Feeding practices and nutritional status of children under two years in Kwahu Afram Plains North and South Districts in Ghana

Abstract

Child undernutrition is a public health problem. In Ghana, less than one out of five children is fed on a minimum acceptable diet. However, less is known about the cultural dynamics of child feeding practices. Also, most previous studies focused on just single feeding indicators and this does not allow for a holistic assessment of how feeding practices determine the nutritional status of children. The purpose of this study was to explore the socio-cultural, maternal and household factors that influence the feeding practices and the nutritional status of children under two years in the Kwahu Afram Plains North and South Districts of Ghana. Moreso, a composite feeding index was constructed and its associations with the nutritional status of children were examined. Focused group discussions were conducted involving grandmothers and health workers to collect qualitative data. For the quantitative data, 935 mothers were interviewed to assess maternal and household factors that are associated with the feeding practices and nutritional status of children. The qualitative data was thematically analysed while logistic regression models were used to determine the association of the maternal and household factors with the feeding and nutritional status. The results revealed that cultural norms prevent mothers from exclusively breastfeeding their babies and feeding them with certain nutritious foods. Only 37.0% and 22.1% of the children had a minimum dietary diversity score and a minimum acceptable diet respectively. The prevalence of wasting (19.1%), underweight (29.5%) and stunting (20.4%) were high. Small household size, access to a toilet facility, being employed, a high educational level, high decision-making power and financial independence of a mother were associated with a higher likelihood of children receiving an adequate minimum acceptable diet. Education on the importance of child nutrition, family planning and crop diversification, providing employment opportunities for mothers and improvement in girl-child education is recommended.