Influence of Maternal Nutrition Knowledge on Infant and Young Child Feeding Practices and Nutrition Status of Children in Musanze District, Rwanda

Abstract

Children under five years of age face multiple malnutrition burdens. Under-nutrition causes approximately half of all deaths in young children every year worldwide. Infant and young child feeding (IYCF) practices pose immediate effects on the nutrition status of under-two year aged children and greatly influence the survival of a child. Low maternal nutrition knowledge is one of the key determinants of suboptimal complementary feeding practices. In Rwanda, only 18% children of age between 6 to 23 months adhere to the infant young feeding practices (IYCF) set by WHO in terms of minimum acceptable diet, despite the high stunting prevalence of 38%. However, little is known about the association between IYCF practices, children nutritional status and maternal nutrition knowledge in the country. This study was, therefore, designed to assess the influence of maternal nutrition knowledge on the IYCF practices and nutritional status as well as the factors associated with child feeding practices and nutritional status. Analytical cross section study was carried out in Musanze, a district of Rwanda and involved 241 mothers having children aged between 6 and 23 months, in August 2019. Data were collected using a pre-tested semi-structured questionnaire. Data analysis was done using SSPSS version 20.0 and ENA for SMART 2011. Chi-square test and logistic regressions were used to determine the associations and risk factors of various variables. The results showed that the majority of mothers (72%) had high nutrition knowledge (≥ 70% score). Minimum meal frequency (MMF) was attained at 83% rate, minimum dietary diversity (MDD) at 57%, minimum acceptable diet (MAD) at 53% and consumption of iron rich foods at 29%. However, younger (6-8 months) children had significantly lower MMD (39%) and MAD (39%). Stunting, wasting and underweight prevalence were 28%, 2% and 5%, respectively. There was an association between MMF (p=0.006) and maternal nutrition knowledge, and the xvii latter was positively correlated with the individual dietary diversity score of a child (r=0.149, p=0.021). There was no significant association between the maternal nutrition knowledge and the child nutritional status. Factors influencing IYCF practices were mother employment status, consumption of animal sourced foods, community health workers’ home visits, community gatherings attendance and income type. The predictors of child nutritional status (stunting) were found to be sex of the child, MAD, consumption of animal sourced foods, child underweight status and income type. Maternal nutrition knowledge should continue to be strengthened through nutrition education done at the community level with a huge focus on child dietary diversity, especially among younger children. The factors influencing IYCF practices and child nutrition status should be taken into consideration by the policy makers and development partners while developing different food and nutrition sensitive programs and interventions.