Introduction: Adequate dietary diversity is vital for the survival, growth and development of infants and children. Inadequate dietary diversity is the major cause of micronutrient deficiency in Sub-saharan Africa, including Ethiopia, where only less than one-fourth of the children aged 6-23 months obtain adequate diversified diet. Thus country implemented a strategy known as the Sustainable Undernutrtion Reduction (SUR) programs to alleviate the problem. However, empirical evidences are scarce on the impact of the program on children aged 6-23 months. Therefore, this study aimed to compare the level of dietary diversity among children aged 6-23 months in districts covered and not covered by SURE program in West Gojjam zone. Methods: A community based comparative cross-sectional study was conducted in three districts of West Gojjam zone, Ethiopia, from February 29 to April 20, 2019. A total of 832 mother and child pairs were selected by the simple random sampling technique. A pretested and structured interviewer-administered questionnaire was used to collect data. A binary logistic regression model was fitted to identify factors associated with dietary diversity. Crude odds and adjusted odds ratios with 95% confidence intervals (CI) were calculated to assess the strength of associations and significance of the identified factors for dietary diversity score. Result: The overall proportion of adequate dietary diversity among children aged 6-23 months was 29.9% (95% CI: 27.0-33.0), whereas in SURE covered and uncovered districts it was 33.4% (95%CI: 29.0-38.and 26.4%(95% CI: 22.0, 31.0), respectively. ANC (Antenatal care) (AOR = 1.7; 95% CI: 1.16, 2.55) and postnatal care services (AOR = 2.1; 95% CI: 1.38, 3.28), participating in food preparation programs (AOR = 1.9; 95% CI: 1.19, 2.96), GMP (AOR = 2.74,95%CI: 1.80, 4.18), vitamin A supplementation (AOR = 2.10,95%CI:1.22, 3.61) and household visits by health extension workers (AOR = 2.0; 95% CI: 1.25, 3.21) were significantly associated with dietary diversity. Conclusion: The proportion of adequate dietary diversity was higher among children in the program than those out of the program. ANC visits, PNC follow-ups, women's participating in food preparation programs and household visits by health extension workers were significantly associated with dietary diversity. Therefore, and strengthening and scaling up the program to non covered districts and providing health and nutrition counseling on Infant and Young Child Feeding (IYCF) during ANC and PNC services are recommended for achieving the recommended dietary diversity.
Participatory action research (PAR) puts high emphasis on the interaction of the research participants. However, with the onset of the Covid-19 pandemic in March 2020, the central role of researchers in participatory research processes had to be questioned and revisited. New modes of PAR developed dynamically under the new circumstances created by the pandemic. To better understand how Covid-19 changed the way PAR is applied, we analyzed PAR in agricultural research for development carried out in the Programme for Climate-Smart Livestock Systems (PCSL) implemented by the International Livestock Research Institute (ILRI) at five research sites in Kenya, Ethiopia, and Uganda. To understand how PAR changed in a component on adaptation research in the PCSL we facilitated a reflexive study with livestock keepers and researchers to document their experiences of PAR during the Covid-19 pandemic. The analytical framework focuses on highlighting the core characteristics and the underlying ethos of PAR in this case study. The lessons learnt in the process of adapting to the realities of doing participatory research in the middle of a pandemic provide important arguments for further amalgamating the PAR philosophy into similar research designs. The onset of the pandemic has led to a further decentering of the researcher and a shift of the focus to the citizen, in this case the local livestock keeper, that made it more participatory in the stricter interpretation of the term. Letting go of controlling both narrative and implementation of the research will be challenging for researchers in many research fields. However, this shift of power and this transformation of research methodologies is inevitable if the research should remain relevant and impactful. Ultimately, the transition into a Covid-19 future and the awareness that similar pandemics could dramatically interrupt our lives any time, will have an impact on how projects are designed and funded. More long-term funding and less pressure on providing immediate results can build community trust and ownership for research at a local level.
BACKGROUND: In critically ill patients, enteral nutrition is recommended as a route for nutrient delivery. Nurses' knowledge and practice of enteral nutrition influence patients' clinical outcomes. Therefore, this study sought to assess nurses' knowledge, practice, and associated factors regarding enteral nutrition in adult intensive care unit patients in public hospitals in Addis Ababa, Ethiopia.METHODS: A cross-sectional study design was used to collect data from 196 nurses working in public hospitals in Addis Ababa from April 11 to April 30, 2020. The data were entered into Epi Data version 3.1 and analyzed with SPSS version 21. The correlation between independent variables and dependent variables was estimated using bivariate and multivariate logistic regression at a 95% confidence level.RESULTS: The level of inadequate knowledge and poor practice of nurses relating to enteral nutrition was 67.7% and 53.8%, respectively. Bachelor's degree holders were less likely to be knowledgeable (AOR= 0.24, 95% CI: (0.61, 0.93)). Nurses' practice about enteral nutrition was significantly associated with nurses' age (AOR = 0.023, 95 % CI: (0.001,0.52), nurses receiving training on enteral nutrition (AOR = 1.951, 95 % CI: (0.06, 0.60)), and nurses from ICUs having a guideline and protocol on enteral feeding practice (AOR = 3.401, 95 % CI: (1.186, 9.789).CONCLUSIONS: In the study, it was revealed that a substantial proportion of nurses had inadequate knowledge of enteral nutrition and practiced poor enteral nutrition.
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