Child-feeding practices as predictors of nutritional status of children in a slum area in Addis Ababa, Ethiopia

Abstract

In a across-sectional study carried out in four purposefully selected slum kebeles of Addis Ababa, the nutritional status of 758 children aged 6 - 36 months was measured and subsequently classified into malnourished and well nourished groups. Child-feeding practices of randomly selected mothers of the two groups of children were compared with the view of identifying practices that contribute to child-nutrition insecurity in the study area. The result indicated that the majority of the mothers (i.e. 99.5% in the malnourished and 98.4% in well nourished groups) had initiated breast-feeding, and no significant difference was found either in the median or mean duration of breast-feeding between the two groups of mothers. After adjustment has been made (through logistic regression) for covariates, the study established that exclusive breast-feeding beyond four months, feeding low quality diet with a frequency of less than four times and giving porridge with feeding bottle as well as low household income are the risk factors contributing to young children’s nutrition-insecurity in the slum section of Addis Ababa. Hence, demonstrative and sustained education focusing on appropriate child-feeding is recommended together with initiation of income generating projects with a view of empowerment of those families whose monthly income is low. [Ethiop. J. Health Dev. 1999;13(3):229-2 Introduction About 79% of the population of Addis Ababa lives in low-grade, congested slum areas (1). Studies which address nutritional problems have found that malnutrition continues to be a serious health problem in the slums (2-5). One study in Nairobi slum (6), where 86.2% of the preschoolers were reported to have been stunted, provides a good basis for understanding that slum children are most vulnerable to malnutrition. Hofvander and Eksmyer (7), who found about 3% prevalence of severe PEM, reported that PEM is the main nutritional problem for young children in the slum of Addis Ababa. It is a well established fact that malnutrition manifests itself as a function of many and complex factors (8-10). It is directly linked to poor dietary intake and diseases, which in turn result from an interaction of various underlying factors which include crisis in household food security, inappropriate child care and feeding practices, unhealthy place of residence, and insufficient basic health services (8-11). An unfavourable health environment caused by inadequate water and sanitation can increase the probability of infectious diseases and indirectly form certain types of malnutrition (8-11). Further, poor socio-economic variables, cultural beliefs, and lack of parental education, especially that of mothers, are all cited to affect a person's nutritional status (8-13). Thus, nutrition planning and advice to a community needs to be grounded on good information and knowledge of which individual variables