Influence of childcare practices on the nutritional status of children aged 6 to 23 months in Lusaka district, Zambia
Abstract Background Malnutrition is a public health problem in many developing countries, Zambia inclusive. According to the Zambia Demographic and Health Survey, the stunting rate in children under five years old is at 40% while underweight is at 15% and wasting at 6%. The purpose of this study was to establish whether childcare practices have an influence on the nutritional status of children aged 6 to 23 months in Lusaka district. Methods A cross sectional study was employed targeting 239 children resident in Munali constituency in Zambia. A researcher administered questionnaire was used to collect data on demographic characteristics, hygiene practices, health seeking behaviour and food consumption pattern. Child anthropometric measurements were taken using calibrated scales and height/length boards for weight and length/height respectively. SPSS version 20 was used to analyse data. WHO AnthroPlus was used to generate anthropometric indices. Bivariate analysis used to establish associations between variables and logistic regression was used to establish predictors of stunting. Results Prevalence of wasting, underweight and stunting was 3.8%, 9.6% and 25.5%, respectively. Stunting was more prevalent among male than female children, (p-value = 0.015). Child care practices that were associated with stunting included: breastfeeding (p-value = 0.002), education level of caregiver (p-value = 0.013), type of toilet used (p – value = 0.004), child morbidity (p – value = 0.040), use of insecticide treated mosquito net (p – value = 0.012). Predictors of stunting included breastfeeding and child morbidity. Breastfeeding before the survey was associated with a reduction in risk of stunting among children (p-value = 0.009, OR = 0.347, 95% CI (0.156 – 0.769)). Surprisingly morbidity two weeks prior to the study was also associated with a reduction in the likelihood of stunting (p-value = 0.009, OR = 0.350, 95% CI (0.166 – 0.773)). Conclusion The study revealed high levels of stunting. Childcare practices that had a significant relationship to nutritional status of the children were: breastfeeding night before survey, type of toilet used, use of insecticide treated mosquito net, education level of caregiver and child morbidity. Key words: childcare, stunting, underweight, wasting, Zambia