooled evidence from the three studies reporting mean energy intake per day revealed a standardized mean difference (SMD) of 0.76, 95% CI (0.63-0.88). For the two studies with median energy intake SMD was 1.06 (95% CI 0.87-1.24). Health workers’ nutrition training also improved feeding frequency among children aged six months to two years. The pooled evidence from the three studies reporting mean feeding frequency showed an SMD of 0.48 (95% CI 0.38-0.58). Regarding dietary diversity, children in intervention groups were more likely to consume more diverse diets compared to their counterparts.Conclusion and recommendationsNutrition training for health workers can improve feeding frequency, energy intake, and dietary diversity of children aged six months to two years. Scaling up of nutrition training for health workers presents a potential entry point to improve nutrition status among children.

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Nutritional Quality of Diets fed to Young Children in Urban Slums can be Improved by Intensive Nutrition Education

Cited by 24 publications

References 10 publications

Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training

Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training

Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability?

Effectiveness of nutrition training of health workers toward improving caregivers’ feeding practices for children aged six months to two years: a systematic review

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