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      Influence of childcare practices on nutritional status of Ghanaian children: a regression analysis of the Ghana Demographic and Health Surveys

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          Abstract

          Objectives

          Guided by the UNICEF framework for childcare, this study examined the association of childcare practices (CCP) with infant and young children's growth (height-for-age Z-scores, HAZ), and investigated whether care practices are more important to growth in some sociodemographic subgroups of children.

          Design

          Cross-sectional survey.

          Setting

          Urban and rural Ghana.

          Participants

          The study sample comprised 1187 dyads of mothers aged 15–49 years and their youngest child (aged 6–36 months).

          Results

          The results showed that CCP was a significant predictor of HAZ, after controlling for covariates/confounders at child, maternal and household levels. Children with higher CCP scores had higher HAZ. A 1-unit increase in the CCP score was associated with a 0.17-unit increase in HAZ. Child's and mother's age, number of children under 5 years, place of residence, maternal weight and wealth index were also significantly associated with HAZ. Statistical interaction analyses revealed no subgroup differences in the CCP/HAZ relationship.

          Conclusions

          This study found a significant, positive association between CCP and child growth, after accounting for other important determinants of child growth at maternal and household levels. This calls for research into the effects on growth of various CCP components, with longitudinal cohort study designs that can disentangle causal relationships.

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          Child feeding practices are associated with child nutritional status in Latin America: innovative uses of the demographic and health surveys.

          Purnima Menon, Marie Ruel (2002)
          Data from the Demographic and Health Surveys (DHS) for 5 Latin American countries (7 data sets) were used to explore the feasibility of creating a composite feeding index and to examine the association between feeding practices and child height-for-age Z-scores (HAZ). The variables used for the index were as follows: current breast-feeding, use of complementary foods and liquids in the past 24 h, frequency of use over the past week and feeding frequency. The index was made age specific for 6- to 9-, 9- to 12- and 12- to 36-mo-old age groups, and age-specific feeding terciles were created. Bivariate analyses showed that feeding practices were strongly and significantly associated with child HAZ in all 7 data sets, especially after 12 mo of age. Differences in HAZ between child feeding terciles remained significant after controlling for potentially confounding influences, for all countries except Bolivia. Multiple regression analyses also revealed that better feeding practices were more important for children of lower, compared with higher socioeconomic status (in Colombia 1995 and Nicaragua 1998); among children of Ladino (Spanish speaking) compared with indigenous origin (in Guatemala 1995); and among children whose mothers had primary schooling compared with mothers with no schooling, or mothers with higher than primary school level (Peru 1996). The data available in DHS data sets can thus be used effectively to create a composite child feeding index and to identify vulnerable groups that could be targeted by nutrition education and behavior change interventions.
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            Influence of care practices on nutritional status of Ghanaian children

            Christina Antwiwaa Nti, Anna Lartey (2008)
            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.
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              Impact of infant & young child feeding & caring practices on nutritional status & health.

              Siddarth Ramji (2009)
              The exclusive breast feeding rates in India at 6 months is about 46 per cent. At 6-8 months only 54 per cent of breast fed and 75 per cent of non breast fed infants are initiated into complimentary feeds. At the start of the second year of life only about 42 per cent of infants receive the recommended appropriate foods at appropriate frequency. There is evidence to suggest that the persistent undernutrition in the country is associated with these inadequate feeding practices prevalent in the country. Experiences from several studies suggest that household level behavioural changes could be achieved by using appropriate behaviour change communication principles, change agents specially trained to address some of these issues, consistent messages, multiple channels to saturate population coverage and engaging communities in a participatory manner and encouraging their ownership of such interventions.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2014
                Publication date (Electronic): 3 November 2014
                Volume: 4
                Issue: 11
                Electronic Location Identifier: e005340
                Affiliations
                [1 ]Department of Health Promotion and Development, University of Bergen , Bergen, Hordaland, Norway
                [2 ]Nutrition Division, Economic and Social Department, Food and Agriculture Organization , Rome, Italy
                Author notes
                [Correspondence to ] Dickson A Amugsi; damugsi2002@ 123456yahoo.com
                Article
                Publisher ID: bmjopen-2014-005340
                DOI: 10.1136/bmjopen-2014-005340
                PMC ID: 4225227
                PubMed ID: 25366675
                SO-VID: 38fb67e8-3f34-41c8-8f75-0b775cadbefd
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 25 March 2014
                Date revision received : 9 September 2014
                Date accepted : 11 September 2014
                Categories
                Subject: Epidemiology
                Subject: Research
                Subject: 1506
                Subject: 1692
                Subject: 1714
                Subject: 1724

                ScienceOpen disciplines: Medicine
                Data availability:
                ScienceOpen disciplines: Medicine

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