Báo cáo nghiên cứu khoa học: "Sử dụng mô hình "bữa ăn nhìn thấy và thực hành" cho việc phòng, chống suy dinh dưỡng của trẻ em dân tộc thiểu số dưới 5 tuổi trong phu xã, huyện Phú Lương, tỉnh Thái Nguyên"

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Tuyển tập báo cáo nghiên cứu khoa học trường đại học huế đề tài: Sử dụng mô hình "bữa ăn nhìn thấy và thực hành" cho việc phòng, chống suy dinh dưỡng của trẻ em dân tộc thiểu số dưới 5 tuổi trong phu xã, huyện Phú Lương, tỉnh Thái Nguyên...

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Nội dung Text: Báo cáo nghiên cứu khoa học: "Sử dụng mô hình "bữa ăn nhìn thấy và thực hành" cho việc phòng, chống suy dinh dưỡng của trẻ em dân tộc thiểu số dưới 5 tuổi trong phu xã, huyện Phú Lương, tỉnh Thái Nguyên"

JOURNAL OF SCIENCE, Hue University, N0 61, 2010 USING THE MODEL “MEALS SEEN AND PRACTISED” FOR THE PREVENTION AND CONTROL OF MALNUTRITION OF ETHNIC MINORITY CHILDREN UNDER 5 YEARS OLD IN PHU DO COMMUNE, PHU LUONG DISTRICT,THAI NGUYEN PROVINCE Nguyen Minh Tuan Thai Nguyen University of Medicine and Pharmacy SUMMARY An intervention using the model “Meals seen and practised” was organized regularly at San Chay households with children under 5 years old in Thai Nguyen Province. The results showed that families with children under 5 years old contributed their time and efforts actively, as well as sharing resources such as 652.9 kg of foods for preparation of complementary food for children. Mother’s nutrient knowledge and practice was clearly improved (Good knowledge: 44.3%, good practice: 35.4%). The prevalence rate of underweight malnutrition in San Chay children under 5 years old decreased to 32.1% from 41.6% as found in the previous survey. (p
Do commune, Phu Lương district, Thai Nguyên province, during a period of 18 months. 2.2. Study design: intervention study with a before and after comparison. - Sample size: - Sample selection: The San Chay minority ethnic mothers and their children under 5 years old were selected under the study, based on a list of children managed at the community health center. 2.3. Intervention contents The practices of “Meals seen and practised” are alternately organized at households with children under 5 years old. The model utilized items available in the family such as fuel, tools for cooking, dishes, vegetable and fruit. The mothers voluntarily contribute materials, food, and their time in preparation of a meal and feeding their children. The meal was estimated to provide about 300 - 350 kcal. The energy rate supplied by protein was from 12% - 14%. The table 1 below was an example of a ration and nutrient value of “Meals seen and practised”. Depending on the food source available in the area, we can increase or decrease particular kinds of food to maintain the diversity of the ration. Table 1. Nutrient value of “Meal seen and practised” for one child Protein Lipid Glucose Energy Food Amount (g) (g) (g) (kcal) Ordinary rice (g) 50 3.95 0. 50 38.10 172.0 Pork (g) 20 3. 80 1. 40 0.00 27.8 Sauropus (g) 20 1.06 0.00 0.68 7. 0 Fat (g) 10 0.00 9.96 0.00 89.6 Fish sauce (ml) 10 0.71 0.00 0.00 2. 8 Papaya (g) 100 1. 00 0.00 7. 70 35.0 Total 10.52 11.86 46.48 334.2 Percentage (%) 12.6 31.9 55.5 100.0 2.4. Data collection methods Mothers were directly interviewed using a set of questionnaires regarding KPC (Knowledge, Practice, Coverage) and to sort out knowledge and practice basing on the cut-off of 75% of total points. 492
To measure the anthropometry of children under 5 years old and then to compare with the reference population of NCHS. 2.5. Data processing and analysis: Anthropometry data were processed by Epinut and then exported to SPSS 13.0 to analyze interventional effectiveness with 2 test and Mann - Whitney U test. 3. Result The activity of the model “Meals seen and practised” was organized monthly at each household in the village. The household who organized this meal would supply all food including cereals, vegetable and fruit as well as vegetable oil and fat. The remaining households would bring other ingredients depending on their capacity and food available in their area. Table 2. Amount of food contributed by the San Chay households during a period of 18 months Food contributed by households Total (n = 237 households) Rice (kg) 171.8 Kinds of vegetable (kg) 68.7 Vegetable oil and fat (litre) 34.4 Fish sauce (litre) 34.4 Ripe fruit (kg) 343.6 Total (kg) 652.9 During 18 months of intervention, the San Chay households in the commune had contributed the total of 652.9kg of cereals, and other food to practice “Meals seen and practised”. These food sources was used to improve the quality of a complementary meal for their children. Table 3. Result to practice “Meals seen and practiced” on a complementary meal with different foods during a period of 18 months of intervention No of times Average number No of attended by of times/ 1 Complementary food practice mothers and mother and child children (n = 237) Egg boiled rice flour/porridge 45 640 2. 7 Meat boiled rice flour/ porridge 54 735 3. 1 Fish boiled rice flour/gruel 32 521 2. 2 493
Crab boiled rice flour/ porridge 26 379 1. 6 Shrimp boiled rice flour/ porridge 21 308 1. 3 Soya curd boiled rice flour/ porridge 19 332 1. 4 Liver boiled rice flour/porridge 16 213 0. 9 China squash boiled rice 13 166 0. 7 flour/porridge Peanut boiled rice flour/ porridge 9 142 0. 6 Total 235 3436 14.5 Note: Every practice, rice flour or porridge were cooked with the same materials The kinds of complementary food were varied, and the highest number of children attending a meal was when boiled rice flour/ meat porridge, egg porridge, fish porridge were prepared. On average, every mother practised preparation of complimentary meals 14.5 times with different materials. Regardless of the number of times “Meal seen and practised” was practiced, it contributed to improving the San Chay children’s daily meals. Table 4. Change in quality of complementary meal in children over 6 months old Before After intervention intervention Ration of 24 h p (n =207) (%) (n =208) (%) Children eaten protein - rich plant
Table 5. Change in the San Chay mother’s young child feeding practices and knowledge Before intervention After intervention p Norm (2test) (n = 231) (%) (n =237) (%) Mother with good 62 26.8 105 44.3
nutrient value of local food source in prevention and control of malnutrition in children. In the model of “Meal seen and practiced,” the mothers were not only seen, but also listened, exchanged, prepared foods by themselves and combined foods appropriately, according to the recommendations of the National Institute of Nutrition. This was a way of visually providing nutrient education that was suitable for the San Chay mother’s level of understanding. The mothers were provided not only information about child feeding and care, but also practices of child feeding and care. So that after intervention, the mother’s knowledge and practices were clearly improved. The knowledge of the mothers on nutrition increased to 44.3% from 26.8% and a good child feeding practices increased to 35.4% from 22.1% (table 5). Through “Meals seen and practiced,” the mothers directly saw their children were fed better, and therefore the mothers adopted these child feeding practices at home using these foods. The survey of rations in 24 hours showed that the quantity and quality o f children’s complementary meals had improved since before the intervention. The number of times a minimum complementary meal was given according to recommendation for each age-group reached 58.2%. The meal was prepared from kinds of plant foods, and foods derived from protein- rich animals and β-caroten- rich vegetables and fruits. The average dietary diversity increased to 4.181.48 from 3.241.11 among 8 food groups recommended by the WHO. The final efficacy and the importance was that the malnutrition prevalence in children under 5 years old was remarkably reduced in the underweight type, from 41.6% to 32.1% (p
care: working day, place, tools and 652.9kg of plant foods. 5.2. “Meals seen and practised” was a very effective form of nutrient education: the good maternal knowledge on nutrition increased to 44.3% from 26.8% and good child feeding practices increased to 35.4% from 22.1% (p