dc.description.abstract | This was a cross-sectional and comparative study carried out between April and May 2003 in
a nutrition intervention project and non-project areas in Addis Ababa. The aim of the study
was to assess and compare childcare practices and nutritional status of children aged 6 to 59
months of the two areas.
Purposive sampling was used to select a Woreda (District) lor the study and simple random
sampling was employed to select the respective sites, Kebele 43 and 44 which were the
project areas and Kebele 47 and 51 the non-project areas as well as the households. Two
hundred and ten children between the ages of 6-59 months were selected. One child,
preferably the youngest of the children aged 6-59 mouths selected from each household as the
index child. A sub-sample of20 households was randomly selected \01' the 24 - hour dietary
recall. Data was collected using a structured questionnaire administered to the mother or
caretaker of the child. The 24-hour recall method was used to analyze the dietary intake of
the children. The statistical package lor social scientists (SPSS ) was used to enter and
analyze data. The three nutritional indices namely weight- \01'- height, weight- for- age,
height- ror- age were COII1(Jutedusing LPI -Info version 6 programme.
The results showed that more than a quarter of the children ill both the project (33.6(%) and
the non-project (28.4I}'o) areas were illtrodu~ed to complementary feeding within the first three
months suggesting that the practice or exclusive breastfeeding is low. Over (60%) of the
children in both areas were weaned between 4-6 months and that the complementary foods
first given to the children consisted mainly of non-enriched cereals.
The consumption of animal protein and vegetables and Iruits as complementary roods was
negligible. Alternative caregivers in both areas were mainly grand mothers followed by
siblings above 15 years of age. Over three quarters ill both the project (89.4%) and (81.7%)
non-project areas had pit latrines. A significant difference (P value <0.01) was observed in
the proportion of children, (95.2°j() in the project area and 79.6% in the non-project areas
who had received complete immunization for age .Similarly, growth monitoring
implementation was significantly lower in the non-project (1%) than in the project (98.1%)
area.
The common types of illnesses afflicting the study children were diarrhea, fever, cough and
runny nose. The prevalence of diarrhea was (12.5%) in the project and (13.8%) in the nonproject
area. The water source was piped tap water but inadequate in amount. More
households in non-project area (44.9%) had their compound contaminated with human waste
than in the project area (7%).
In terms of the nutritional status, significantly more children were stunted in the non-project
(48.6%) than in the project (35%) area. Furthermore, the stunting was significantly higher in
children who were weaned between 4-{) months of age and above six months in the nonproject
area which could possibly be due to infection in early weaning and inadequate dietary
intake in the case of late weaning. In breastfeeding children, the underweight level was
significantly higher in the non-project (46.6%) than the project (14.3%) area.
Higher rates of stunting, underweight and wasting were observed in children of casual
labourers in the project and non-project areas but not statistically significant (p>O.05).
Children whose mothers attended 5 - 8 years of education were significantly underweight in
the non-project than in the project area. No difference was observed at income levels in both
areas. Among those children infected by Ascaris in both areas the proportion of stunted
children was significantly higher in the non-project than in the project area (p<O.05).
In conclusion, the households had similar socio-demographic and economic status, there was
no difference in the feeding practices, in the daily calorie and protein intakes, in morbidity
and nutritional status of the children in the two areas but there was significant difference in
health seeking behaviors in that high immunization coverage and growth monitoring was
encountered in the project than in the non-project area (p<O.05).
Even though, health and nutrition services are incorporated into the project area no difference
was observed in the general childcare and nutritional status of children in the project and nonproject
areas. Therefor, the hypothesis there is 110 di Ilereuce in the childcare practices and
nutritional status of children in the project and non-project areas was not rejected.
It is therefore recommended that mothers be encouraged to exclusively breastfeed for at least
four months and continue to breastteed Cor up to two years. Health and nutrition education
for mothers and caregivers will increase their level of awareness on the dangers of early
weaning, the importance of animal protein, vegetables and fruits, the role of personal and
environmental sanitation lor growth and development or children under five years in
particular.
Income generating activities if properly coordinated by government and NGO's would
contribute tu the alleviatiun of the general household nutrition problems. The Provision uf
alternative care by government and non-government organizations such as Jay care centers
would help mothers tu provide better care lor their children. Deworming of children is another
means ofimproving the nutritional status ofthe children while continuos monitoring and
evaluation would help in identifying and tackling chiklcare practices associated with the
health and nutrition conditions 01" children under five years of age. | en |