The potential effectiveness of the nutrition improvement program on infant and young child feeding and nutritional status in the Northwest and Southwest regions of Cameroon, Central Africa

Abstract

BackgroundDespite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers’ knowledge, and improves breastfeeding, complementary feeding, and children’s linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP) has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF). The study objective was to evaluate the effects of NIP’s infant feeding counselors on exclusive breastfeeding (EBF), complementary feeding (CF), and children’s linear growth.MethodsA cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359) and non-NIP sites (n = 415) from Infant Welfare Clinics (IWCs) in the Northwest (NWR) and Southwest Regions (SWR) of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children’s linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression.ResultsAfter adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94) more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver, children were five times (OR: 5.5; CI: 3.37, 9.02; β = 1.71) more likely to be stunted at non-NIP sites compared to non-NIP sites.ConclusionTraining a cadre of nutrition counselors is one approach towards increasing nutrition human resources to implement nutrition interventions to improve maternal and child nutrition. In this research project, the study design did not allow for conclusive results, but rather suggest IYCF counseling provided by nutrition counselors was effective in increasing EBF and reduced the risk of stunting in children 6–8 months.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1899-z) contains supplementary material, which is available to authorized users.

Maternal nutrition counselling is associated with reduced stunting prevalence and improved feeding practices in early childhood: a post-program comparison study

“…Furthermore, higher number of children from the intervention areas fulfilled minimum dietary diversity requirement of eating food items from at least 4 food groups, which is particularly important for the children to attain proper nutrition [41, 42]. A few studies [16, 17] carried out in similar settings also reported that counselling mothers on child feeding practices is associated with overall improvement in optimum infant and child feeding practices. Although, some studies found that maternal nutrition counselling results in reduced childhood stunting [19, 20], other studies [43, 44] reported that nutrition counselling were ineffective in reduction of stunting among young children.…”

“…In fact, suboptimal feeding practices in childhood has been identified as one the most three prominent drivers of childhood stunting in South Asian countries [15]. Although some studies carried out in resource poor setting reported that maternal nutrition counselling is associated with improved infant and young child feeding (IYCF) practices [16, 17] and reduced childhood stunting [18–20], there is limited evidence from Bangladesh.…”

Determinants of stunting among children < 5 years of age: Evidence from 2018-2019 Zambia Demographic and Health Survey

“…In terms of maternal health and nutrition, these include: maternal nutritional and health status before, during and after pregnancy that influences a child's early growth and development, commencement in the womb. Infant and young child feeding practices that contribute to stunting include suboptimal breastfeeding (specifically, non-exclusive breastfeeding) and balancing feeding that is limited in quantity, quality and variety [10][11][12][13][14][15].…”

Nutritional counselling interactions between health workers and caregivers of children under two years: observations at selected child welfare clinics in Ghana

“…Hence,interventions in the form of nutritional counselling services and health educational talks that are offered to caregivers with children below two years have been recommended as effective strategies that can help improve infant and young child feeding (IYCF) practices, reduce child undernutrition and hence enhance child survival [9, 12, 13]. However, Reinsma et al, (2016) [14] noted that although most of the nutrition counselling in sub-Saharan Africa is primarily conducted by nurses or health volunteers, little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. In addition, Kohli and Chadha (2017) [12] asserted that, studies that focus on assessing nutritional counselling activities and skills of health workers are scarce.…”