Evaluation of the effect of PD/Hearth Model on Chilren 6 - 59 months and caregivers:

Abstract

Malnutrition is the major cause of mortality in children below five years, accounting for up to 60% of the mortality. Although health facility or institutional based approaches have been used to prevent or rehabilitate malnutrition in Uganda, their effect has not been comparably felt in the rural areas where facilities are not well equipped or are non existent. The main objective for conducting this study was to evaluate the effect of PD/Hearth model on children 6-59 months and caregivers in Zirobwe Sub-county, Luwero district.

Methodology The study was a descriptive cross sectional survey where 101 PD/Hearth children aged 6-59 months and 101 PD/Hearth caregivers were considered. The effect of PD/Hearth model was evaluated by considering outcome variables of weigh for age (WFA) change of children and caregivers’ practices. Both qualitative and quantitative methods were used to analyze data.

Results The median age of children was 37 months, majority (46%) of the children weighed 13-15 kilograms. 92% 0f children were well-nourished (WAZ>-2 SD) at the time of the survey. 89% of mothers reported practicing exclusive breastfeeding for the first six months. Majority (94%) of children who were breastfed exclusively up to six months were significantly well nourished (p=0.040). 87% of caregivers started complementary feeding at 6 months. 65% feed their children four times and/or more a day. Children who were fed at least four times a day were significantly well nourished (p=0.032). 96% of caregivers give their children snacks in between main meals. 80% of caregivers increase the amount of fluids given to their children when they get diarrhea. Majority (94%) of children whose mothers could give more drinks/fluids during a diarrhea attack were significantly well nourished (p=0.024). Only 36% of caregivers increase the frequency of breastfeeding when the breast milk is not enough for the child. 94% of children whose mothers increased the frequency of breast feeding in case breast milk was not enough were significantly well nourished (p=0.045). 82% of caregivers thought food is the most important need a child needs. Almost all (95%) children whose caretakers thought enough food is the most important need a child needs were significantly well nourished (p=0.043). Only 28% of caregivers desired to have 1-4 children. Caretakers who desired one to four children, majority (96%) of their children were significantly well nourished (p=0.046). 90% of caregivers desired to use a modern method of family planning. Caretakers who desired to use a method of family planning had a significantly higher proportion (93%) of children well nourished (p=0.020). 94% of children had completed immunization schedule. Majority (95%) of children who completed the immunization schedule were not significantly well nourished (p=0.067). 90% of caregivers sought medical care within 24 hours when their children were ill. 95% of children whose caretakers sought medical care within 24 hours in case the child gets sick were significantly well nourished. 79% of caretakers knew how to locally prepare ORS. Caretakers who knew how to prepare homemade ORS had a significantly higher proportion (93%) of their children well nourished.

Recommendation There is need for a monitoring process by Luwero district authoriries to ensure such adopted practices continue to be practiced by caregivers of children below five years in Zirobwe Sub County. Luwero district health authorities should embrace and prioritize this model and include it in the Primary Health Care programs for prevention and management of malnutrition in children under 5 years. This approach should be adopted by Luwero district Health authorities to improve health seeking, childcare and feeding practices of caregivers in other sub counties where this model was not enrolled. Ministry of Health should adopt and scale up this model in all areas of Uganda having a problem of malnutrition