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Mothers Adherence to Global Infant and Young Child Feeding Strategies in Ketu North District, Volta Region - Ghana

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Mothers Adherence to Global Infant and Young Child Feeding Strategies in Ketu North District, Volta Region - Ghana European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 Mothers Adherence to Global Infant and Young Child Feeding Strategies in Ketu North District, Volta Region - Ghana Prince Kubi Appiah, (MPH) Wilson Mensah Dzata, (BPH) Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana Duut Abdulai Bonchel, (MPhil) Department of Social Work, University of Ghana, Legon, Accra, Ghana Anang Rhoda Naa Korklu, (BPH) Doe Jessica Naa Ayeley, (BPH) Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana Georgina Agartha Fenu, (BPH) Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Ho, Ghana Timay Ibrahim Abdul-Rahman, (BPH) Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana Doi: 10.19044/esj.2017.v13n30p183 URL:http://dx.doi.org/10.19044/esj.2017.v13n30p183 Abstract Background: Infant and young child nutrition has been engaging the attention of scientists and governments over the years. Their feeding practices comprise both breastfeeding as well as complementary feeding which have major role in determining the nutritional status of the child, therefore, there has been a well-established link between malnutrition and infant feeding. Children are the future of the world and yet the most vulnerable population, with some 6.6 million children dying before their fifth birthday globally. Studies have shown that poor breastfeeding and complementary feeding practices, coupled with high rates of morbidity from infectious diseases are the primary causes of malnutrition and death in the first two years of life. Ketu-North district noted that even though nutrition and health programmes were in place, breastfeeding coverage has been between 53% in 2013 and 69% in 2015. This study sought to assess mothers or caregivers adherence to Infant and Young Child Feeding (IYCF) practices 183 European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 in Ketu North District of the Volta Region in Ghana. Method: A cross- sectional study among mothers/caregivers with children 0-24 months in the district. Multistage sampling techniques was used to select 518 respondents. A semi-structured questionnaire was used to conduct face-to-face interviews. Statistical software Epi Data version 3.1 and Stata version 12.1 were used for data entry and analysis respectively. Descriptive statistics was presented in tables and graphs. Beyond descriptive statistics, associations between the outcome and predictor variables were analysed using Pearson chi-square and logistics regression. P-value < .05 was considered as statistically significant. Findings: Respondents had a mean age of 25.6 years (±3.6 SD). Only 8.7% of the mothers adhered to IYCF strategies with practices of exclusive breastfeeding, complementary feeding, hygiene and sanitation practices, meal variety, and meal frequency being 57.9%, 38.0%, 16.2%, 37.1%, and 33.2% respectively. Ethnicity (p < .000), age of child (p = .032), employment (p =.041) and level of education (p = .042) were found to be associated with adherence to IYCF strategies. Conclusions: Adherence to infant and young child feeding practices were not encouraging in the district therefore the district health management team need to strengthen health education and implement other behaviour change interventions to improve on the adherence to feeding strategies. Further studies should be conducted to assess factors influencing the low adherence to the feeding strategies in the district. Keywords: Exclusive breastfeeding, complementary feeding, mothers/caregivers, Ketu North District Introduction Infant and young child nutrition has been engaging the attention of scientists and governments over the years (Ramji, 2009). Infant and young child feeding practices comprise both the breastfeeding as well as the complementary feeding and have major role in determining the nutritional status of the child (Lenggogeni, 2016). The link between malnutrition and infant feeding has been well established (Ramji, 2009). The first two years of life are critical stages for child growth and development, and any damage caused by nutritional deficiencies during this period could lead to impaired cognitive development, compromised educational achievement and low economic productivity (Grantham- mcgregor et al., 2007; Oddy et al., 2003). Studies have shown that poor breastfeeding and complementary feeding practices, coupled with high rates of morbidity from infectious diseases are the primary causes of malnutrition in the first two years of life (Grantham-mcgregor et al., 2007). However, 184 European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 under-nutrition is persistent in low and middle income countries, with Africa and Asia being the most affected (Bain et al., 2013) Globally, nearly one in four children (165 million or 26%) are affected by the most severe life-long consequences of under-nutrition (stunting) (WHO, 2010). Malnutrition underlies majority of under five deaths, 70% of which occur in the first year of life with estimated 32% (186 million) children aged below five years in developing countries stunted and about 10% (55 million) wasted (Satija et al 2015; WHO, 2010). In 2010, one out of thirteen children in Ghana died before their fifth birthday mostly as a result of under-nutrition (GHS, 2010), and currently 5% wasted, 19% stunted, 11% underweight, 3% overweight or obese state (UNICEF, 2015). In 2015, 5 million children in developing countries died before their fifth birthday with over one third caused by malnutrition due to inadequate complementary feeding (Satija et al., 2015). In 2002, World Health Assembly championed by WHO and UNICEF emphasized on Maternal Nutrition and Infant and Young Child Feeding (IYCF) to prevent and reduce child under-nutrition especially stunting which cannot be corrected after the first 1000 days of life (Lartey, 2008). Mothers/Caregivers are required to exclusively breastfeed newborns up to six months and continue breastfeeding up till two years or beyond while introducing complementary foods at six months (Finance & Focused, 2016). However, studies have shown low compliance to these recommendations (Agbozo, Colecraft, & Ellahi, 2015). This has led to 70% of infants in Africa facing greater risk of morbidity and mortality (AU, 2009). According to Volta Regional Health Directorate (VRHD), there has been a reduction in underweight cases from 12.8% in 2012 to 10.5% in 2015 (VRHD, 2015) revealing little reduction in the prevalence of underweight under-nutrition over a period of five years, with breastfeeding coverage being between 53% in 2013 and 69% in 2015 in Ketu North district (KNHD, 2015). In the light of this, the study was conducted in Ketu North District to assess mothers/caregivers adherence to infant and young child feeding strategies. Materials and Methods Study Site The Ketu North District is one of the 32 new districts created in Ghana in the year 2008. It was carved out of the then Ketu District by a Legislative Instrument (LI 1841 of 2008) and was inaugurated on the 29th February, 2008. The district has Four (4) health demarcated sub-districts with about 272 communities. It has its administrative capital at Dzodze, which lies about 80 kilometres south of Ho, the regional capital. Ketu North District is located between Latitude 6o 03’N and 6o 20’N and Longitude 0o 185 European Scientific Journal October 2017 edition Vol.13, No.30 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 49’E and 1o 05’E. It shares boundaries with the Akatsi North District to the north, the Keta Municipality to the south-west, Republic of Togo to the east. To the south, it is bounded by the Ketu South Municipality and to the west by the Akatsi South District. The District covers a total surface area of 423.8 square kilometres representing 2.1 percent of the total land area of the Volta Region. The population of Ketu North District, according to the 2010 Population and Housing Census, is 99,913 representing 4.7 percent of the region’s total population. Males constitute 46.5% and females represent 53.5%. Nearly Sixty-six percent (65.8%) of the population is rural. The district has a sex ratio of 87.2. The population of the district is youthful (43.0%) depicting a broad base population pyramid which tapers off with a small number of elderly persons (6.5%). The total age dependency ratio for the District is 82.3, the age dependency ratio for males is higher (87.3) than that of females (77.8) (GSS, 2012). The major ethnic groups found in the District according to the 2010 PHC are Ewes, Akans, Ga-Adangbe and Guan with the dominant tribe being Ewe (98.2%). In terms of religion, Christians form the majority of the population (55.6%) while traditionalists constitute 33.5%. Persons who profess no religion and other religions constitute 10% of the total population while Muslims constitute less than one percent (0.9%) of the population. The District has one hospital, a community private clinic, seven (7) health centres, four (4) Community based Health Planning and Service (CHPS) zones and one (1) RCH unit with an Adolescent Health Corner. There is one (1) college of education in the district, and a number of primary and second cycle schools. Agriculture is the pillar of the economy of the Ketu North District. Farming is largely carried out on small-scale basis. The average acreage cultivated ranges from four to six acres for all crops. The District’s irrigation potential remains largely untapped. Apart from the Afife Irrigation Project, there are numerous dams and dugouts which could be developed for use. The crop sector accounts for about 60 percent of agricultural activities in the District.
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