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Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania.
Food Nutr Bull. 2006 Sep; 27(3):236-44.FN

Abstract

BACKGROUND

Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving.

OBJECTIVE

To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status.

METHODS

A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements.

RESULTS

The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home.

CONCLUSIONS

The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.

Authors+Show Affiliations

Department of Food Science and Technology, Sokoine University of Agriculture, Morogoro, Tanzania. kissakulwa@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17542114

Citation

Kulwa, Kissa B M., et al. "Constraints On Good Child-care Practices and Nutritional Status in Urban Dar-es-Salaam, Tanzania." Food and Nutrition Bulletin, vol. 27, no. 3, 2006, pp. 236-44.
Kulwa KB, Kinabo JL, Modest B. Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania. Food Nutr Bull. 2006;27(3):236-44.
Kulwa, K. B., Kinabo, J. L., & Modest, B. (2006). Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania. Food and Nutrition Bulletin, 27(3), 236-44.
Kulwa KB, Kinabo JL, Modest B. Constraints On Good Child-care Practices and Nutritional Status in Urban Dar-es-Salaam, Tanzania. Food Nutr Bull. 2006;27(3):236-44. PubMed PMID: 17542114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania. AU - Kulwa,Kissa B M, AU - Kinabo,Joyce L D, AU - Modest,Beata, PY - 2007/6/5/pubmed PY - 2007/6/26/medline PY - 2007/6/5/entrez SP - 236 EP - 44 JF - Food and nutrition bulletin JO - Food Nutr Bull VL - 27 IS - 3 N2 - BACKGROUND: Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. OBJECTIVE: To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status. METHODS: A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. RESULTS: The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. CONCLUSIONS: The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding. SN - 0379-5721 UR - https://www.unboundmedicine.com/medline/citation/17542114/Constraints_on_good_child_care_practices_and_nutritional_status_in_urban_Dar_es_Salaam_Tanzania_ L2 - http://journals.sagepub.com/doi/full/10.1177/156482650602700306?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -