Nutritional Challenges Among Children Under Five in Limpopo Province, South Africa: Complementary Feeding Practices
Tshilidzi Mafhungo1, Lindiwe Priscilla Cele1, Mmampedi Mathibe1
1Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa 0208, South Africa.
Insights
Poor complementary feeding and low dietary diversity are linked to malnutrition in children under five in Limpopo Province. Interventions are needed to address these nutritional challenges and improve child health outcomes.
Area of Science:
- Public Health
- Nutrition Science
- Pediatrics
Background:
- Malnutrition, encompassing undernutrition and overnutrition, remains a significant public health issue globally.
- Inadequate complementary feeding practices and poor dietary diversity are critical factors contributing to malnutrition in young children.
- Understanding these factors in specific contexts, like rural South Africa, is essential for developing effective interventions.
Purpose of the Study:
- To evaluate complementary feeding practices and dietary diversity among children under five in the Thabazimbi sub-district, Limpopo Province.
- To determine the relationship between these feeding practices, dietary diversity, and the nutritional status of young children.
- To identify factors associated with different forms of malnutrition in the study population.
Main Methods:
- A cross-sectional study involving 409 mother-child pairs was conducted.
- Data collection included socio-demographics, feeding practices, anthropometry, and 24-hour dietary recalls.
- Nutritional status was assessed using WHO growth standards, and dietary diversity was evaluated using WHO infant and young child feeding (IYCF) indicators.
Main Results:
- High rates of stunting (38%), underweight (13%), thinness (5%), and overweight/obesity (17%) were observed.
- Only 24% of children met the minimum dietary diversity score (DDS ≥ 4).
- Stunting and underweight were associated with male gender and lower dietary diversity, while thinness and overweight/obesity were linked to specific age groups and higher household income.
Conclusions:
- Deficits in complementary feeding and dietary diversity significantly contribute to the dual burden of malnutrition in rural Limpopo.
- These findings underscore the urgent need for targeted, context-specific nutrition interventions to improve child nutritional status.
- Addressing these feeding and diversity gaps is crucial for mitigating malnutrition and promoting healthy growth in vulnerable populations.
Abstract:
Objective: The aim of this study was to assess complementary feeding practices and dietary diversity in relation to the nutritional status of children under five attending health facilities in the Thabazimbi sub-district, Limpopo Province. Methods: A cross-sectional study was conducted among 409 mother-child pairs. Data on socio-demographics, feeding practices, and anthropometry were collected using validated tools. Nutritional status was assessed using WHO growth standards, and dietary diversity was evaluated using WHO infant and young child feeding (IYCF) indicators and a 24 h dietary recall. Associations were analyzed using prevalence ratios in STATA 18. Results: Among 409 children (median age: 18 months, IQR: 12-24), 38% were stunted, 13% were underweight, 5% were thin, and 17% were overweight/obese. Exclusive breastfeeding was reported in 27%, and only 24% met the minimum dietary diversity (DDS ≥ 4). Complementary feeding practices varied significantly by maternal age, with mixed feeding more common among older mothers and younger mothers more likely to receive feeding advice (p = 0.001). Stunting was associated with being a boy (PR = 1.27; 95% CI: 1.00-1.61), age > 24 months (PR = 0.33; 95% CI: 0.16-0.65), and DDS ≥ 4 (PR = 0.72; 95% CI: 0.52-0.99). Underweight was more prevalent among boys (PR = 2.40; 95% CI: 1.40-4.11), but less likely in children with DDS ≥ 4 (PR = 0.43; 95% CI: 0.20-0.92) and those from spouse-headed households (PR = 0.33; 95% CI: 0.13-0.87). Thinness was associated with DDS ≥ 4 (PR = 2.70; 95% CI: 1.13-6.45) and age 12-24 months (PR = 2.80; 95% CI: 1.02-7.64). Overweight/obesity was linked to age 12-24 months (PR = 1.94; 95% CI: 1.25-3.03) and household income > ZAR 15,000 (PR = 4.09; 95% CI: 2.33-7.17). Conclusions: Complementary feeding and dietary diversity deficits contribute significantly to the dual burden of malnutrition in rural Limpopo, highlighting the need for targeted, context-specific nutrition interventions.
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