Investigating Caregivers’ Young Child Feeding Knowledge and Practices, Time Allocated to Child Care, and Pathways for Improving Children’s Diets Through Mass Media in Rural Ghana

Investigating Caregivers’ Young Child Feeding Knowledge and Practices, Time Allocated to Child Care, and Pathways for Improving Children’s Diets Through Mass Media in Rural Ghana
Author: Yvonne Goh
Publisher:
Total Pages:
Release: 2021
Genre:
ISBN:

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"Nutrition-sensitive agricultural (NSA) interventions use integrated approaches to improve rural nutrition. The Nutrition Links (NL) project was a multi-faceted nutrition-sensitive intervention in the Upper Manya Krobo District (UMKD) of Ghana. The NL project included an agriculture-education trial targeted at women with an infant 12 months and below, and a district-wide nutrition education intervention delivered through radio. This doctoral research included three studies within the context of the NL project. The dissertation objectives were to: (i) understand maternal time allocation to child care in the UMKD (ii) explore current caregiver’s infant and young child feeding knowledge and practices, and (iii) test the effect of a behaviour change campaign to improve infant and young child feeding (IYCF) practices. The first study involved mother-child pairs in the NL agriculture-education trial. The intervention (NL-I) mothers received point-of-lay chickens, training on agriculture and home gardening, and nutrition education; the control (NL-C) mothers received standard government services. A subsample of mothers (74 NL-I and 69 NL-C) were observed at home by two field staff; one observed the mother and the other the child for 1 minute, every 5 minutes, for a total of 6 hours. The results showed that caregiving by the mother did not differ by treatment group (OR=1.07, 95% CI [0.89,1.28]). There was however a higher odds of any allocare (OR= 1.36, 95%CI [1.04, 1.79]) and, specifically, allocare by siblings who were less than 11 years old (25% vs 15%; p

Nurturing young children through responsive feeding: thematic brief

Nurturing young children through responsive feeding: thematic brief
Author: World Health Organization
Publisher: World Health Organization
Total Pages: 16
Release: 2023-05-18
Genre: Medical
ISBN: 9240070303

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Responsive feeding is part of nurturing care and an essential aspect of adequate childhood nutrition and responsive caregiving. This brief is organized around five key messages and is intended for an audience involved in the design, management, and implementation of maternal and child health and nutrition programmes and services.

Care and Nutrition

Care and Nutrition
Author: Patrice L. Engle
Publisher: Intl Food Policy Res Inst
Total Pages: 60
Release: 1997-01-01
Genre: Social Science
ISBN: 9780896293342

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List of tables; Education of caregiver; Knowledge, attitudes, and beliefs of caregiver; Physical health and nutritional status of caregiver; Mental health, self-confidence, and lack of stress of caregiver; Autonomy and control of resources in the household by caregiver; Workload and time availability of caregiver; Social support for caregiver; Estimates of time spent on child care from observation and recall; Feeding practices: caregiver-child interactions; Feeding practices: child variables; Psychosocial care: child and caregiver interactions; Psychosocial care: child variables; Illustrations; The unicef conceptual model; The extended model of care; The transactional model of care; Pathways of interaction of education with caregiving; Possible pathways of interaction of maternal health and caregiving; Summary; Introduction; Developments in conceptualizing care; Resources for care; Care practices.

A Mixed Methods Research Study to Understand Infant Feeding Practices and Inform Strategies to Improve Maternal, Infant, and Child Nutrition in Guinea -- a Biocultural Perspective

A Mixed Methods Research Study to Understand Infant Feeding Practices and Inform Strategies to Improve Maternal, Infant, and Child Nutrition in Guinea -- a Biocultural Perspective
Author: Teresa Schwendler
Publisher:
Total Pages: 0
Release: 2024
Genre:
ISBN:

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The prevalence of stunting (30%) and wasting (9%) among children under the age of five years (U5) in Guinea have seen little decline in the past decade. One contributor to the high prevalence of stunting and wasting among children U5 is poor diet quality. In 2018, less than half of children 6 -- 23 months consumed the recommended food groups (15%) and meals (25%) per day to meet their nutrient requirements. However, there has been little qualitative or quantitative research conducted over the past decade to explore the multilevel determinants of infant and young child (IYC) diets and growth outcomes in Guinea. The United Nations Children's Fund (UNICEF) conceptual framework theorizes the immediate (diet, care), underlying (food, practices, services), and enabling determinants (resources, norms, governance) determinants of maternal, infant, and young and child nutrition (MIYCN). However, the UNICEF framework does not provide a robust model for exploring the factors shaping IYC diets, an immediate determinant of nutritional status. However, the Ecological Model of Food and Nutrition (EMFN) has been used for over 50 years to explore the various factors influencing diets across contexts. In addition to immediate determinants such as diet, caregiver feeding style is an underlying determinant of IYC diets and nutritional status. However, there has been little work conducted across low-and-middle income-countries including Guinea to understand the relationship between caregiver feeding styles and IYC dietary quality. Finally, enabling determinants including programs and policies are upstream factors that shape IYC diets and nutritional status. UNICEF recommends intervening through water, sanitation, and hygiene (WASH), social protection, food, and health systems to improve IYC diets and growth outcomes. However, to our knowledge, no study has systematically explored what evidence-based program modalities across systems are being supported by policies or programs in Guinea. To better understand key immediate, underlying, and enabling determinants of IYC nutritional status, this study sought to explore the infant feeding practices and inform strategies to improve MIYCN in Guinea. To fill this research gap, our first study sought to understand what factors are associated with infant dietary diversity score (DDS) in Forécariah, Guinea. To assess and define factors that shape infant DDS, a dietary assessment and survey were administered to caregivers of indexed infants (6 -- 9 months). Then, to understand the factors shaping infant diets, 3-hour observations were conducted among indexed infants (n = 81) and interviews were conducted with caregivers (n = 34) and community leaders (n = 13). A stepwise linear regression was used to understand what factors were significantly associated with infant DDS. Textual data were then analyzed deductively using the EMFN to understand how different factors shape the feeding practices of caregivers who fed infants a more diverse diet from those who did not. Findings from our study revealed that food insecurity, maternal time, and feeding advice received through various channels (i.e., radio, interpersonal) shape caregiver feeding behaviors and infant diet. Factors found to be positively associated with infant dietary diversity scores include having access to water in the household, feeding infants the same foods as primary caregivers weekly, owning land for homestead food production, and infant age. Conversely, adhering to food taboos was negatively associated with infant dietary diversity score. Imported foods were symbolized as 'clean' and locally sourced foods were symbolized as 'unclean' caregivers who fed less diverse diets. Our second study sought to understand what caregiver feeding styles are being employed by indexed caregivers and how they relate to infant DDS in Forécariah, Guinea. To define caregiver feeding styles we carried out 3-hr observations of indexed infants (n = 81), Then, to understand how and why caregivers were employing these feeding styles we carried out interviews among a subset of indexed caregivers (n = 34). Quantitative data from direct observations were subjected to k-medoid cluster analysis and textual data were analyzed using content analysis. Findings from our study revealed that three distinct feeding styles were being employed in Forécariah, Guinea including responsive, forceful, and uninvolved. Most caregivers in our sample carried out responsive feeding behaviors but fed their infants the least diverse diets. Drivers of responsive, forceful, and uninvolved feeding styles included maternal time, caregiver trust in the infant's hunger and satiety cues, and cues associated with an infant being developmentally ready to self-feed, respectively. Our third study sought to understand how current policies and programs can be leveraged to improve MIYCN in Guinea. To understand the current policy and program environment, we conducted a narrative literature review of operating programs (i.e., 2019-2022) and policies across systems. Then, to understand what factors shape program implementation, we conducted semi-structured interviews with stakeholders (n = 20) across systems. Textual data were analyzed using a content analysis approach guided by the UNICEF systems framework and a nutrition implementation science framework. Findings revealed that most evidence-based program modalities across systems were being cited in policy (25/32) and program documents (28/32). Salient factors identified to be shaping programs during interviews included poor policy development, suboptimal funding, variable stakeholder technical knowledge, low provider-to-beneficiary ratios, substandard program planning, scale-up, and resources at the community level. However, the most salient factor discussed across domains was programming planning and scale-up which was namely due to duplication of activities, poor supply chains, funding-related constraints, and suboptimal integration of activities across systems and within systems. Findings from our study suggest that multilevel determinants shape infant diets in Forécariah but also MIYCN in Guinea at large. Food taboos identified in this study and intervention approaches that have been successful in shifting social norms in other contexts could be used to dismantle food taboos and improve infant DDS in Forécariah, Guinea. Findings from this research also indicate that policymakers in Guinea may also consider introducing guidelines against advertising of IYC foods in line with WHO guidance to improve infant DDS. Findings from our second study could be used to generate tailored messaging to encourage caregivers to feed responsively during mealtimes. Finally, findings from our third study could be used as a guide for stakeholders across systems in Guinea to leverage the integration of currently operating programs to improve MIYCN using a multisectoral approach.

Supplemental Nutrition Assistance Program

Supplemental Nutrition Assistance Program
Author: National Research Council
Publisher: National Academies Press
Total Pages: 235
Release: 2013-04-23
Genre: Medical
ISBN: 0309263476

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For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families. In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.

Young Child Feeding Practices and Child Nutritional Status in Rural Ghana

Young Child Feeding Practices and Child Nutritional Status in Rural Ghana
Author: Christina A. Nti
Publisher:
Total Pages: 0
Release: 2011
Genre:
ISBN:

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A study was conducted in the Manya Krobo district of Ghana with the objective of studying young child feeding practices and child nutrition situation in the area. The study was a cross-sectional survey involving 400 mothers with young children between 0 and 18 months. A combination of methods, including structured interviews using questionnaire, dietary assessment and anthropometry, was used to collect data for the study. The data obtained were analysed using spss version 10 in Windows. Means and standard deviations were generated for continuous variables and frequency distribution for categorical variables. The results revealed that although breastfeeding rates were high (97%), complementary feeding practices were less than ideal with as many as 14% of the children being introduced to complementary foods below the age of 3 months. The nutritional quality of complementary foods were poor and the prevalence of stunting among the children was high (20%). For adequate complementary feeding and improved child nutrition in this population, nutrition education intervention programmes aimed at improving nutrient intake among young children, through improved diet diversity and increased use of local foods rich in iron and other nutrients, need to be undertaken.

Measuring Childcare Practices

Measuring Childcare Practices
Author: Marie T. Ruel
Publisher: Intl Food Policy Res Inst
Total Pages: 102
Release: 2003
Genre: Social Science
ISBN: 0896295052

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To thrive, young children need more than food. It is now widely recognized that they also require a healthy and sanitary environment and adequate care and feeding practices. As governments and NGOs initiate programs to ensure child survival, health, and development, the need for simple methods and indicators to measure the effectiveness of these programs grows. With a strong focus on methodology, this food policy review describes measurement approaches, problems, and solutions and offers practical suggestions for monitoring and evaluating child nutrition programs.

Tracking Progress on Child and Maternal Nutrition

Tracking Progress on Child and Maternal Nutrition
Author:
Publisher: UNICEF
Total Pages: 124
Release: 2009
Genre: Law
ISBN: 9280644823

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This report offers a rationale for urgently scaling up effective interventions to reduce the global burden of child and maternal undernutrition. It provides information on nutrition strategies and progress made by programmes, based on the most recent data available. The success stories and lessons leaned that are described in the publication demonstrate that reducing undernutrition is entirely feasible. The report presents detailed, up-to-date information on nutritional status, programme implementation and related indicators for the 24 countries where 80 per cent of the world’s stunted children live. While this report is a call to action for these 24 high-burden countries, it also highlights the need for accelerated efforts to reduce undernutrition in all countries.

Effect of Caregiver Feeding Behaviours on Child Nutritional Status in Rural Ghana

Effect of Caregiver Feeding Behaviours on Child Nutritional Status in Rural Ghana
Author: Christina A. Nti
Publisher:
Total Pages: 0
Release: 2014
Genre:
ISBN:

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A six-month observational study involving 100 mothers with infants between the ages of 6 and 12months was conducted in the Manya Krobo district of Ghana. The objective was to assess the role of caregiver feeding behaviours on child nutritional status using a modified positive deviance approach. Each child was in the study for 6months, during which they were observed at home once a month. On each visit, data were collected on the child anthropometry, child meal frequency, diet diversity, responsiveness of caregiver during feeding, childs appetite and feeding atmosphere as well as caregiver hygienic practices related to feeding. Using weight-for-age (WAZ) and length-for-age (LAZ) scores, the children were classified as positive or negative deviant children. The study revealed significant differences between the two groups of children in terms of caregiver feeding behaviours. Positive deviant children had significantly higher meal frequencies (3.1±0.4 vs. 2.4±0.6, P=0.001), diet diversity scores (6.3±0.6 vs. 3.7±1.1, P=0.001), were fed under better hygienic conditions (7.2±0.9 vs. 4.2±1.1, P=0.001) and were much more interested in food during feeding (85.8% vs. 59.3%). Caregiver responsiveness during feeding was also significantly higher among the positive deviant group (6.5±0.8 vs. 4.5±0.9, P=0.001). This study has demonstrated the tremendous effect of caregiver feeding behaviours on child nutritional outcomes and provides a scientific basis for introducing care during feeding as a component of intervention to improve child nutritional status in Ghana.

Making Child Feeding Frequency a Priority

Making Child Feeding Frequency a Priority
Author: Katherine Birks
Publisher:
Total Pages:
Release: 2013
Genre:
ISBN:

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"The World Health Organization has identified adequate feeding frequency as an important component of infant and young child feeding (IYCF) practices to ensure optimal growth and development. In 2008, appropriate feeding frequency was observed in only 50% of breastfed and 22% of non-breastfed Ghanaian children 6 to 23 months of age; however, no similar information currently exits for children two to five years of age. The present study investigated practices and perceptions of caregivers as well as counseling experiences of health care providers (HCP) regarding child feeding frequency, and evaluated socioeconomic and demographic determinants of feeding frequency of children under five years of age. Qualitative research was conducted in two small towns in Ghana: Asesewa in the Upper Manya Krobo district, Eastern region, and Navrongo in the Kassena Nankana East district, Upper East region. Six focus group discussions (n=4-5 each) and 14 individual interviews were conducted with caregivers of children zero to 59 months of age. Individual interviews were also conducted with 10 HCP. Analysis was performed using ATLAS.ti 6.0 to identify themes related to feeding frequency. Secondary analysis was conducted on weighed food intake data of 116 children nine months of age from the Eastern region (2004-2008 RIING study), and 76 children two to five years of age from the Central, Brong Ahafo, and Upper East regions (2004-2009 ENAM study). Using SAS 9.3, Analysis of Covariance was used to determine predictors of feeding frequency. Most caregivers were unaware of the importance of increasing their children's feeding frequency, and reported feeding their child according to household eating behaviours. When probed, a lack of time and money were identified as main barriers, while social networks were facilitators to increasing feeding frequency. Although socioeconomic status was not statistically significant, other variables that indicated resource constraints, including region (p=0.001) and harvest season (p=0.031), were significant predictors. Caregiver occupation (p=0.025), and breastfeeding status (p