BackgroundUnder nutrition remains a serious problem among children in Sub-Saharan Africa. Analysing how diets composed of local foods could achieve nutritional goals for infants and young children in low-income settings is essential. The objective of this study was to analyse how local foods can be used rationally and to what extent these foods can be supplemented to achieve nutrient requirements for children aged 6 – 23 months in resource-poor settings.MethodsA cross-sectional study was carried out to estimate dietary intakes of 400 children aged 6-23 months using a 12-h weighed dietary record, 24-h dietary recalls, and 7-days food records. Anthropometric measurements on each subject were also taken. Analyses were done to establish the level of nutrient intake, and nutritional status of the study population using Microsoft Excel 2013 and ProPAN software version 2.0.ResultsThe results showed that the prevalence of stunting, wasting and underweight for children aged 6–23 months was 30–41%, 1.5–3% and 4–9%, respectively. In addition, the results showed that diets that were consumed by the subjects comprised of local foods met vitamin A, vitamin C, protein and energy requirements for children aged 6–23 months. However, the extent of deficit in iron, zinc and calcium in baseline diets was large and difficult to meet under the existing feeding practices.ConclusionsThe study shows that local foods in the study area have a potential to achieve recommended dietary intakes of some essential nutrients, and that interventions are needed to meet the required amount of iron, zinc and calcium for children aged 6–23 months. The interventions we propose here may encourage changes in traditional feeding habits and practices of the target population. Possible intervention options are (1) supplementation of local foods with nutrient-dense foods that are not normally consumed in the locality (2) providing new avenues for increasing the production and wide consumption of local nutrient-dense foods, or optimizing the way local diets are constituted so as to achieve nutrient recommendations for infants and young children.
Complementary feeding of 6-to 24-month-old infants and young children with adequate, safe and developmentally appropriate food is essential to child health.Inappropriate complementary foods and feeding practices are linked to the high incidences of undernutrition among infant and young children in most developing countries, including Tanzania. Mycotoxin risk is an additional concern, given the documented presence of aflatoxin and fumonisin in food systems of Africa, especially maize and groundnut. In preparation for a trial of mycotoxin mitigation, we conducted focus group discussions and recipe trials to explore complementary foods and feeding practices in Kongwa, a rural district of central Tanzania. Sixty mothers of infants from 6 to 18 months of age in five villages across the district were purposefully sampled. During focus group discussions, mothers reported to mostly feed their children with cereal and groundnut-based foods as thin or thick porridges.The most common porridge preparations contained cereal (mostly, maize) ranging from 66.7% to 80.0% by weight and groundnuts from 7.7% to 33.3%. The ratio of cereal to groundnut ranged from 3:1 to 4:1. For the recipe trial sessions, mothers chose similar ingredients reported during discussions to prepare complementary foods. The reliance on maize and groundnuts in complementary foods predisposes the children to undernutrition and exposure to aflatoxins and fumonisins. These formative research results suggest multiple intervention points to improve complementary feeding and reduce mycotoxin exposure in this population, including education messages package on feeding practices, mycotoxin control practices and complementary food formulation.aflatoxin, complementary feeding practices, fumonisin, infant and young child, Tanzania, undernutrition | INTRODUCTIONExclusive breastfeeding in the first 6 months of life (Butte et al., 2002;Kramer & Kakuma, 2001) and appropriate complementary feeding from around 6 months of age are critical for early childhood growth and development (WHO/PAHO, 2003). After exclusive breastfeeding for the recommended period of 6 months, complementary feeding of 6-to 24-month-old infants and young children (IYC) with safe, nutritious and developmentally appropriate food is imperative to prevent undernutrition and exposure to food-borne toxins and to
There is growing recognition of the importance of maternal mental health for the well‐being of both mothers and children. In addition to being of importance to public health concern on its own right, maternal depression could impede women's capacity to provide quality care to their children. However, the covariates of maternal depression, especially in low‐resource settings, are not well‐understood. In particular, the role of gender equity in maternal depression needs further investigation. Therefore, we sought to understand covariates associated with maternal depression in a rural farming community in Tanzania. We hypothesized that greater food insecurity and gender inequity in a household would be positively correlated with maternal depression.The Singida Nutrition and Agroecology Project (SNAP‐Tz) is a participatory agroecology and nutrition intervention with rural farmers with children <1 y in Singida, Tanzania. As part of the baseline assessment in February 2016, women from the 587 participating households were asked about a range of socio‐demographic, agricultural, health, and nutrition topics. The Center for Epidemiologic Studies Depression Scale (CES‐D, range: 0–65) was used to measure maternal depression. The Household Food Insecurity Access Scale (HFIAS, range: 0–27) was used to measure household food insecurity. Gender equity was indicated by a summed score of husband's help with household chores (range: 0–7), women's (dis)satisfaction with leisure time, and women's experience with domestic violence. Social support was measured using the Perceived Social Support scale (PSS, range:0–40). Multivariate linear regression models of depression were then built using backwards stepwise elimination and include village fixed effects. Standard error estimates considered clustering at the village level.CESD scores indicated probable depression (CES‐D≥17) among 69.2% of women. Probable major depression (CES‐D≥26) was indicated for 42.5% women. The mean HFIAS of 14.0 (sd: 7.9) suggested that food insecurity was also very common. In multivariate models of depression, food insecurity score was positively and strongly correlated with maternal depression score (β=0.62, p=0.000). Having experienced domestic violence was positively associated with increased maternal depression score (β=4.29, p=0.004). Greater help from husband and satisfaction with amount of leisure time were negatively correlated with maternal depression score (β=−0.65, p=0.011 and β=−3.00, p=0.000, respectively).In sum, the prevalence of maternal depression is very high in Singida, Tanzania. While some covariates were not modifiable, several important ones were, including food insecurity, unbalanced household division of task, and domestic violence. Causality should be further explored, but these data suggest important and novel domains in which to intervene to improve maternal mental health.Support or Funding Information(1) Collaborative Crop Research Program, McKnight Foundation. (2) Sera L Young was supported by the National Institutes of Health (K01 MH098902) Household characteristics of participants of Singida Nutrition and Agroecology Project, February 2016 Mean (sd) or n(%) Range HFIAS, mean (sd)1 14.02 (7.89) 0 – 27 Age, mean (sd) 29.59 (7.51) 15.7 – 48.1 Education (years), mean (sd) 5.98 (2.68) 0 – 11 Marital status, n(%) Monogamous married 495 (84.9%) Polygamous married 46 (7.9%) Separated/divorced/widowed 26 (4.5%) Never married 16 (2.7%) Household dependency ratio, mean (sd)2 1.56 (1.03) 0.1 – 7 Social support score, mean (sd)3 34.36 (8.36) 0 – 40 Husband drink more than 3x/week, n (%) 182 (32.8%) Proportion of asset owned by woman, mean (sd) 1.29 (1.66) 0 – 10.5 Husband help score, mean (sd) 2.47 (2.06) 0 – 7 Satisfaction with leisure time, mean (sd) 1.41 (1.06) −2 – 2 Acceptance towards domestic violence, mean (sd)4 4.09 (2.52) 0 – 7 Experience with domestic violence, n (%) 186 (32.2%) Coates, J., Swindale, A. & Bilinsky, P. Household Food Insecurity Access Scale (HFIAS) for measurement of Food access: indicator guide. (Food and Nutrition Technical Assistance (FANTA), 2007). Population's Division, U.N. World Population Prospects: The 2006 Revision, vol. I: Comprehensive Tables. (2007). Antelman, G. et al. Predictors of HIV‐1 serostatus disclosure: a prospective study among HIV‐infected pregnant women in Dar es Salaam, Tanzania. Aids 15, 1865–1874 (2001). DHS Questionnaire Modules (English, French). Available at: http://dhsprogram.com/publications/publication‐dhsqm‐dhs‐questionnaires‐and‐manuals.cfm Bivariate and multivariate linear regression models of maternal depression score bivariate β (p) multivariate, all β (p) multivariate, parsimonious β (p) HFIAS 0.75 (0.00)*** 0.62 (0.00)*** 0.62 (0.00)*** Social support score −3.36 (0.02)** −2.97 (0.07)* −3.38 (0.02)** Husband drink alcohol more than 3x/week 4.19(0.00)*** 1.12 (0.27) Women drink alcohol more than 3x/week 3.08(0.15) Proportion of asset owned by woman 1.43(0.00)*** 0.42 (0.32) Husband help score −1.35(0.00)*** −0.67 (0.01)** −0.65(0.01)** Satisfaction with leisure time −4.41 (0.00)*** −3.03 (0.00)*** −3.00 (0.00)*** Attitude towards domestic violence 0.64(0.01)** 0.18 (0.26) Experience with domestic violence 4.26 (0.00)*** 4.09 (0.00)*** 4.30(0.01)*** Age 0.20 (0.02)** 0.02 (0.86) Education (years) −0.44 (0.03)** −0.69 (0.76) Marital status Married, monogamous (comparison) (comparison) (comparison) Married, polygamous −2.07 (0.32) −1.63(0.33) −1.04 (0.52) Separated/divorced/widowed 9.79 (0.00)*** 5.32 (0.06)* 6.70 (0.01)** Never married −0.08 (0.98) −0.53(0.81) −0.54 (0.80) Asset index deciles −0.68 (0.00)*** 0.04 (0.85) Household dependency ratio 0.93 (0.08)* −0.40 (0.42) Whether women born in the village −(0.19 (0.87) Tribe (comparison) Nyaturu 1.07 (0.78) Nyiramba 4.98 (0.27) Other (comparison) Religion 0.77 (0.54) Muslim 4.57 (0.73) Christian −5.43 (0.69) Traditional African Other N 566 572 Adjusted R‐2 0.369 0.364
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