Palwala Misba, Sharma Shweta, Udipi Shobha A, Ghugre Padmini S, Kothari Gopa, Sawardekar Pradeep
Department of Food Science and Nutrition, S.N.D.T. Women's University, Juhu Rd., Santa Cruz (West), Mumbai 400049, India.
Food Nutr Bull. 2009 Dec;30(4):317-26. doi: 10.1177/156482650903000402.
Almost half of India's children under 3 years of age are undernourished and at risk for illness and death. Poor complementary feeding practices contribute substantially to the problem. Promoting appropriate feeding practices is critical for ensuring child survival, health, and nutrition. Nutrition education is a feasible intervention and has the potential to help achieve the Millennium Goals, provided it is implemented appropriately. However, in existing programs, education is too generalized and based on information transfer.
To develop and implement a need-based, situation-specific education program for mothers to bring about changes in complementary feeding practices, with emphasis on the quantity and nutritional quality of complementary feeds.
Four hundred fourteen mothers or caregivers from five slums in Mumbai participated in a 3-month intervention study. Gaps in complementary feeding practices were identified at baseline. Education was given by trained fieldworkers, first to groups of 8 to 10 mothers or caregivers using innovative modules and demonstrations, followed by weekly monitoring and reinforcement. A simple checklist was used at each follow-up to assess impact, identify practices not adopted, and provide further inputs. Data collected at three follow-ups were compared with baseline and analyzed by SPSS using the chi-square test, the t-test, and ANOVA to assess whether feeding practices of the mothers or caregivers were altered favorably.
The intervention process used in this study, the modules used, and the use of the checklist as a monitoring tool were successful in favorably changing complementary feeding practices. Incorporation of these in existing Growth Monitoring and Promotion programs would help to improve child nutrient intakes and thus reduce the prevalence of undernutrition.
印度近半数3岁以下儿童营养不良,面临患病和死亡风险。不良的辅食喂养习惯在很大程度上导致了这一问题。推广适当的喂养习惯对于确保儿童生存、健康和营养至关重要。营养教育是一种可行的干预措施,只要实施得当,就有潜力帮助实现千年发展目标。然而,在现有项目中,教育过于笼统,且基于信息传递。
为母亲们制定并实施一项基于需求、因地制宜的教育项目,以改变辅食喂养习惯,重点关注辅食的量和营养质量。
来自孟买五个贫民窟的414名母亲或照料者参与了一项为期3个月的干预研究。在基线时确定辅食喂养习惯方面的差距。由经过培训的现场工作人员进行教育,首先以8至10名母亲或照料者为一组,使用创新模块和示范进行授课,随后进行每周监测和强化。每次随访时使用一份简单的清单来评估影响、确定未采用的习惯并提供进一步的指导。将三次随访收集的数据与基线数据进行比较,并使用SPSS通过卡方检验、t检验和方差分析进行分析,以评估母亲或照料者的喂养习惯是否得到了有利改变。
本研究中使用的干预过程、所使用的模块以及将清单用作监测工具,成功地有利改变了辅食喂养习惯。将这些纳入现有的生长监测与促进项目将有助于提高儿童的营养摄入量,从而降低营养不良的患病率。