Improving Young Child Nutrition Clinical Trial
In Ghana the level of malnutrition is high among children below five years of age,
particularly in rural areas. The objective of the study was to investigate the effects of an
education intervention aimed at addressing poor complementary feeding (CF) practices on the
food intakes and growth of young children in the Upper Manya Krobo district of Ghana.
Interviews and focus group discussions involving community health and agricultural workers,
as well as caregivers of children 6-24 months old were conducted to investigate the
facilitators and challenges to optimal CF practices and education on CF. The trials of
improved practices (TIPs) method was used to test the feasibility and acceptability of
potential education messages among mothers of young children (6-24 months) living in the
study area. Child welfare clinic centers in the area were randomly assigned to one of three
groups which were control, nutrition education and integrated education. Mothers of children
6-24 months in the integrated education group received monthly nutrition education from
community health volunteers and agricultural education from agricultural extension agents
for six months in addition to standard monthly child growth monitoring services from
community health nurses. Mothers in the nutrition education group received monthly nutrition
education from community health volunteers for six months in addition to standard care.
Mothers of 6-24 months in the control group received only the standard monthly child
monitoring services. The effects of the educational intervention on maternal knowledge on
optimal complementary feeding, as well as food intakes and growth of young children were
determined among 367 mother-child dyads over a period of at least six months. The study
hypothesised that mothers receiving the education would have improved knowledge on good
complementary feeding practices compared to those in the control group. The study also
hypothesised that young children in the integrated education would have better nutrient
intakes and growth compared those in the nutrition education and control groups, and those
in the nutrition education group would have better nutrient intakes and growth than the
children in the control group.
From the interviews and focus group discussions, reported initiation of CF was satisfactory,
while other reported practices such as the addition of animal source foods, vegetables and
fruits to young children's diet were found to be sub-optimal. Poverty and maternal time
constraints were identified as the main challenges of optimal complementary feeding, while
farming was seen as a facilitator. Lack of education materials, language barrier, maternal
time constraints and lack of in-service training for health workers were the main challenges
to education on complementary feeding. From the TIPS study, mothers expressed their
willingness to improve the diets of their 6-24 months old children by adding or increasing
the amount of animal source foods, dark-green leafy vegetables and fruits, as well as
increasing feeding frequency daily. However, availability and affordability of protein-rich
foods like animal source foods, groundnut paste and soya beans powder was a challenge for
some mothers.
The intervention did not lead to a significant improvement in maternal knowledge on
complementary feeding practices. However, it showed a tendency to reverse a general
decreasing trend in knowledge among mothers on appropriate complementary feeding practices
in the study area. Significantly more children in the integrated education group consumed
animal source foods compared those in the other two groups when compared at nine months
after baseline. However, the intervention did not improve the general nutrient intakes and
growth of the young children in the study area.
| Status | Completed |
| Enrollment | 367 |
| Est. completion date | March 2012 |
| Est. primary completion date | March 2012 |
| Accepts healthy volunteers | Accepts Healthy Volunteers |
| Gender | Both |
| Age group | 6 Months to 11 Months |
| Eligibility |
Inclusion Criteria: - child aged 6-11 months old and attending monthly growth monitoring clinic - mother and child living in the study area Exclusion Criteria: - birth defects which results in difficulty in feeding of child |
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
| Country | Name | City | State |
|---|---|---|---|
| Ghana | Upper Manya Krobo district | Assesewa | Eastern Region |
| Lead Sponsor | Collaborator |
|---|---|
| McGill University | International Development Research Centre, Canada |
Ghana,
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | growth (change in weight and length) | 9 months | No | |
| Secondary | maternal nutrition knowledge | 9 months | No |