Child care practices in households with malnourished children and those with well nourished children in a slum area of Addis ababa, Ethiopia

Abstract

Child care practices playa great role in the prevalence of childhood malnutrition in the slum environments. In a cross sectional study carried out in four purposively selected slum kebeles of Addis Ababa, nutritional status of 753 children aged 6 to 36 months was measured and subsequently classified into malnourished and well nourished group. Child feeding practices of systematically selected mothers of the two groups of chi ldren were compared with the view of identifying practices that contribute to child nutrition insecurity in the area. The study established that majority of the mothers in both groups of households had initiated breast feeding (i.e 99.5% in malnourished and 93.4% in the well nourished group (p>O.05), and no significant difference was found either in the median or mean duration of b r e a s t f e e d i n g . Significantly more mothers (23.9%) in the malnourished households exclusively breast fed beyond four months of age than those (7.3%) in the well nourished households (p<O.05). At 4-6 months of age, a significantly higher number of mothers in well nourished households (58.8%) had started supplementation than those in malnourished ho us e h o l d s (42.7%) (p<O.OOl). The mean age of commencement of supplementation was significantly higher in the malnourished group (4.9 ±2.9 months) than in the well nourished group (4.2 ±2.4 months). Significantly more mothers (p<O.01) in well nourished households (14.1%) fed enriched porridge than those in the malnourished households (5.2%). The mean feeding frequency was significant Ly higher in the well nourished group (4 times) than in the malnourished gro~p (3.4 times) (p<O.Ol). More mothers in the malnourished group (29.6%) practised bottle feeding of porridge than those in the well nourished group (3.3%) (p<O.01). Food withholding habits and the prevalence of immunization had no significant influence on child nutrition. However. morbidity status of the child's mother. health facility based management of children with diarrhoea had a significant (p<O.05) bearing on nutritional status of children. Also, stagnant water in the compound, child waste inside the house, storage of cooked foods for more than 24 hours (p<O.OOl), poor handling of food (p<O.OOl) and drinking water (p<O.OOl), and serving food with dirty hands (p<O.05) had a significant bearing on child nutrition. It is concluded that exclusive breast feeding beyond four months, feeding low quality diet with a frequency of less than four times and giving porridge with feeding bottle and failure to take children with diarrhoea to hospitals/clinics are the principal risk factors associated with the nutritional status of children in the study area. Moreover, the presence of stagnant water in compounds and faecal matter inside the house, prolonged holding of cooked foods, poor handling of drinking water and foods were other areas of concern which had deleterious effects on the nutritional well being of children. Demonstrative and sustained nutrition and health education focusing on appropriate child feeding,household hygiene and sanitation practices is recommended together with initiation of income generating projects with a view of empowerment of those families whose monthly income is below 251 Birr.