The Impact of Infant/Child living Condition on feeding pattern and growth path way for children aged below six years in Lusaka urban:a retrospective cohort study

Abstract

The proliferation in institutional care facilities for children makes it increasingly imperative to understand the exact nature of services that these facilities provide and the impact they hove on children. Although residential care of young children has been cyclically embraced as a promising alternative for children in foster care, there has been grovving concern about its impact on children, especially the young ones below the age of six years.The study sought to determine the impact of residential care on infant feeding and growth patterns for children aged below six years in Lusaka Urban. A retrospective cohort study was used. Ethical clearance for the study was given by the University of Zambia Research Ethics Committee. Permission to undertake the study was granted by the Graduate Committee and the Department of Community Medicine. Study cohorts comprised 140 children aged below six years, who lived under residential care, in Lusaka Urban. The comparative non-exposed group was composed of the some age-group of 140 young children, in the same catchment area but these were home based; they lived in the community proxy to the sampled resident child care institutions. A structured questionnaire was administered to the randomly selected children's caregivers for both the control and study cohorts. Stratified random sampling method was used to select study participants.The coded data was entered into a computer using Epi data. SPSS version 11.0 and Epi Info version 3.5.1 were concurrently used for data analysis. Steps in the analysis of processed data included: descriptive analysis of background variables; establishing incidence rates between study and control cohorts to the suspected factor; and identification of confounding factors. After adjusting for the confounding factors, if any, the Relative Risk (RR) and 95 percent confidence intervals (CI) ore reported. A p-value of less than five percent indicated statistical significance. Evidence from the study showed that the impact of infant/child living condition on child survival prospects was only significantly associated with one out of the five child development outcomes investigated, namely: infant/child feeding pattern for the first six months of life. Young children who were under residential care were more likely to be appropriately fed than those who were home-based (RR = 0.80, 95 % CI 0.66, 0.96). In essence, intensification of feeding counseling and integrated growth monitoring promotion were required for caregivers under both modes of care, but more so for children who were home-based.