How well do WHO complementary feeding indicators relate to nutritional status of children aged 6–23 months in rural Northern Ghana?

Abstract

BackgroundThough the World Health Organization (WHO) recommended Infant and Young Child Feeding (IYCF) indicators have been in use, little is known about their association with child nutritional status. The objective of this study was to explore the relationship between IYCF indicators (timing of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet) and child growth indicators.MethodsA community-based cross-sectional survey was carried out in November 2013. The study population comprised mothers/primary caregivers and their children selected using a two-stage cluster sampling procedure.ResultsOf the 1984 children aged 6–23 months; 58.2 % met the minimum meal frequency, 34.8 % received minimum dietary diversity (≥4 food groups), 27.8 % had received minimum acceptable diet and only 15.7 % received appropriate complementary feeding. With respect to nutritional status, 20.5 %, 11.5 % and 21.1 % of the study population were stunted, wasted and underweight respectively.Multiple logistic regression analysis revealed that compared to children who were introduced to complementary feeding either late or early, children who started complementary feeding at six months of age were 25 % protected from chronic malnutrition (AOR = 0.75, CI = 0.50 - 0.95, P = 0.02). It was found that children whose mothers attended antenatal care (ANC) at least 4 times were 34 % protected [AOR 0.66; 95 % CI (0.50 - 0.88)] against stunted growth compared to children born to mothers who attended ANC less than 4 times. Children from households with high household wealth index were 51 % protected [AOR 0.49; 95 % CI (0.26 - 0.94)] against chronic malnutrition compared to children from households with low household wealth index.After adjusting for potential confounders, there was a significant positive association between appropriate complementary feeding index and mean WLZ (β = 0.10, p = 0.005) but was not associated with mean LAZ.ConclusionsThe WHO IYCF indicators better explain weight-for-length Z-scores than length-for-age Z-scores of young children in rural Northern Ghana. Furthermore, a composite indicator comprising timely introduction of solid, semi-solid or soft foods at 6 months, minimum meal frequency, and minimum dietary diversity better explains weight-for-length Z-scores than each of the single indicators.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2494-7) contains supplementary material, which is available to authorized users.

The effect of maternal and child factors on stunting, wasting and underweight among preschool children in Northern Ghana

“…This relationship has been reported in the literature from developing countries including Ghana [14,26], Tanzania [27], Ethiopia [24], Cambodia [3] and India [28]. In spite of this widespread identification of the male susceptibility to stunting, the exact factors underlying it have yet to be well understood [14] but likely to be biological [29]. Short maternal stature was associated with higher odds of child stunting in present study.…”

“…Male children were also more likely to be stunted compared to female children. This relationship has been reported in the literature from developing countries including Ghana [14,26], Tanzania [27], Ethiopia [24], Cambodia [3] and India [28]. In spite of this widespread identification of the male susceptibility to stunting, the exact factors underlying it have yet to be well understood [14] but likely to be biological [29].…”

“…To make valid conclusions in a community-based cluster study, a minimum of 25 clusters is usually required [13,14]. This study used this minimum number of clusters by randomly choosing 25 communities from a list of communities from four sub-districts across the Central Gonja district using Excel generated random numbers.…”

Associations between feeding practices and growth and neurodevelopmental outcomes at 36 months among children living in low- and low-middle income countries who participated in the BRAIN-HIT trial

“…For example, a study from Senegal showed that HAZ was positively associated with the WHO indicators up to one year of age but less strongly as children became older, which may explain why we saw no significant results at 36 months of age between diet and linear growth [24]. Further, our results are in line with another study from Ghana which showed that these indicators better explain WHZ-scores than HAZscores for young children because the tool reflects current diet rather than habitual intake [25].…”

Hubungan Pemberian Mp-Asi Dan Usia Pertama Pemberian Mp-Asi Dengan Kejadian Stunting Pada Anak Usia 6-24 Bulan Di Desa Leyangan Kecamatan Ungaran Timur Kabupaten Semarang

“…Berdasarkan hasil uji chi square diperoleh nilai p = 0,002 jika dibandingkan dengan nilai α = 0.05, maka nilai p = 0,002 kurang dari 0,05 sehingga dapat diinterpretasikan bahwa terdapat hubungan yang bermakna antara frekuensi pemberian MP-ASI dengan kejadian stunting pada anak usia 6-24 bulan Desa Leyangan Kecamatan Ungaran Timur Kabupaten Semarang. Hal tersebut sejalan dengan penelitian Saaka (2015) dengan adanya hubungan yang bermakna antara frekuensi pemberian MP-ASI dengan kejadian stunting (p = 0,06 ; p value < 0,05 Berdasarkan hasil uji korelasi chi square diperoleh nilai p value 0,015 jika dibandingkan dengan nilai α = 0.05, maka nilai p = 0,015 kurang dari 0,05 sehingga dapat diinterpretasikan terdapat hubungan yang bermakna antara tekstur MP-ASI yang diberikan dengan kejadian stunting pada anak usia 6-24 bulan di Desa Leyangan Kecamatan Ungaran Timur Kabupaten Semarang. Hasil penelitian ini sejalan dengan penelitian yang dilakukan oleh Sreedhara (2013) yaitu ada hubungan antara konsistensi atau tekstur MP ASI yang diberikan dengan kejadian stunting dan nilai p value = 0,001 (p < 0,05).…”