Accuracy of maternal recall of birth weight and selected delivery complications in Zanzibar

Background: Birth weight is one of the key predictor for survival, health and future development of a child. In developing countries data on birth weights are limited to obtain due to difficulties in keeping records especially among rural women. Maternal recall of birth weight can therefore become a useful source of birth weight data. This study was carried out to determine recall of birth weight and delivery complications among mothers in Unguja West District of Zanzibar.Methods: This cross-sectional study involve mothers who had children below five years of age. Pretested structured questionnaire was used to collect information on socio-demographic characteristics of the mother, age of the child, birth weight of the child and delivery complications. Other information was obtained from maternal antenatal clinic and child’s growth monitoring cards. Results: A total of 260 women were included in the study. The mean age of the mothers was 29 years, ranging from 17 to 45 years. More than half (62%) had attained secondary education and few had informal education (6.5%) or post-secondary education (12%). Majority of the mothers (85%) delivered at the health facility assisted by trained health care provider. Those who delivered at home (15%) were either assisted by a relative or Traditional Birth Attendant (TBA). Over three quarters (78.5%) of the mothers had birth weights of their children recorded in the postnatal care cards. Out of 38 children who were born at home, 87% (n = 33) were not weighed and there were 23 women (10.4%) who delivered at the hospital but their children’s weight were not recorded. Overall, 46 (20%) mothers could not correctly recall birth weights of their children where. There was strong correlation between recall and recorded birth weight (r2=0.79; p<0.01). Reported/recorded delivery complications were hypertension, excessive bleeding, low birth weight, episiotomy, anaemia and preeclampsia.Conclusion: Maternal recall can provide reliable information with regard to child’s birth weight and delivery complications. Health facility staff should measure child’s weight correctly, inform the mother and record in the child’s card in order to facilitate correct recall by the mothers

Infant and young child feeding practices on Unguja Island in Zanzibar, Tanzania: a ProPAN based analysis

Background: Undernutrition in children has remained a challenge despite the success achieved in reduction of other childhood diseases in Zanzibar. Most empirical studies on infants and young child feeding (IYCF) have examined nutritional value of foods fed to the children in terms of energy and micronutrient content. Little is known on the role of culture, traditions and social norms in influencing IYCF practices. This study aimed at assessing the existing IYCF practices and socio-cultural factors influencing these practises using ProPAN tool to get an in-depth understanding of the mothers’ practices with respect to exclusive breastfeeding and infant and young child feeding.Methods: A cross sectional study involving mothers/caregivers was conducted using semi-structured interviews and opportunistic observations on Unguja Island, Zanzibar. A random selection of 36 Shehias and 213 households with children 0 – 23 months old was done proportional-to-size of Shehias and children. Quantitative and qualitative data were collected using the ProPAN tool and embedded software for analyses.Results: A total of 213 of mothers/caregivers were involved in the study. Almost all new-borns were fed colostrum (96%). Proportion of mothers who   initiated breastfeeding within one hour after giving birth was 63%. About 24% of the women practiced exclusive breastfeeding and 21% of the children were given pre-lacteal feeds 2-3 days after birth. The mean age of introduction of complementary foods was four months. Responsive feeding was not practiced by some mothers as 31% of the children 12-23 months of age were left to eat alone without any support from caregivers. The common reasons for non-adherence to the recommended feeding practices were related to income and socio-cultural norms which are strong in the community and supported by other family members.Conclusion: Infant and young child feeding in Unguja was suboptimal. Inadequate care practices, use of pre-lacteals, early introduction of complementary foods, low rate of exclusive breastfeeding and low meal frequency were among the common practices. The main causes of the observed feeding practice were related to socio-cultural norms and beliefs. There is a need to strengthen IYCF education into the antenatal clinic regime

Prevalence and Determinants of Undernutrition among 6- to 59-Months-Old Children in Lowland and Highland Areas in Kilosa District, Tanzania: A Cross-Sectional Study

Background. Undernutrition is the most dominant form of malnutrition among children in developing countries. Studies conducted in Tanzania have reported high levels of undernutrition among children below five years of age. However, there is limited information on differences in stunting prevalence across agroecological zones. This study aimed to determine the prevalence of undernutrition and its determinants in the lowland and highland areas in Kilosa District, Tanzania. Methods. A cross-sectional study was conducted in a sample of 200 randomly selected households from the lowland and 141 from the highland areas of Kilosa District in Morogoro Region, Tanzania. Sociodemographic, feeding practices, hygiene, and sanitation data were collected using a structured questionnaire. Weight and height of children were measured using a standard procedure, and age was calculated from the birth date obtained from the child growth card. Anthropometric data were analyzed by using Emergency Nutrition Assessment (ENA) software. The logistic regression model was used to explore the determinants of undernutrition. Results. Prevalence of stunting, underweight, and wasting was 41.0%, 11.5%, and 2.5% in lowland and 64.5%, 22.0%, and 1.4% in highland areas, respectively. The prevalence of stunting and underweight was higher in the highland compared to the lowland areas (p<0.001). Significant determinants of underweight were areas of residence (AOR 4.21, 95% CI: 1.62–10.9), age of the children (AOR 5.85, 95% CI: 1.81–18.97), and child birth weight (AOR, 4.98 95% CI: 1.65–15.05), while determinants of stunting were the area of residence (AOR, 2.77 95% CI: 1.43–5.36), maternal age (AOR, 0.33 95% CI: 0.14–0.79), sex of a child (AOR, 1.89 95% CI: 1.03–3.50), and child birth weight (AOR, 3.29 95% CI: 1.21–8.97). Conclusion. The prevalence of undernutrition, especially stunting and underweight, was high in the study areas. Determinants of stunting differed between highlands and lowland areas, highlighting the needs of having properly integrated interventions based on the geographical location