Gaps in Knowledge Levels of Health Workers on Recommended Child Feeding Practices and Growth Monitoring and Promotion Actions

Abstract

Background: Mothers rely greatly on the advice given by Health Workers (HWs) on appropriate Infants and Young Children Feeding (IYCF) practices. Therefore, the knowledge levels of HWs play an important role in the effective promotion of recommended IYCF practices. However, evidence in literature highlights that HWs do not have adequate knowledge on recommended child feeding practices Objective: This study aims at assessing the nutritional knowledge levels of HWs who work in child health facilities in two predominately rural districts in Ghana. Methods: The study is a descriptive cross-sectional. Responses from 192 HWs working at Child Welfare Clinic (CWC) departments of 21 health facilities to a selfadministered questionnaire is used for analysis. In all, respondents responded to 31 questions which assess their knowledge levels on recommended daily feeding practices for various age groups of young children and the recommended age of introducing water and other foods. Some of the questions also evaluate their ability to interpret growth curves of children and carry out the required action(s) thereafter. Their knowledge levels are also assessed with respect to body-building, body-protective, energy-giving, calcium, iron and vitamin A rich food sources. Results: Some of the HWs (14.1%) did not know the appropriate age for introducing dairy foods to infants and few (7.8%) wrongly indicated that water should be introduced before 6 months of age. Only a small percentage of the HWs (6.8%) knew that non-breastfeeding children aged between 6 and 23 months should be fed 4 or more times daily. More than 80% of the HWs were unable to identify all the actions that should be targeted at each of the 5 growth patterns of children. Only 22.9%, 25.0% and 10.9% were able to mention at least three iron, vitamin A and calcium rich food sources respectively. About 83.9% and 90.6% of the HWs did not know absorption enhancers and inhibitors of iron-rich foods. Overall, a higher proportion (52.4%) of the surveyed HWs had an average score ranging between 50% and 69% whereas, only 6.5% had a good score of > 70%. Conclusion: The surveyed HWs demonstrated low knowledge on recommended child feeding practices, actions that should be targeted at the various growth patterns of children and the majority of the HWs did not know food sources of iron, vitamin A and calcium. This low level of knowledge jeopardizes the provision of high quality nutritional support by caregivers. It is recommended that the nutritional knowledge of HWs working in CWCs should be enhanced and updated accordingly, either by the regular participation in refresher or continuing education programmes that also focus on complementary feeding of children. The findings also suggest that HWs require more education on recommended growth promotion actions.