Dietary Intakes And Nutritional Status Of Rural Ghanaian Children

A study was conducted in the Manya Krobo district of Ghana with the objective of studying young child feeding practices and child nutrition situation in the area. The study was a cross-sectional survey involving 400 mothers with young children between 0 and 18 months. A combination of methods, including structured interviews using questionnaire, dietary assessment and anthropometry, was used to collect data for the study. The data obtained were analysed using spss version 10 in Windows. Means and standard deviations were generated for continuous variables and frequency distribution for categorical variables. The results revealed that although breastfeeding rates were high (97%), complementary feeding practices were less than ideal with as many as 14% of the children being introduced to complementary foods below the age of 3 months. The nutritional quality of complementary foods were poor and the prevalence of stunting among the children was high (20%). For adequate complementary feeding and improved child nutrition in this population, nutrition education intervention programmes aimed at improving nutrient intake among young children, through improved diet diversity and increased use of local foods rich in iron and other nutrients, need to be undertaken.

Surveys the World Bank's experience in supporting developing country civil service reforms and begins to assess the progress made. The World Bank recognizes the importance of the civil service to the general welfare of the 4.6 billion people in low and middle income countries. Between 1981 and 1991, civil service reform was a prominent feature of 90 World Bank lending operations. This paper surveys the Bank's experience in supporting this reform and assesses the progress made. The lending operations concentrated on two separate dimensions: (1) Shorter-term, emergency steps to reform public pay and employment policies, which center on measures to contain the cost and the size of the civil service (2) longer-term civil service strengthening efforts directed toward ongoing, sustained management improvements. After examining the record of these reforms, the authors conclude that the results have been mixed at best. They recommend greater emphasis on devising a coherent, far-reaching strategy for reform and on detailing the set of tactics by which these goals will be achieved.

Weather shocks and other shocks affecting the economy of farm households often trigger a cascade of coping mechanisms, from reducing food consumption to selling assets, with potentially lasting consequences on child development. In polygynous households (in which a man is married to several women), the factors that may aggravate or mitigate the impacts of such adverse events are still poorly understood. In particular, little is known about the complex mechanisms through which women’s empowerment may affect the allocation of household resources in the presence of more than one female decision-maker. Where polygyny is associated with discriminatory social norms, co-wives may have limited bargaining power, which may translate into poorer outcomes for their children. While competition between co-wives may generate inefficiencies in the allocation of household resources, cooperation in the domains of agricultural production or domestic labor may lead to economies of scale and facilitate informal risk sharing. The rank of each co-wife may also have a strong influence on the welfare of her own children, relative to other children. Using the Feed the Future Ghana Population Survey data, I investigate the relationship between polygyny and children’s nutrition, and how it may be mediated through women’s bargaining power. Using the age of each co-wife as a proxy for rank, I also study how the senior-wife status of a mother may influence her children’s nutrition outcomes.

"Inappropriate complementary feeding (CF) practices and inadequate nutrient intakes contribute to the high level of malnutrition among children 6-24 months of age in Ghana. In communities where the economy is agricultural-based, interventions aimed at addressing malnutrition among infants and young children may need to focus on both food production and caregivers' nutrition knowledge. The aim of this study was to assess the effectiveness of a combined nutrition and agricultural education intervention, delivered through community health workers and agricultural extension agents, to improve infant and young child diet and growth in the Upper Manya Krobo district of Ghana. The current CF practices, and facilitators and barriers of CF education were identified through in-depth interviews of community health workers (n = 28) and staff of the Ministry of Food and Agriculture (n = 3), as well as three focus group discussions with caregivers (n = 22) of children 6-24 months of age. The Trials of Improved Practices method was used to test the feasibility of potential nutrition education messages. This process guided the development of the subsequent intervention. A cluster-randomised study design was used to compare the feeding practices, nutrient intakes, and growth of infants and young children (n = 367) in two intervention groups (combined nutrition and agricultural education [IE], nutrition education only [NE]), and a control group [CT]. Each child's diet and anthropometric data, and household demographic and agricultural production information were collected at baseline and at three-month intervals for nine months. Food insecurity can influence the types and amounts of food that young children consume, which may then affect their nutritional status and health. Therefore, the level of household food insecurity during the pre-harvest season and its relation with infant morbidity and growth were also assessed (n = 333). The results indicate that in this rural setting, 21.6% of households experienced food insecurity in the previous month. Household food insecurity was associated with respiratory infections in the second half of infancy, but not with diarrhea or stunting. Inclusion of animal source products, fruits, and vegetables in young children's diet was not common in the area. Poverty and maternal time constraints, and lack of teaching materials and language barrier, were identified as challenges to optimal CF practices and provision of CF education, respectively. Almost half of intervention mothers (45%) never attended an education session. Children in the IE were twice as likely to meet the minimum meal frequency compared to the CT children (aOR = 2.62; 95% CI; 1.11, 6.16), but energy, vitamin A, calcium, and iron intakes from complementary foods, and growth indicators did not differ among the three groups. Additionally, children of mothers who attended at least one nutrition education session in the IE group tended to receive the minimum acceptable diet (aOR = 2.30, 95% CI; 0.98, 5.39, p = 0.055) compared to children in the CT group at the end of the study. There were no differences between the two intervention groups, and feeding practices among children in the NE group did not improve at the end of the study. Future education interventions will need to increase the involvement of participants at the development phase of interventions, as a way of improving participation among caregivers of infants and young children." --

List of tables; Education of caregiver; Knowledge, attitudes, and beliefs of caregiver; Physical health and nutritional status of caregiver; Mental health, self-confidence, and lack of stress of caregiver; Autonomy and control of resources in the household by caregiver; Workload and time availability of caregiver; Social support for caregiver; Estimates of time spent on child care from observation and recall; Feeding practices: caregiver-child interactions; Feeding practices: child variables; Psychosocial care: child and caregiver interactions; Psychosocial care: child variables; Illustrations; The unicef conceptual model; The extended model of care; The transactional model of care; Pathways of interaction of education with caregiving; Possible pathways of interaction of maternal health and caregiving; Summary; Introduction; Developments in conceptualizing care; Resources for care; Care practices.

There are several reasons why a consolidation of recent advances in our understanding of the interaction of diarrhea and malnutrition is indi cated and timely. It is now widely recognized that diarrhea is a major cause of morbidity and mortality among children of poor countries. Due to recent advances in laboratory and field diagnostic techniques, many of the previously unrecognized etiologic agents responsible for diarrhea have been identified, thereby providing new scientific knowledge for rational control strategies. Increasingly these advances suggest that the morbidity burden of diarrhea may be of equal, if not greater, public health consequence than mortality. Diarrhea only rarely causes disease severe enough to require institutionalized medical care. The vast major ity of diseases are of mild or moderate severity, and because of high prev alence, diarrhea imposes an enormous morbidity burden and exerts a sig nificant negative impact on child growth and development. Moreover, the effects of successive episodes of diarrhea are likely to be cumulative. In contrast to several other childhood infections, the treatment of the diarrheal diseases is feasible because it uses simple, effective, and low cost medical technologies. Within the context of these developments, there has been a major resurgence of international interest in, and commitment to, the control of the diarrheal diseases. The World Health Organization recently has launched a global program for the control of diarrhea, and simulta neously, an independent international research center on diarrhea has been established in Bangladesh.

Malnutrition among African infants and pre-school children has been reported to exist in South Africa on a very large scale. Many presss reports have indicated that there is a high rate of malnutrition countrywide, and this is a matter of great concern to the public health workers.

Governments use food for education (FFE) programs to increase school participation and support learning through better nutrition. But how effective are these programs? This food policy review surveys the empirical literature to assess the impact of FFE programs on the students' schooling, learning, and nutrition. It examines the economic rationale for FFEs, critically assesses the evidence on their effectiveness, identifies areas where further research is needed, and offers guidelines for future program design and use.