Caractérisation de l’alimentation des jeunes enfants âgés de 6 à 36 mois en milieu rural et urbain du Sud– Bénin

Objectif: La période d’alimentation complémentaire est une période critique pour la croissance de l’enfant. Cette étude vise à décrire l’alimentation des jeunes enfants âgés de 6 à 36 mois en milieu rural et urbain du Sud-Bénin.Méthodologie et Résultats: Une enquête transversale a été menée sur 600 mères ayant des enfants âgés de 6 à 36 mois dans les zones rurales et urbaines du sud-Bénin, où la prévalence de la malnutrition chronique est élevée (prévalence variant de 40 % à 43 %). Les caractéristiques socio-économiques de la population, les connaissances (définition correcte de l'alimentation complémentaire) et les pratiques (âge d'introduction de l'aliment de complément, les caractéristiques des aliments de complément) ont été documentées. L'analyse en composante principale a été utilisée pour identifier les associations entre les caractéristiques socioéconomiques de la population et les pratiques d’alimentation des jeunes enfants de 6 à 36 mois. Dans l’ensemble, 65% des mères méconnaissent la notion d’alimentation complémentaire. L’introduction précoce des aliments de complément est observée dans 48.5% des cas. La bouillie dans 99.16% des cas est le premier aliment de complément donné aux enfants. Globalement, 67% des mères utilisent des bouillies locales, peu enrichies avec des matières protéiques. La consommation de bouillie issue des farines infantiles vendues dans le commerce est associée au milieu urbain alors que la bouillie locale est associée au milieu rural.Conclusion et application des résultats: Les bouillies locales sont peu enrichies avec des matières protéiques et les fréquences de consommation journalière sont faibles. Ces résultats révèlent l’importance d’améliorer les procédés et formulations traditionnelles des bouillies, stratégies endogènes durables qui méritent d’être encouragées par l’éducation nutritionnelle pour la production de bouillies enrichies à haute valeur nutritionnelle avec des matières premières locales accessibles pour couvrir les besoins nutritionnels et énergétiques des jeunes enfants, gage d’une croissance optimale.Mots clés: Alimentation, enfants de 6 à 36 mois, bouillies, BéninEnglish Title: Characterization of the feeding of young children aged 6 to 36 months in rural and urban areas of the South BeninEnglish AbstractObjective: The period of complementary feeding is a critical period for the growth of the child. This study aims to describe the feeding of young children aged 6 to 36 months in rural and urban areas of the South Benin.Methodology and Results: A cross sectional survey was conducted on 600 mothers having children aged 6 to 36 months in rural and urban areas of the South Benin, where the prevalence of chronic malnutrition is high (prevalence between 40% to 43%). The socio economics data, knowledge (correct definition of complementary feeding) and practices (age of introduction of Complementary Foods, characteristics of Complementary Foods) were collected. Analysis of principal component was used to identify the associations between the socio economics data and feeding practices for 6 to 36 months’ young children. About, 65% of mothers ignore the concept of complementary feeding. The early introduction of complementary foods was observed in 48.5% of cases. Porridge in 99.16% of cases is the first complementary food given to children. Overall, 67% of mothers use local porridges slightly enriched with protein feeds. Porridge based on commercial infant flour consumption is associated with the urban area while local porridge is associated with rural areas.Conclusion and application and results: Local porridge is poorly enriched with protein feeds in rural areas and the frequencies of daily consumption are low. These results reveal the importance of improving the processes and traditional formulations of local porridges. Sustainable strategies that need to be encouraged by mothers ‘nutritional education for the production of enriched porridges with high nutritional value and local raw materials accessible in order to cover the nutritional requirements and energy need of young children, pledge of an optimal growth.Keywords: feeding, children of 6 to 36 months, porridges, Beni

Determining factors associated with breastfeeding and complementary feeding practices in rural Southern Benin

This study aimed at characterizing breastfeeding and complementary feeding practices in a food-insecure area of Benin and identifying factors associated with these practices. A cross-sectional study was conducted in the districts of Bopa and Houéyogbé among n = 360 mother–child pairs. Children aged 0–17 months were considered. Socioeconomic characteristics among children and mothers, Breastfeeding on demand, Breastfeeding frequency during children illness, and Positioning and Attachment of children while breastfeeding were assessed using semi-structured interviews and observations. Qualitative 24-hr recalls were administered to mothers to compute WHO recommended complementary feeding practices indicators namely minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) among 6–17 months old children (n = 232)

Weight Loss and Nutritional Status of 6-59 Months Children after Positive Deviance/Hearth Approach in Southern Benin Rural Area: Associated Factors to Later Underweight

Aims: To appreciate the evolution of weight gain by malnourished children and factors associated to children underweight after the Positive Deviance/Hearth sessions. Study Design: Longitudinal study. Place and Duration of Study: Districts Ze and Lalo (Southern Benin), from May to August 2014 Methodology: This study was conducted on 98 children aged of 6-59 months who fully participated in Positive Deviance/Hearth (PD/H). During one month, four measurements of weight have been taken on the 77th, 84th, 91th, and 98th day after the beginning of PD/H. Questionnaire was administered to mother on environmental, hygiene practices, and food accessibility of household. Relation among factors of food accessibility, household hygiene, and child nutritional status was sought by an Analysis of Factorial Components. Results: The children who participated in 12 days of PD/H gained significantly 0.63 kg and 1.13 kg of weight in Lalo and Ze respectively (P<.001). From the 12th to 77th day after the end of PD/H, we noticed a significant weight loss from 10.54 to 10.09 kg in Ze and from 9.75 to 9.19 Kg in Lalo (P=.003). Prevalence of underweight children on the 77th day was 45.8% with 12.5% of severe case and 63.5% with 18.9% of severe case in Lalo and Ze, respectively. The severe underweight children were characterized by households where i) it rarely arrived to be without food ii) one member rarely have a day without eaten but iii) the drinking water is from well. Conclusion: On the 77th day after the PD/H, the children of our study had weight loss. Food accessibility and household hygiene are mainly the limited factors that could explain the degradation of the nutritional status of children and high prevalence of underweight. This first study conducted in Benin on PD/H approach is more exploratory and helps to appreciate this approach efficacy and sustainability

Dietary diversity predicts the adequacy of micronutrient intake in 6- to 23-month-old children regardless of the season in rural Southern Benin

Background: The Infants and Young Children Dietary Diversity Score (IYC-DDS-7) has been validated to assess dietary quality in children. However, its applicability to predict the adequacy of micronutrient intake remains a challenge in all contexts. Design and Methods: A 24-hour dietary recall assessment was conducted on a sample of 628 children aged 6 to 23 months in the plenty season (PS) as well as in the lean season (LS). The IYC-DDS-7 was calculated based on 7 food groups, whereas the mean micronutrient density adequacy (MMDA) for 11 micronutrients. The β regression models were used to assess the relationship between IYC-DDS and MMDA and differences in nutrient intake between the 2 seasons. A receiver-operating characteristic curve analysis was also performed to determine IYC-DDS-7 cutoff levels that maximized sensitivity and specificity in assessing dietary quality and predicting MMDA below- or above-selected cutoff levels. Results: Participating children’s MMDA was 56.9% ± 12.8% versus 61.9% ± 8.6% and IYC-DDS-7 was 3.43 ± 1.5 versus 3.77 ± 1.0 in the PS and LS. The IYC-DDS-7 had a positive correlation with MMDA, irrespective of the season. For a 1-unit increase in IYC-DDS-7, MMDA increased by a mean of 10.7% (CI, 8.3%-13.1%; P < .001). The minimum threshold of the 4 food groups corresponded to a sensitivity of 76% and 61% and a specificity of 75% and 70% for the prediction of inadequate diet in the PS and LS, respectively. Conclusions: The IYC-DDS-7 predicted MMDA, regardless of seasons for infants and young children. The IYC-DDS-7 cutoff of 4 groups performed well in classifying children with low-diet quality

Local knowledge of agricultural biodiversity and food uses of edible plant species in two agroecological zones of southern Benin

Locally available food plants are not only a good source of essential micronutrients but also provided culturally acceptable foods. Their evaluation could be a sustainable strategy that can effectively meet the nutrient requirements for vulnerable groupsin rural areas. They are therefore of great importance in ensuring food security in low-and middle-income countries. Several communities in Benin depend mainly on indigenous food sources especially plant species. An ethnobotanical survey was conducted in southern Benin to document the edible plant species (EPS) used by people living in two agroecological zones (AEZ 6 and AEZ 8). Field investigations were carried out in eight villages of the two agroecological zones, with four villages per agroecological zone. Data were collected through focus group discussions (FGDs) and analyzed using descriptive statistics. A total of 146 edible plant species belonging to 46 families were recorded and herbarium specimens were collected and deposited at the national herbarium of Benin. Species diversity was lower in AEZ 6 compared with AEZ 8. Herbs and shrubs were the dominant plant habits, with leaves and fruits (arils, flesh, pulp) as the most reported plant parts that were consumed mainly as leafy vegetables or fruits. The study area harbors an important plant diversity with high nutritional potential. Nutrient-dense leafy vegetables and fruit species were dominant. This represents an opportunity that could be used to improve the diet quality and food security in the study area. However, the locally available food plant species remain undervalued

Towards adequate food environment in Benin public primary schools, the challenge of food supply and hygiene practices: a case study of three municipalities

Background and aim: School food environment is a component of food system which provides the opportunity to implement interventions that lead to better nutrition. This study aimed to describe two of the five components of food environment notably food supply and food safety through hygiene practices in schools inside Cotonou, Abomey-Calavi and Sèmè-Kpodji, in Benin country. Methods: Twelve schools were randomly selected from a sampling frame of all public primary schools with canteens and that have space for school gardens and closer to the market garden sites. In the selected schools, we assessed the diversity of the Food Supply using Food Group Score (FGS) and Hygiene practices using the Summary Hygiene Index (SHI). Data were mainly collected using semi-structured questionnaire administered to foods cookers/ vendors and by observation within schools. Fifteen food groups were considered to determine the FGS and 15 for SHI. Wilcoxon test was used to compare scores among urban and peri-urban areas. Results: Food supply appeared to be limited in 9 schools (FGS< 8) over the 12 with no significant difference between periurban and urban zone (p-value = 0.72). The most represented food group which was available in all schools are cereals, legumes, nuts, seeds, followed by sweet foods and drink while others groups (source of vitamin A and micronutrients) are poorly represented. It appears in all schools a low variability of food within each group. Basically, 8 schools out of 12 have a SHI lower than the median score (08) and the urban zone has a SHI (SHI = 9.5 ± 1.29) higher than peri-urban (SHI = 6.5 ± 1.18) with p-value = 0.015. Conclusions: The food supply is not very diversified in public primary schools and hygiene practices need to be improved for a healthy food environment around schools

Evidence-informed decision making for nutrition: African experiences and way forward

Although substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises proceedings of a symposium on how evidence can guide decision makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learnt from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated strong interest for partnership between researchers and decision makers, and use of research evidence for prioritisation and decision making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations and evidence contextualisation. Investing in knowledge partnerships and development of capacity and leadership are key to drive appropriate use of evidence in nutrition policy and programming in Africa

Assessment of the potential of sauces accompanying staple foods in Benin to meet Vitamin A requirements of young children.

L'identification et l'amélioration du potentiel pro-vitaminique A des sauces accompagnant les aliments de base pourraient constituer une voie alimentaire de lutte contre la carence en vitamine A (CVA) chez les jeunes enfants au Bénin. La qualité nutritionnelle et la rétention en provitamines A des sauces lors des procédés traditionnels de préparation ont été évaluées au moyen d'une démarche itérative terrain et laboratoire. Une enquête de consommation alimentaire par pesées et mesures anthropométriques auprès de 420 enfants a permis d'évaluer l'état nutritionnel des sujets et l'adéquation des apports en fer, zinc et vitamine A (VA) et d'identifier les principales sources de VA dans l'alimentation. La mangue, les œufs, l'huile de palme rouge (HPR) ou diverses sauces légumes-feuilles (LF) constituent les principaux aliments locaux riches en VA consommés (34,2% des enfants enquêtés). Lorsqu'elles sont consommées, les sauces participent à la couverture de 71 à 129% des apports journaliers recommandés en VA des jeunes enfants. Le suivi au niveau ménage des procédés traditionnels de préparation des sauces les plus prometteuses notamment les sauces LF-amarante à base d'HPR ou de jus de noix de palme (NP), a permis d'identifier les traitements thermiques appliqués aux LF, aux NP ou à l'HPR comme des étapes critiques. Le chauffage de l'HPR à 180-200°C apparaît comme l'étape la plus préjudiciable à la VA. Elle réduit de plus de 70%, et en moins de 3 min, les teneurs en α-carotène, en β-carotène et en activité équivalent rétinol (AER). La violaxanthine, caroténoïde non pro-VA est le seul composé significativement affecté lors du blanchiment des feuilles d'amarante (100°C) mais l'AER reste élevée avec ou sans ajout de potasse traditionnelle. Les sauces formulées à base des ingrédients LF-amarante, NP ou HPR présentent une bonne acceptabilité, une AER élevée et leur consommation pourrait être promue avantageusement dans le cadre d'approches alimentaires de lutte contre la CVA.The identification and the improvement of the potential in pro-vitamins A of sauces accompanying staple foods could constitute a food-based approach for combating vitamin A deficiency (VAD) among young children in Benin. The nutritional quality and the retention of pro-vitamins A in sauces during traditional home processing has been assessed by using a field-laboratory iterative approach. Anthropometric measurements were used to appreciate subjects' nutritional status. A food consumption survey of 420 young children was conducted to assess the adequacy of iron, zinc and vitamin A (VA) intakes, and to identify the main VA-rich foods eaten by children using the weighed food record method. Mangoes, eggs, red palm oil (RPO), various leafy vegetables (LV) and palm nut juice sauces appeared to be the main VA-rich foods consumed by 34.2% investigated children. When consumed, these LV sauces containing RPO or palm nut juice (PNJ) contributed to the meeting of 71-129% of the recommended VA intake of young children. The traditional processing method of the most promising sauces such as amaranth leaf sauces based on RPO or PNJ was monitored step by step during home visits and allowed identifying the thermal treatments applied to LV, to palm nut or to RPO as critical steps. Heating the RPO at 180-200°C appears as the more prejudicial step to VA. It decreased more than 70% and in less than 3 min, α-carotene, β-carotene and Retinol Activity Equivalent (RAE) contents. Violaxanthin, a non pro-VA carotenoid, was the only compound to be significantly affected by the thermal treatment (100°C) of amaranth leaves. RAE remained high after blanching even when alkaline traditional potash was added. The formulated sauces on the basis of the ingredients LV-amaranth, palm nut or RPO present a good acceptability, a high RAE and their consumption could be promoted favorably in food-based strategies to alleviate VAD

Characterization and challenges of food environments of children-under-five in north Benin drylands

Food environments play a crucial role in children's diets by influencing households' supply and access to nutritious foods. By gaining insight into the food environments, there is a potential to design better interventions to reduce the burden of children's malnutrition. However, in the African drylands, data on food environments are limited. This study aims to characterize the current food environments of children-under-five in north Benin drylands. To achieve this, we conducted individual interviews with key informants (n=11) to identify relevant actors and villages for data collection. Focus group discussions (n=12) were then conducted to capture information on the existing foods. Furthermore, we examined markets, shops, and domestic stalls (n=17) to obtain information on the prices of food sold, their properties, and promotional activities related to their sale. Descriptive statistics and multiple correspondence analysis were performed to describe the dimensions and clusters of the food environments, as well as the types of food environments present and the challenges associated with accessing nutritious foods.The study identified a total of 94 foods, which were categorized into four clusters. Clusters 1 and 2 relate to seasonal foods, foods obtained from agriculture, livestock, or forests, and foods available year-round in local markets. In contrast, Clusters 3 and 4 relate to packaged and imported foods that are available year-round in shops and pharmacies. These findings indicate that the food environment in the study area is in transition, featuring both natural and informal market types. The challenges related to accessing nutritious foods include the affordability of processed nutritious foods from the informal market type, as well as the continuous supply of nutritious food from the natural food environment type. Addressing these challenges will require the development of food policies and new interventions and study aimed at improving the external dimensions of the food environment

Association between poor food production and intimate partner violence among smallholder farmers in northwestern Benin

Rates of intimate partner violence (IPV) remain concerningly high in Benin, particularly in the predominantly rural region of Atacora in the northwest. In the context of increasing food insecurity, concerns have been raised regarding the role that lack of food in the household may be playing in increasing the rate of IPV in this context. This study aims to investigate the association between household food production and IPV in Atacora, Benin. Using a social ecological model and drawing from family stress theory, we analysed data from a cross-sectional survey of 300 women in the study region. Logistic regression and sequential modelling results show that after controlling for individual, household and community level factors, insufficient food production is positively associated with women’s likelihood of experiencing physical (adjusted OR=6.50 [2.48, 17.04], p < .01) and sexual violence (adjusted OR=4.49 [1.68, 11.99], p < .01). We conclude that production-oriented interventions in rural farming communities may reduce women’s risk of IPV by increasing households’ access to food and reducing family stress. Long term interventions would do well to focus on improving women’s access to land and building capacity in the management of marital conflict without violence