Feeding Behavior Clinical Trial
Official title:
Effectiveness of Behavior Change Communication on Optimal Complementary Feeding Through Community Level Actors in Improving Feeding Practices, Nutritional and Health Status of Infants in West Gojjam Zone, Northwest Ethiopia
Child under nutrition is a major risk factor for ill health and mortality, contributes
substantially to the burden of disease in low-income and middle-income countries and is
associated with close to half of all child deaths. The prevalence of both underweight and
stunting is highest in Africa and South-Central Asia. Ethiopia is one of the poorest
countries in Sub- Saharan Africa, and child malnutrition is a serious public health problem
where the rates for stunting (40%), underweight (25%) and wasting (9%) among children under 5
years are among the highest in the world.
Globally, about 40% of child mortality less than two years is associated with inappropriate
feeding practices. Optimal breastfeeding and appropriate complementary feeding could prevent
13% and 6% under-five mortality, respectively. Over two third of malnutrition is associated
with inappropriate feeding practices during the first year of life.
The first two years of life provides a critical window of opportunity for ensuring
appropriate growth and development of children from generation to generation through optimal
feeding. Hence, the objective of this study to evaluate the effectiveness of behavior change
communication on optimal complementary feeding through community level actors in improving
feeding practice, health and nutritional status of infants.
A cluster-randomized controlled trial which was conducted in West Gojjam Zone, Northwest
Ethiopia from May 9, 2016 to October, 2017. Behavior change communication on complementary
feeding was conducted in the intervention kebeles/villages for 8 months. A validated
interviewer administered structured questionnaire was used for collecting information on the
study subjects both at the baseline and after intervention. Data will be checked, coded and
double entered using EPI info and exported to SPSS version 21 for statistical analysis.
The output of the study findings could be useful for health and nutrition policy makers and
other concerned bodies in decision making and to design effective intervention strategies to
improve feeding practices thus mitigating child malnutrition and improving their health and
growth. The total budget needed to conduct the study is 7,000 US dollar.
Globally, about 40% of death children less than two years is associated with inappropriate
feeding practices. Optimal breastfeeding and appropriate complementary feeding could prevent
13% and 6% under-five mortality, respectively. Over two third of malnutrition is associated
with inappropriate feeding practices during the first year of life.
Every day, 3000-4000 infants die in the developing world from diarrhea and acute respiratory
infections because they are given inadequate amounts of breast milk. More than 10 million
children die each year in sub- Saharan Africa and South Asia. A major contributor to their
deaths is poor breastfeeding practice. The risk of death from diarrhea of partially breastfed
infants 0 - 6 months of age was 8.6 times the risk for exclusively breastfed children.
Infant and young feeding practices for infant and young children worldwide are not optimal.
It is only 34.8% of infants are exclusively breastfed worldwide. Complementary foods are
often introduced too early or too late and are often nutritionally inadequate or unsafe. Only
about 39% of infants in the developing countries, 25% in Africa are exclusively breastfed for
the first six months and 6% of infants in developing countries are never breastfed.
A wide range of harmful infant and young child feeding practices were documented in Ethiopia.
According to EDHS of 2011, 52% of infants started breastfeeding within one hour of birth and
exclusive breastfeeding during the first six months with the 4.2 months mean duration of
exclusive breastfeeding. About half (49%) of children aged 6-8 months consumed solid,
semi-solid, or soft foods and 5% of children were fed minimum dietary diversity and 4% of
children fed minimum meal frequency per day while 96% of children continued breastfeeding at
one year, and 82% continued at 2 year. Only 4% of children 6 - 23 months living with their
mothers are fed in accordance with infant and young child feeding practices and 66% children
under the age of two receive age-appropriate breastfeeding. Overall, nearly three children in
every ten (27%) are given prelacteal feeds within the first three days of life.
In Amhara region, 38% of infants started breastfeeding within one hour of birth while only 2%
and 34% of children 6-24 months were fed according to the minimum standards with respect to
food diversity (four or more food groups) and meal frequency.
Sub-optimal infant and young child feeding practices are associated with caretakers' poor
knowledge, lack of information and being restricted by traditional beliefs. It is essential
to give caregivers necessary knowledge and information to alter their inappropriate feeding
behaviors. Promotion of appropriate feeding practices, therefore, is fundamentally important
in reducing child malnutrition and mortality and, thus, for achieving MDG 1. In order to
sustain the gains made by promoting exclusive breastfeeding for the first six months of life,
interventions need to extend into the second half of infancy and beyond. This could be
ensured by enabling caregivers to appropriately feed their children with safe and adequate
complementary foods while maintaining frequent breastfeeding.
Several efforts to improve the feeding status of the infant and young children have been
carried out at different times. The Ethiopian government developed the infant and young child
feeding guideline in 2004 following WHO recommendations of global strategy for feeding
infants and young children for proper nutrition & health. Community based nutrition program
was also designed to build upon the HEP packages and implemented in all agrarian regions of
Ethiopia. However, these efforts have failed to bring about substantive and sustainable
changes leading to improvement of infant and young child feeding practices since efforts
(nutrition actions) were not based on the evidence on existing feeding practices and what
works and what does not. Moreover, the health extension workers were not effectively
networked with the community volunteers, work load for health extension workers and lack of
training and supervision outcomes could factor their effects on the feeding practices.
As a result, the problem of stunting has remained pervasively high in the country. The
government has designed an accelerated stunting reduction program under the revised national
nutrition program. Moreover the Federal Ministry of Health has made reduction of child
malnutrition in Ethiopia a priority flagship program under the commitment to the Seqota
declaration, which states zero level hunger among under two children by 2030. Therefore, the
aim of this study is to evaluate the effectiveness of behavior change communication on
optimal complementary feeding through community level actors in improving feeding practice,
nutrition and health status of infants.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT04502979 -
Learning to Love Mealtime Together
|
N/A | |
Completed |
NCT03334266 -
Preventing Early Childhood Obesity, Part 2: Family Spirit Nurture, Prenatal - 18 Months
|
N/A | |
Completed |
NCT03651258 -
Facilitate the Transition From Passive Feeding to Active Feeding in Preterm Infants Through Early Play
|
||
Completed |
NCT05992753 -
Mothers' Breast Milk Expression Experiences, Infant Feeding Attitudes and Perceived Social Support Levels
|
||
Completed |
NCT03332108 -
Novel Approach To Improving Lactation Support With Mobile Health Technology
|
N/A | |
Completed |
NCT03941392 -
Nutritional Study in Spanish Pediatric Population
|
||
Completed |
NCT03949543 -
The Timing of Main Meal Consumption Effect on Gut Microbiota and Host
|
N/A | |
Not yet recruiting |
NCT05059574 -
Breast Crawling,Breastfeeding Success and Mothers' Attitudes to Feeding Their Babies
|
N/A | |
Completed |
NCT03242863 -
Effect of Varying Proportions of Low and High Energy Dense Foods Over 5 Days in Preschool Children
|
N/A | |
Completed |
NCT03127579 -
Family Meal Duration and Children's Eating Behavior
|
N/A | |
Completed |
NCT02996422 -
Appalachians Together Restoring the Eating Environment: Improving Healthy Diet in Rural Appalachian Kentucky
|
N/A | |
Enrolling by invitation |
NCT03755999 -
A Cue-based Developmental Approach Toward the Preterm Infants During Feeding Transition Period
|
N/A | |
Recruiting |
NCT03439618 -
Comparison of Time-restricted Feeding and Continuous Feeding in Critically Ill Patients
|
N/A | |
Recruiting |
NCT04960969 -
The Effects of Time-Restricted Eating Model
|
N/A | |
Completed |
NCT02930642 -
Food Insecurity, Obesity, and Impulsive Food Choice
|
N/A | |
Completed |
NCT03926065 -
Variations in Palatability and Portion Size of Vegetables on Meal Intake of Preschool Children
|
N/A | |
Completed |
NCT03886428 -
The Influence of Satiation Measures on the Portion Size Effect
|
N/A | |
Completed |
NCT03025815 -
Effects of the Oral Stimulation Program in Extreme Preterm Infants
|
N/A | |
Completed |
NCT02347527 -
Neuronal and Behavioral Effects of Implicit Priming in Obese Individuals
|
N/A | |
Completed |
NCT03664154 -
Stress and Feeding (SAFE): A Pilot Intervention for Mothers and Their Preterm Infants
|
N/A |