Child Care Practices and Nutritional Status Effect of Child CarePractices on Nutritional Status of Children 0-5 Years Old in BoramaTown, Somaliland

Abstract

ABSTRACT
The study investigated the effect of child care practice on nutritional status of children 0-5 years old in Borama town, Somaliland. Child care practices are complex set of behaviors that range from child feeding practices to responses that promote a safe and healthy environment for the child, nutritional status is a status which is determined by a child’s health after physical examination and anthropometric measurements. Globally in 2015, about 7.7% of children were wasted, 24.5% were stunted and 15% were underweight. The African region and South-East Asia have reported the highest prevalence of under nutrition, with the former accounting for about 39.4% of the stunted, 24.9% of the underweight and 10.3% of the wasted children below 5 years of age. In Somaliland,
the prevalence of moderate acute malnutrition among children 0-5 years old suddenly increasing. It increased from 21.9% in2016 to 34% in 2017, and 44.8% in 2018.In Borama town, the proportion of moderately malnourished children increased from23% in 2016 to 37.3% in 2017 and from 37.3% to 44.8% in 2018 .This reflects a general increase of 33.3% in 3 years, or an increase 11.1% per year in moderate acute malnutrition, which has resulted in increased cases of death among children under five years within the study area by 0.5% in 2016 to over 2% in 2018 Guided by the theory of Health Belief Model developed by Ronsen stock in 1950.The study used cross-sectional survey design .The study used stratified, simple random and purposive sampling methods; on sample of 196 children attending four MCHs in Borama town on February 2019 The study found that sanitation significantly decrease the odds of child developing
malnutrition within the study area by 26%, OR= .074 confidence interval of 1.011-1.142, p= 0.021.the study also found that socioeconomic characteristics of the mother insignificantly increase the odds of child developing malnutrition within the study area by 1.1%, OR= 1.011, confidence interval, 0.992-1.029, p= 0.260. Furthermore, the study found that feeding practices significantly decrease the odds of child developing malnutrition in the study area by 7%, OR=0.930, 95% confidence interval of 1.004-1.084, p=.031. First the researcher recommends that ministry of health should increase community awareness of importance of sanitation and encouraging the community weekly campaign of garbage collection from the different parts of the town. Ministry of health together with nongovernmental health organizations should plan training on promoting knowledge, attitude and practices of mothers on proper disposal
household refuses. Secondly the researcher also recommends that the policy by the government should be enacted to allow working mothers to have more time to care their children. The government should also create a policy to encourage child spacing since house hold size is one of the elements of mother’s socioeconomic characteristics and the majority of mothers within the study area had 5-7 children. The researcher recommends that the government other health and nutrition working organizations should create strategy to strengthen mothers’ feeding practices behavior to their children. Health and nutrition workers should come up with strategies to ensure that children discharged from nutrition treatment programs are followed up periodically and their nutritional status documented to enhance timely identification of possible relapse cases.