SPOON, Portland, OR, United States.
Access to Health Zambia, Lusaka, Zambia.
Front Public Health. 2024 Sep 4;12:1331907. doi: 10.3389/fpubh.2024.1331907. eCollection 2024.
This study aimed to estimate the prevalence of undernutrition and risk of feeding difficulties and describe common feeding practices for children from birth to 10 years of age living in residential care in Zambia.
This was a secondary analysis of de-identified cross-sectional data on 397 children living in 22 residential care facilities in four provinces. Child demographics, anthropometrics, hemoglobin levels, risk for feeding difficulties, and facility-level feeding practices were collected by a trained study team using , a digital health app. Interviews with staff were conducted at 15 residential care facilities.
Around half of the study sample were boys (53.4%) and <5 years old (55.4%). Special healthcare needs were reported in 10.3% of the children, with cerebral palsy being the most common (3.5%). Underweight, stunting, wasting (using weight-for-length/height), and anemia were found in 22.4, 28.0, 7.1 and 54.7% of children, respectively, with higher rates in children with special healthcare needs and children <24 months old. Duration of residential care was positively associated with length/height-for-age but not weight-for-age or weight-for-length/height -scores. A risk for feeding difficulties was found in 41.4 and 26.0% of children with and without special healthcare needs, respectively. Suboptimal bottle-feeding practices, including the use of altered nipples and poor caregiver-infant interactions, were observed for infants <12 months old. Residential care staff reported suboptimal diets in their facilities and gaps in knowledge and resources to meet children's nutritional needs.
These results demonstrate that a large proportion of children living in residential care in Zambia are at high risk for undernutrition and feeding difficulties and contribute to the small body of literature on children living in residential care, both in Zambia and globally. In the context of Zambia's efforts to improve child nutrition and reform its alternative care, these findings can inform programming and policies for children living in residential care to fulfill their rights to health and family care.
本研究旨在估计赞比亚居住照料儿童中营养不良和喂养困难风险的流行率，并描述 0-10 岁儿童的常见喂养实践。
这是对来自赞比亚四个省 22 个居住照料设施的 397 名儿童的横断面数据进行的二次分析。使用 数字健康应用程序，由经过培训的研究团队收集儿童人口统计学、人体测量学、血红蛋白水平、喂养困难风险和设施喂养实践方面的数据。对 15 个居住照料设施的工作人员进行了访谈。
研究样本中约有一半是男孩（53.4%）和<5 岁（55.4%）。10.3%的儿童有特殊医疗保健需求，脑瘫最常见（3.5%）。22.4%、28.0%、7.1%和 54.7%的儿童分别有消瘦、发育迟缓、消瘦（用长度/身高表示）和贫血，有特殊医疗保健需求和<24 个月大的儿童的比例更高。居住照料的持续时间与年龄/身高成正比，但与年龄/体重或长度/身高-体重不成正比。有特殊医疗保健需求和无特殊医疗保健需求的儿童中分别有 41.4%和 26.0%存在喂养困难风险。对于<12 个月大的婴儿，观察到奶瓶喂养实践不佳，包括使用变形奶嘴和照顾者与婴儿互动不佳。居住照料工作人员报告说，他们的设施中的饮食不佳，并且在满足儿童营养需求的知识和资源方面存在差距。
这些结果表明，赞比亚居住照料儿童中很大一部分处于营养不良和喂养困难的高风险中，为赞比亚和全球范围内居住在照料机构中的儿童的少量文献做出了贡献。在赞比亚努力改善儿童营养和改革替代照料的背景下，这些发现可以为居住在照料机构中的儿童的规划和政策提供信息，以实现他们的健康和家庭关怀权利。
