Comparative Study of Growth Monitoring & Promotion of Children with Special Care (IYCF Counseling) and without Special Care

Abstract

This comparative study was conducted to see the challenges and impact of counselling of Infant and Young Child Feeding (IYCF) to the mother’s knowledge and the practices of the mother from case group and control on best IYCF interventions, mainly targeted the behavioral change of the mother and to see the effect on the nutritional status of the children under 2 years. A total of 353; 177 mother of case group for counselling and 176 of control group for non-counselling, eligible mothers having children 0-11 months were approached with the purpose of study and informed consent was obtained from the mothers. Then all 177 mothers from case group received IYCF counseling according to the need of mothers as well as on key IYCF messages. At the same time the 176 mothers from control group didn’t receive any kind of IYCF support and counselling, they received only regular health services counselling and messages on IYCF. IYCF practices have a great impact on the physical and mental development of the child. The objective of this study was the lactating mothers with the children in the age group 0-11 months were studied and delivered IYCF counseling according to their need basis as well as key IYCF messages from case group and at the same time mothers from control group would not receive any kind of message from study and they would receive only regular health program messaging. Low percentage of mothers from the case group had knowledge on early initiation of breast feeding within one hour after birth, the exclusive breast-feeding up to 6 months. Timely initiation of complementary feeding after 6 months (61,0%, 58.7%, 61.6% & 55.4% respectively) before IYCF counselling to mothers. After IYCF counselling to the mothers of case group, they motivated and learnt to early initiation of breast feeding within one hour after birth, the exclusive breast-feeding up to 6 months. Timely initiation of complementary feeding after 6 months (79.1%, 75.7%, 75.2% & 65.5% respectively). For control group the results were 61.9%, 65.3%, 65.9% & 63.6% respectively before study and 66.5%, 67.7%, 66.8% & 64.1% after the study. The study result showed that the impact of IYCF counselling and messaging on the mother knowledge was great and it changed the knowledge level of the mother in dramatic way. The percentage of mothers from the case group & the control group those had children over 6 months practiced the exclusive breast-feeding were (60.2% & 73.5%) before study. After IYCF counselling to the mothers of case group, they motivated and changed their attitude to ensure the exclusive breast feeding for their children (73.5% and 73.9% from case and control group respectively). Before the study Minimum Dietary Diversity (MDD) was observed in only 30.3% & 36.6% respectively from case and control group for the children between 6- and 11months age group and after IYCF counselling mothers from the case group improved their practice for MDD for their children aged 6-23 months and increased to 39.0% in case group and in control group improved to 37.3%. Minimum Meal Frequency (MMF) was observed in the majority (63.6%) of children aged 6–23 months before the study and after IYCF intervention it increased to 74.6% in case group. But in Control group it changed from 72.6% to 73.1%. The indirect effect of IYCF counselling on the nutritional status of the children who are benefited from the improved mother knowledge and practices to good practices. Before the controlled comparative study, the GAM rate of the children was 21.1% & 20.3% respectively for case & control group of wasting (WHZ) and after study it was 20.1% & 20.3% respectively for case & control group. The same happened for underweight (WAZ) & stunting (HAZ). They also changed from 36.9% to 35.4% and 45.4% to 43.8% for underweight & stunting respectively. The IYCF practices are strongly influenced by what people know, think and believe and also affected by social circumstances and economic factors. Effective communication for behavioral change is necessary for ensuring optimal infant and young child feeding. Awareness regarding IYCF practices and their benefits in Maternal and Child Health (MCH) is poor leading to poor compliance. It is important to educate mothers during the antenatal visits. This study showed same impact as stated above.