IMPACT OF NUTRITIONAL COUNSELLING ON NUTRITIONAL STATUS OF UNDER-FIVE CHILDREN IN SEMI-URBAN COMMUNITIES IN OSUN STATE.

IMPACT OF NUTRITIONAL COUNSELLING ON NUTRITIONAL STATUS OF UNDER-FIVE CHILDREN IN SEMI-URBAN COMMUNITIES IN OSUN STATE.

Abstract

Background and Objectives: Malnutrition among under five children is a major public health problem in developing countries as it has been reported to be associated with up to 60% of mortalities in this age group. Among the various determinants of malnutrition in this age group, infants and young child feeding is a critical point for intervention to reduce this burden, most importantly through nutritional counselling of mothers. This community intervention study evaluated the impact of nutritional counselling on knowledge, attitude and practices of mothers on feeding of infants and young children as well as on the children’s nutritional status. The overall goal is to propose feasible and sustainable nutritional counselling strategies.
Material and Methods: The study was conducted in Osun State using two communities, Iwara and Ifewara that were selected for the study because of their similar demographic, social and cultural characteristics but randomly allocated as study and control communities respectively. Mothers of infants and young children aged 0-18 months were recruited into the study from both communities by simple random sampling technique. Information was collected from the recruited mothers with a semi-structured interviewer administered questionnaire to obtain information on knowledge, attitude and practices (KAP) of mothers on feeding of infants and young children. The children of recruited mothers were also weighed and their heights measured. In addition, focus group discussions (FGD) were held with mothers, fathers and healthcare workers in both communities at pre-intervention. The information generated during this phase formed the baseline data and was also used to develop an appropriate information, education and communication (IEC) material that was used for intervention in the intervention community. Intervention involved group counselling of mothers and food demonstrations, which were carried out at the health facilities every fortnight in the intervention community for 6 months. Evaluation of intervention was by repeat assessment of KAP of the mothers and the children’s nutritional status. This study was carried out for a total period of 13 months.
Results: At pre-intervention, it was observed that respondents from the two communities were comparable in terms of demographic and socio-economic variables examined and in their levels
of KAP on infants and young children feeding (P>0.05 in all cases). Similarly, children of recruited mothers were comparable in terms of the prevalence of nutritional indices examined (Underweight, wasting and stunting) (P>0.05 in all cases). After 6 months of intervention, respondents who had nutritional counselling demonstrated better attitudes to key BFHI and IMCI feeding recommendations. They also had better knowledge of EBF, the duration of EBF, total duration of breastfeeding and appropriate timing of the introduction of complementary foods compared to respondents from the control community (P<0.05 in all cases). Similarly, they exclusively breastfed their infants longer with mean age at introduction of complementary foods at 5.3 months compared to 4.5 months in the control community (P<0.05), they also breastfed their children longer (P<0.05). Children of respondents who had nutritional counselling gained more weight and the prevalence of underweight, wasting and stunting of a subgroup (children aged 7–18) were reduced by one-third to half of their values before intervention compared to those from the control community. However, at post-intervention, there were no statistically significant differences in the prevalence of these nutritional indices of children between the two communities (P>0.05 in all cases).
Conclusion: This study concluded that nutritional counselling of mothers improved their level of KAP on infant and young children feeding and increased weight gain of their children. It is recommended that this study should be replicated in other settings in Nigeria and other parts of developing countries with longer period of follow-up and intervention.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

IMPACT OF NUTRITIONAL COUNSELLING ON NUTRITIONAL STATUS OF UNDER-FIVE CHILDREN IN SEMI-URBAN COMMUNITIES IN OSUN STATE.