The Acceptability of Innovative Feeding Tools to Improve Maternal and Child Nutrition in Western Kenya Pubblico

Abstract

Dietary practices in Kenya often fail to provide adequate nutrition during the first 1000 days of life. We developed and qualitatively assessed a low-cost, easy-to use demarcated bowl and slotted spoon to assist mothers with appropriate diet practices during pregnancy, breastfeeding, and complementary feeding of children 6-18 months. We conducted 12 focus group discussions with community members and 5 interviews with nutrition experts to assess acceptability and obtain recommendations on design and delivery in Western Kenya. We also conducted 24-28 days of user testing with 14 pregnant, 14 breastfeeding women, and 32 mothers with infants 6-18 months. Tools were positively received by communities. Mothers perceived improvements in theirs and their children's food intakes including increased quantity, frequency, consistency and diversity. Many attributed their own and their child's weight gain or increase in energy to tool use. A minority of women reported using the bowl for other activities, or not using the bowl due to food insecurity. Results indicate these tools have the potential to positively impact maternal and child nutrition, however future work should address food insecurity and counseling on responsive feeding.

Table of Contents

Table of Contents

CHAPTER 1: INTRODUCTION ............................................................................................................................ 2
Context of the Project:................................................................................................................. 2
Problem Statement: ..................................................................................................................... 4
Purpose of the Project: ................................................................................................................ 4
CHAPTER 2: LITERATURE REVIEW ..................................................................................................................... 6
Burden of Maternal and Child Malnutrition: ....................................................................................... 6
Causes of Malnutrition: ................................................................................................................ 7
Strategies to Alleviate Malnutrition during the 1000 Days: ................................................................... 8
Interventions during Pregnancy and 0-6 Months Postpartum: ............................................................... 9
Interventions for Infant and Young Child Feeding (IYCF): .................................................................... 13
Models for Improving Maternal and IYCF: ........................................................................................................... 18
CHAPTER 3: MANUSCRIPT ............................................................................................................. 23
Abstract: ................................................................................................................................... 25
Introduction: .............................................................................................................................. 26
Methods: ................................................................................................................................... 28
Results: ..................................................................................................................................... 32
Community Norms Regarding Maternal and Child Feeding Practices: ....................................................... 33
Effects of Feeding Tools on Dietary Practices: .................................................................................. 36
Discussion: ................................................................................................................................ 40
Tables and Figures: ........................................................................................................................................ 46
CHAPTER 4: CONCLUSIONS AND RECOMMENDATIONS ......................................................................... 53
Public Health Implications: ............................................................................................................ 53
Future Research: ........................................................................................................................ 57
REFRENCES: .................................................................................................................................................... 58

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Agriculture, Food Science and Technology Engineering, Industrial
Parola chiave	Maternal and child nutrition Bowl and spoon Nutrition Infant and young child feeding Western Kenya
Committee Chair / Thesis Advisor	Girard, Amy Webb, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs International Non-governmental organization (e.g., CARE, Inc.)

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