Dataset Information

Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study.

ABSTRACT: Background: Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar.

Objectives: This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6-23 mo in the Vakinankaratra region of Madagascar.

Methods: Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than -2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach.

Results: Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers' workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding.

Conclusions: Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.

SUBMITTER: Rakotomanana H

PROVIDER: S-EPMC7695809 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study.

Rakotomanana Hasina H Hildebrand Deana D Gates Gail E GE Thomas David G DG Fawbush Fanjaniaina F Stoecker Barbara J BJ

Current developments in nutrition 20201020 11

<h4>Background</h4>Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar.<h4>Objectives</h4>This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6-23 mo in the Vakinankaratra region of Madagascar.<h4>Methods</h4>Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to e ...[more]

PMID: 33274306

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Project description:Background and objectivesStudies in low-and middle-income countries where nutrition transition is underway provides mixed evidence of double burden of maternal overnutrition and child undernutrition among mother-child pairs. Shifting dietary pattern and rapid increase in overweight/obesity among adults with persistent child undernutrition indicate that India is experiencing nutrition transition and double burden of malnutrition. Hence, the study explores the presence of and the factors associated with mother-child dyads of over- and undernutrition in India.Methods and materialsThe study uses National Family Health Survey 2015-16 data. The analytic sample consists of 28,817 weighted mother-child pairs where an overweight/obese mother is paired with an undernourished child. The nutritional status of children is defined according to WHO 2006 child growth standards as underweight (i.e., low weight-for-age), stunting (i.e., low height-for-age) and wasting (i.e., low weight-for-height). Maternal overweight/obesity (i.e., BMI ≥ 25 kg/m2) is defined using adult BMI criterion. Descriptive, bivariate, and adjusted multivariable logistic regression analysis are conducted.ResultsOf the overweight/obese mothers, 21.3%, 26.5%, and 14% have underweight, stunted, and wasted children respectively. In adjusted models, maternal short stature (aOR: 2.94, 95% CI: 2.30-3.75), age of child (aOR: 3.29, 95% CI: 2.76-3.92), and poorest wealth status (aOR: 2.01, 95% CI: 1.59-2.54) are significant predictors of overweight/obese mothers and stunted child pairs. Similarly, poor wealth status (aOR: 1.68, 95% CI:1.32-2.14), maternal stature (aOR: 2.70, 95% CI: 2.08-3.52), and child aged 2-5 years (aOR: 1.77, 95% CI:1.51-2.08) are also significantly associated with higher occurrence of overweight/obese mother and-underweight child pairs.ConclusionFindings of the study are consistent with the phase of nutrition transition and double burden of malnutrition. The paper concludes with suggestions to improve the socioeconomic condition, more strategic nutrition specific investments and policy interventions to eliminate all forms of malnutrition for achieving SDGs.

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Dataset Information

Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study.

Publications

Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study.

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