How can we really improve childcare practices in Nigeria?

Suboptimal care is an important risk factor for undernutrition and disease. Such care includes inappropriate breastfeeding (BF) and child-feeding practices and inadequate immunization and supplementation. Over the past several years, Nigeria has increased the availability of health workers and health facilities. The use of health services has also increased. However, this has not led to an improvement in childcare practices, and certain practices that are mediated through behavior change communication, such as BF, have even declined. This article presents the result of a study that identified potential reasons for the decline in these childcare practices. The study was conducted in a primary health-care center (PHC) in South Eastern Nigeria. A key informant interview was held with the Chief Matron of the PHC. The delivery of nutrition and health information to mothers was observed over a 3-month period, and 107 women completed questionnaires to document their knowledge and practice of appropriate childcare practices. The findings from this study show that both health worker and maternal factors may contribute to less than optimal childcare practices. Health workers had received training in nutrition and health education, but their delivery of information was inconsistent and unstructured. Moreover, many mothers who regularly utilized the PHC services, and were aware of adequate childcare practices, were not adopting the practices. These results underscore the need to improve existing behavior change communication channels, as well as identify the barriers to the utilization of the information provided.