Kulwa Kissa B M, Kinabo Joyce L D, Modest Beata
Department of Food Science and Technology, Sokoine University of Agriculture, Morogoro, Tanzania.
Food Nutr Bull. 2006 Sep;27(3):236-44. doi: 10.1177/156482650602700306.
Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving.
To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status.
A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements.
The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home.
The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.
护理日益被视为儿童健康与营养的关键要素，与粮食安全、卫生服务可及性以及健康环境同等重要。尽管坦桑尼亚在抗击营养不良方面已取得显著成效，但城市地区学龄前儿童的营养状况仍未得到改善。
评估婴幼儿的护理方式及营养状况，以改善喂养方式和儿童营养状况。
在坦桑尼亚达累斯萨拉姆市开展了一项横断面研究。该研究从伊拉拉市（构成达累斯萨拉姆市议会的三个市之一）的家庭中随机选取了100名6至24个月儿童的母亲。通过结构化问卷、现场检查观察和人体测量收集数据。
发育迟缓、体重不足、消瘦和发病率的患病率分别为43%、22%、3%和80%。纯母乳喂养的患病率极低（9%），大多数发育迟缓儿童（88%）在出生后的前6个月未进行纯母乳喂养。引入辅食和液体的平均年龄为3.26±1.12个月（范围为1至5个月）。所提供的液体主要是水和稀谷类粥。超过一半的家庭保持良好的卫生习惯。大多数心理社会行为（如照顾者的关注、关爱以及参与儿童喂养、卫生、医疗保健和培训）由母亲进行，但做饭、喂孩子和儿童培训大多由其他照顾者完成。近一半的母亲（44%）外出工作。平均每日工作时长较长（10.32±2.13），因此需要使用其他照顾者。年龄别身高z评分与母亲外出工作时长之间存在负相关。
该城市人口中慢性营养不良和发病率的患病率较高，儿童喂养方式不当。母亲的就业和教育特征限制了良好的儿童护理方式，随着母亲加入劳动力大军，其他照顾者在儿童护理中发挥着更为重要的作用。我们建议开展形成性研究，以了解照顾者的实际行为，从而为儿童护理教育项目奠定基础。此外，还需要加强国家卫生系统对改善儿童喂养的支持。
