Supplementary feeding with fortified spread among moderately underweight 6-18-month-old rural Malawian children.

We aimed to analyse growth and recovery from undernutrition among moderately underweight ambulatory children receiving micronutrient-fortified maize-soy flour (Likuni Phala, LP) or ready-to-use fortified spread (FS) supplementary diet. One hundred and seventy-six 6-18-month-old individuals were randomized to receive 500 g LP or 350 g FS weekly for 12 weeks. Baseline and end of intervention measurements were used to calculate anthropometric gains and recovery from underweight, wasting and stunting. Mean weight-for-age increased by 0.22 (95% CI 0.07-0.37) and 0.28 (0.18-0.40) Z-score units in the LP and FS groups respectively. Comparable increase for mean weight-for-length was 0.39 (0.20-0.57) and 0.52 (0.38-0.65) Z-score units. Recovery from underweight and wasting was 20% and 93% in LP group and 16% and 75% in FS group. Few individuals recovered from stunting and mean length-for-age was not markedly changed. There were no statistically significant differences between the outcomes in the two intervention groups. In a poor food-security setting, underweight infants and children receiving supplementary feeding for 12 weeks with ready-to-use FS or maize-soy flour porridge show similar recovery from moderate wasting and underweight. Neither intervention, if limited to a 12-week duration, appears to have significant impact on the process of linear growth or stunting

Complementary feeding with fortified spread and incidence of severe stunting in 6- to 18-month-old rural Malawians.

OBJECTIVE: To compare growth and incidence of malnutrition in infants receiving long-term dietary supplementation with ready-to-use fortified spread (FS) or micronutrient-fortified maize-soy flour (likuni phala [LP]). DESIGN: Randomized, controlled, single-blind trial. SETTING: Rural Malawi. PARTICIPANTS: A total of 182 six-month-old infants. INTERVENTION: Participants were randomized to receive 1 year of daily supplementation with 71 g of LP (282 kcal), 50 g of FS (FS50) (256 kcal), or 25 g of FS (FS25) (130 [corrected] kcal). OUTCOME MEASURES: Weight and length gains and the incidences of severe stunting, underweight, and wasting. RESULTS: Mean weight and length gains in the LP, FS50, and FS25 groups were 2.37, 2.47, and 2.37 kg (P = .66) and 12.7, 13.5, and 13.2 cm (P = .23), respectively. In the same groups, the cumulative 12-month incidence of severe stunting was 13.3%, 0.0%, and 3.5% (P = .01), of severe underweight was 15.0%, 22.5%, and 16.9% (P = .71), and of severe wasting was 1.8%, 1.9%, and 1.8% (P > .99). Compared with LP-supplemented infants, those given FS50 gained a mean of 100 g more weight and 0.8 cm more length. There was a significant interaction between baseline length and intervention (P = .04); in children with below-median length at enrollment, those given FS50 gained a mean of 1.9 cm more than individuals receiving LP. CONCLUSION: One-year-long complementary feeding with FS does not have a significantly larger effect than LP on mean weight gain in all infants, but it is likely to boost linear growth in the most disadvantaged individuals and, hence, decrease the incidence of severe stunting

Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi

Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children

Asiakaskokemus mobiiliapplikaatioissa

Asiakaskokemuksesta on kehittynyt yrityksille keskeinen kilpailuedun lähde, ja näin ollen vallitsevilla markkinoilla erinomaiset tuotteet tai palvelut eivät enää riitä. Samalla teknologian kehityksen myötä ym-päristömme on muuttunut monikanavaiseksi, jolloin asiakkaat ovat yhteydessä yritykseen monien eri kanavien kautta. Lisäksi kohtaamispisteiden määrä asiakaspolulla on kasvanut merkittävästi. Kehityksen seurauksena mobiilikanavaa on alettu hyödyntämään runsaasti, ja asiakkaat ovat omaksuneet sen käytön osaksi arkipäivää. Haasteeksi nykyisessä ympäristössä nousee ainutlaatuisen asiakaskokemuksen tarjoa-minen kaikissa yrityksen kanavissa. Miten yritykset pystyvät tarjoamaan ainutlaatuisen kokemuksen myös mobiilissa, joka eroaa ominaisuuksiltaan perinteisistä kanavista? Tämän tutkielman tarkoituksena on selvittää, miten johtaa asiakaskokemusta mobiilissa asiointiympäristössä. Tutkielmassa keskitytään erityisesti mobiiliapplikaatioiden asiakaskokemukseen. Toinen ja kolmas luku muodostavat tutkimuksen teoreettiseen viitekehyksen. Teoria luo ymmärrystä asiakaskokemuksen käsitteestä ja sen muodostumisesta sekä mobiiliympäristöstä ja sen keskeisistä ele-menteistä. Tutkimuksen empiirisessä osiossa analysoidaan kuluttajien mobiiliasiakaskokemuksia ja esite-tään niiden pohjalta kehitysehdotuksia. Tutkimus toteutettiin laadullisena tutkimuksena teemahaastatte-luiden avulla. Haastattelut toteutettiin lumipallomenetelmällä ja yhteensä niitä tehtiin 10 kappaletta. Mobiiliasiakaskokemusta tulee johtaa yhtenäisesti muiden kanavien kanssa. Kanavien tulee integroitua toisiinsa, jotta yrityksen on mahdollista vastata asiakkaiden odotuksiin saumattomasta kokemuksesta. Nykyisessä ympäristössä asiakkaat käyttävät mobiiliapplikaatioita monipuolisesti asiakaspolun varrella ja ovat halukkaita käyttämään sitä yhä enemmän. Kokemuksen johtamisessa tulee huomioida kuitenkin mobiiliympäristölle keskeiset elementit. Mobiili on luonteeltaan henkilökohtainen, interaktiivinen sekä välitön, mikä mahdollistaa ainutlaatuisen kokemuksen tarjoamisen. Mobiiliapplikaatioissa kokemuksen muodostamiseen vaikuttavat utilitääriset teknologiset tekijät, koettu nautinto sekä ajankäyttö. Yrityksen on tärkeää huomioida nämä tekijät, jotta kokemus johtaa applikaation jatkuvaan käyttöön

Perceptions and experiences of community members on caring for preterm newborns in rural Mangochi, Malawi: a qualitative study

Background The number of preterm birth is increasing worldwide, especially in low income countries. Malawi has the highest incidence of preterm birth in the world, currently estimated at 18.1 percent. The aim of this study was to explore the perceived causes of preterm birth, care practices for preterm newborn babies and challenges associated with preterm birth among community members in Mangochi District, southern Malawi. Methods We conducted 14 focus group discussions with the following groups of participants: mothers (n = 4), fathers (n = 6) and grandmothers (n = 4) for 110 participants. We conducted 20 IDIs with mothers to preterm newborns (n = 10), TBAs (n = 6) and traditional healers (n = 4). A discussion guide was used to facilitate the focus group and in-depth interview sessions. Data collection took place between October 2012 and January 2013. We used content analysis to analyze data. Results Participants mentioned a number of perceptions of preterm birth and these included young and old maternal age, heredity, sexual impurity and maternal illness during pregnancy. Provision of warmth was the most commonly reported component of care for preterm newborns. Participants reported several challenges to caring for preterm newborns such as lack of knowledge on how to provide care, poverty, and the high time burden of care leading to neglect of household, farming and business duties. Women had the main responsibility for caring for preterm newborns. Conclusion In this community, the reported poor care practices for preterm newborns were associated with poverty and lack of knowledge of how to properly care for these babies at home. Action is needed to address the current care practices for preterm babies among the community members.BioMed Central open acces