Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
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Influence of care practices on nutritional status of Ghanaian children

  • Published : 2008.06.30
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Abstract

A community-based longitudinal study was conducted in the Manya Krobo District of the Eastern Region of Ghana with the objective of assessing how caregiving practices influence nutritional status of young children in Ghana. The study subjects were one hundred mothers with infants between the ages of 6 and 12 months. Each child was visited at home monthly for a period of six months. On each visit, information was collected on caregiver household and personal hygiene, child's immunization status, child's dietary diversity, caregiver responsiveness during feeding, caregiver hygienic practices related to feeding and child's weight and length. At the end of the study, summary scores were generated for each variable and quality of care practice determined based on their distribution. Classification of child nutritional status was based on z-scores for both weight-for-age and length-for-age. The results revealed that caregivers who exhibited better quality of care practice had well-nourished children. Such caregivers were more likely to practice good household and personal hygiene than those of poorly nourished children (97.1% vs 31.8%, p<0.001). They were also more likely to complete their children's immunization schedules (88.2% vs 62.2%, p<0.001), provide good quality diets from highly diversified sources (79% vs 23%, p<0.001), exhibit high responsiveness during feeding (100% vs 22.7%, p<0.001) and feed under hygienic conditions (100% vs 22.7%, p<0.001). Based on the findings it was concluded that good caregiving practices are associated with improved child nutritional status.

Keywords

References

  1. Ahmed NV, Zeitlin MF, Beiser AS, Super CM & Gershoff SN (1993). A longitudinal study of the impact of behavioural change intervention on cleanliness, diarrhoea, morbidity and growth in children in rural Bangladesh. Soc Sci Med 37:159-171 https://doi.org/10.1016/0277-9536(93)90452-A
  2. Amar-Klemesu M & Ruel MT (2000). A positive deviance approach to studying child feeding practices and care in Accra, Ghana. A Report submitted to Food and Nutrition Technical Assistance (FANTA) of AED/USAID. USA
  3. Amar-Klemesu M, Ruel MT, Maxwell D, Levin CE & Morris SS (2000). Poor maternal schooling is the main constraint to good childcare practices in Accra. J Nutr 130:1597-1607
  4. Arimond M & Ruel MT (2004). Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr 134:2579-2585
  5. Bartlett AV, Hurtado E, Schroeder DG, & Mendez H (1992). Association of indicators of hygiene behaviour with persistent diarrhoea of young children. Acta Paediatr 381:66-71
  6. Berggren WL & Wray JD (2002). Positive deviant behavior and nutritional education. Food Nutr Bull 23:7-8 https://doi.org/10.1177/15648265020234S202
  7. Cebu Study Team (1991). Underlying and proximate determinants of child health: The Cebu Longitudinal Health and Nutrition Study. Am J Epidemiol 133:185-201 https://doi.org/10.1093/oxfordjournals.aje.a115857
  8. Chinese Nutrition Society (1990). The recommended dietary allowance of nutrients and the Chinese dietary guidelines. Acta Nutr Sini 12:1-5
  9. Dettwyler KA (1986). Infant feeding in Mali, West Africa: Variations in belief and practice. Soc Sci Med 23(7):651-664 https://doi.org/10.1016/0277-9536(86)90112-7
  10. Drewnowski A, Alhtrom HS, Driscoll A & Rolls BJ (1997). The dietary diversity score: Assessing diet quality in healthy young and older adults. J Am Diet Assoc 97:266-271 https://doi.org/10.1016/S0002-8223(97)00070-9
  11. Engle PL, Menon P & Haddad L (1997). Care and nutrition: Concepts and measurements. FCND Discussion Paper No. 18, IFPRI, Washington, D.C. USA
  12. Engle PL & Zeitlin M (1996). Active feeding behaviour compensates for low interest in food among young Nicaraguan children. J Nutr 126:1808-1816
  13. Engle PL, Bentley M & Pelto G (2000). The role of care in nutrition research programme: current research and a research agenda. Proc Nutr Soc 59:25-35
  14. FAO (1990). Conducting small-scale nutrition surveys. A field manual. Nutrition in Agriculture 5 Rome
  15. Ferguson E & Opare-Obisaw C (1993). Seasonal food consumption patterns and dietary diversity of rural preschool Ghanaian and Malawian children. Ecol Food Nutr 29:219-234 https://doi.org/10.1080/03670244.1993.9991307
  16. Gorter AC, Sandiford P, Pauw J, Morales R, Perez RM & Alberts H (1998). Hygiene behaviour in rural Nicaragua in relation to diarrhoea. Int J Epidemiol 27:1090-1100 https://doi.org/10.1093/ije/27.6.1090
  17. Guldan GS, Zeitlin MF, Beiser, AS, Super CM, Gershoff SN, & Dhatta S (1993). Maternal education and child feeding practices in Bangladesh. Soc Sci Med 36:925-935 https://doi.org/10.1016/0277-9536(93)90084-H
  18. Hatlfy A, Hallund J, Diarra M.M & Oshaug A (2000). Food variety, socio economic status and nutritional status in urban and rural areas of Koutiala (Mali). Public Health Nutr 3:57-65 https://doi.org/10.1017/S1368980000000628
  19. Hodgson JM, Hsu-Hage B & Wahlqvist ML (1994). Food variety as a quantitative descriptor of food intake. Ecol Food Nutr 32: 137-148 https://doi.org/10.1080/03670244.1994.9991395
  20. Kant AK, Schatzkin A & Ziegler RG (1995). Diet diversity and subsequent specific mortality in the NHANES I epidemiologic follow-up study. J Am Coll Nutr 14:233-238 https://doi.org/10.1080/07315724.1995.10718501
  21. Lartey A, Manu A, Brown KH & Dewey KG (2000). Predictors of growth from 1 to 18 months among breastfed Ghanaian infants. Eur J Clin Nutr 54:41-49 https://doi.org/10.1038/sj.ejcn.1600891
  22. Le Vine RA, Le Vine SE, Richman A, Uribe FMT, Sunderland- Correa C & Miller PM (1991). Women's schooling and child care in the demographic transition: A Mexican case study. Popul Devt Rev 17:459-496 https://doi.org/10.2307/1971950
  23. Mackintosh UG, Marsh R.M & Schroeder DG (2002). Sustained positive deviant care practices and their effect on child growth. Food Nutr Bull 23:16-25 https://doi.org/10.1177/15648265020234S204
  24. Ruel MT, Levin CE, Amar-Klemesu M & Merris SS (1999). Good care practices can mitigate the negative effects of poverty and low maternal schooling on children's nutritional status: Evidence from Accra. World Dev 27:1993-2009 https://doi.org/10.1016/S0305-750X(99)00097-2
  25. Shekar M, Habicht J-P & Latham MC (1991). Is positive deviance in growth the converse of negative deviance? Food Nutr Bull 13:7-11
  26. Tucker K & Sanjur D (1988). Maternal employment and child nutrition in Panama. Soc Sci Med 26:605-612 https://doi.org/10.1016/0277-9536(88)90024-X
  27. UNICEF (1990). Strategy for improved nutrition of children and women in developing countries. UNICEF, New York. USA
  28. UNICEF (1998). The State of the Worlds Children. Oxford University Press, New York. USA
  29. Vecchia CL, Munoz SE, Braga C, Fernandez E. & Decarli A (1997). Diet diversity and gastric cancer. Int J Cancer 63:785-789 https://doi.org/10.1002/ijc.2910630606
  30. Vella V, Tomkins A, Borgeshi A, Milgiori GB, Adrika BC & Greratin E (1992). Determinants of child nutrition and mortality in Northwest and Southwest Uganda. Bull World Health Organ 5:637-643
  31. Whishik SM & Van der Vynckt S (1976). The use of nutritional positive deviants to identify approaches for modification of dietary practices. Am J Public Health 66:38-42 https://doi.org/10.2105/AJPH.66.1.38
  32. WHO (1983). Measuring change in nutritional status. WHO, Geneva
  33. Zeitlin MF (1994). Child care and nutrition. The findings from positive deviance research. School of Nutrition,Tufts Univ., Medford, Mass. USA
  34. Zeitlin MF, Ghassemi, H & Mansour, M (1990). Positive Deviance in Child Nutrition. United Nations University Publication, Tokyo. Japan
  35. Zeitlin M, Houser R, & Johnson FC (1989). Active maternal feeding and nutritional status of 8-20 month old Mexican children. Society for Research in Child Development, Kansas City, Mo. USA