Improvement in dietary diversity and feeding habits of malnourished under-five children attending supplementary feeding programmmes: a community-based cross-sectional study in Zambia

Abstract

A community-based cross-sectional study was conducted on 390 under-five malnourished children enrolled in the Rainbow Project supplementary feeding programmmes-SFPs. Dietary diversity, feeding habits and nutritional status at admission (T1) and at discharge (T2) were compared. At T1 the diet was monotonous and unbalanced, with a progressive decline in dietary diversity and anthropometric values noted with children’s age growth (p < 0.001). Significant improvements were registered at T2: DDS 5.1 ± 1.1 SD vs. 8.3 ± 1.0 SD; meal frequency 3.0 ± 0.6 SD vs. 4.9 ± 0.2 SD; animal-protein consumed 62.8% vs. 90.5%; drinking water treated 41.0% vs. 97.2%. At T1, the risk of having ZMUAC < 2.5SD increased when teenage motherhood (AOR: 5.3; CI: 1.8–15.2; p = 0.002), followed by children’s age >2 years (AOR: 1.9; CI: 1.1–3.5; p = 0.020). Children’s age was associated with an increased risk of WAZ < 2.5 SD (AOR: 4.9; CI: 2.4–10.4; p < 0.001). When considering inadequate DDS, the variable associated was breastfeeding cessation (AOR: 12.0; CI: 4.6–31.4; p < 0.001). Rainbow’s SFPs have proved effective in treating under-five malnourished children, irrespective of the severity of malnutrition.

Keywords:

• Under-five child malnutrition
• dietary diversity
• feeding habits
• supplementary feeding programmes
• Zambia

Acknowledgements

The authors acknowledge, with gratitude, all the children and their guardians who assisted in SFPs during these years of work. The authors thank the Association Pope John the 23rd and all the operators and volunteers of NGOs/CBOs involved in the nutritional programme for their tremendous job in the community. The authors are particularly grateful to Elisabetta Garruti and Gloria Gozza for project management, guidance and support. A special thanks to Maxildha Mushoke for the supervision of Rainbow nutritional programmes in the field. We would also like to thank the Ndola District Health Office for their constant support and advice.

Disclosure statement

No potential conflict of interest was reported by the author(s).