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14/02/2013
1
IMCF Baseline – Preliminary Results
Preah Vihear and Otdar Meanchey
10.09. – 07.10.2012Anika Reinbott (PhD Student), Judith Kuchenbecker (PhD Student)
Dr. Irmgard Jordan, Prof. Dr. Michael Krawinkel
1. Background - IMCF
“Improving the dietary intakes and nutritional status of
infants and young children through improved food
security and complementary feeding counselling”
IMCF Baseline Results - Anika Reinbott - 12.02.2013
• Poor nutritional status in early infancy:
morbidity, delayed motor and mental development,
mortality
• Lack of knowledge on age-appropriate infant and
young child feeding practices using locally available
foods
2
1.Background - IMCF baseline objectives
• To determine the nutritional status of mothers and
children under two years of age with a focus on child
growth, particularly stunting, and micronutrient status
especially iron and vitamin A status.
• To collect data on the knowledge of mothers/caregivers
on child health care and feeding practices.
• To understand living conditions, socioeconomic
indicators and dietary diversity of households.
IMCF Baseline Results - Anika Reinbott - 12.02.2013 3
2. Methods
• Cross-sectional nutrition baseline survey in
2 districts in Preah Vihear
4 districts in Otdar Meanchey
• Study population: mothers/primary caregivers and
children < 2 years
• Random selection of villages on commune level
proportional-to-population-size
• Random selection of participants on village level
IMCF Baseline Results - Anika Reinbott - 12.02.2013 4
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2. Methods – Study site: Preah Vihear
IMCF Baseline Results - Anika Reinbott -
12.02.20135
2. Methods – Study site: Otdar Meanchey
IMCF Baseline Results - Anika Reinbott - 12.02.2013 6
2. Methods - Indicators
• Interview with standardized questionnaire
Socio-economic status,
Sanitation, Hygiene, access to health facilities,
Breastfeeding and complementary feeding practices,
Dietary Diversity Score (Household and individual level),
Child health,
Household Hunger Scale
• Anthropometric measurements (parents and child)
• Motor milestones (child)
• Haemoglobin levels (mother and child)
• Blood plasma for iron and vitamin A status (child)
IMCF Baseline Results - Anika Reinbott - 12.02.2013 7
3. Results- participants
Households Children
N 1028 1028
Details of N 992 mothers
36 caregivers
572 male
456 female
Age – Mean 27 years 11.6 months
Age – Minimum 17 years 5 days
Age - Maximum 48 years 731 days/23months
Mean No. of members per household 5.16
Main income source Sale of agricult. products (71.6%)
Ever attended school 67%
Able to read 54%
IMCF Baseline Results - Anika Reinbott - 12.02.2013 8
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3. Results – Ownership of agricultural land and homegarden (N =1028)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
7%
29%
71%
93%
no agricultural land no homegarden homegarden
9
3. Results – homegarden usage (N= 713)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
30.6% 63%
6%
no homegarden growing vegetables
not growing vegetables
10
3. Results – cooking place, access to health facilities, sanitation facilities
IMCF Baseline Results - Anika Reinbott - 12.02.2013
Indicator in %
Cooking place
(N= 1032)
in the house 78.8
in a seperate building 11.4
outdoors 9.8
Nearest health facility
(N= 1025)
< 1 hour 87.3
1 to 3 hours 12.4
3 hours to half a day 0.3
Sanitation facilities
(N= 1028)
improved 18.7
unimproved 81.3
Source of drinking water
(N= 1028)
protected 86.6
unprotected 13.4
11
cooking places
IMCF Baseline Results - Anika Reinbott - 12.02.2013 12
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IMCF Baseline Results - Anika Reinbott - 12.02.2013
↑ water stored covered
with a lid
← protected water source
13
3. Results- Household Wealth
• Wealth index was calculated using PCA
• Inclusion criteria for variables:frequency distribution >5% and <95%
• Variables included:• number of people per room used for sleeping
• material of the floor
• sanitation facility
• drinking water source
• size of land owned
• ownership of certain possessions
IMCF Baseline Results - Anika Reinbott -
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3. Results- Household Dietary Diversity (N = 1028)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
0%
5%
10%
15%
20%
25%
2 3 4 5 6 7 8 9 10 11 12
Household Dietary Diversity Score
15
3. Results – episodes of illness: fever, diarrhoea, ARI among children
under 2 (N= 1028)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
65.20%
37.20%
46.20%
0%
10%
20%
30%
40%
50%
60%
70%
fever in past 2 weeks diarrhoea in past 2 weeks ARI in past 2 weeks
16
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3. Results- Prevalence of diarrhoea and mothers‘/caregivers‘ knowledge
IMCF Baseline Results - Anika Reinbott -
12.02.2013
Respondent‘s knowledge of diarrhoea causes and prevention in %
Knew at least one causes of diarrhoea 66.4
Causes named:
- Contaminated food, water, hands
Knew at least one way to prevent diarrhoea 70.0
Ways of prevention named:
- boiling/filtering water for drinking
- Covering food and water supplies
- Washing hands
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3. Results- exclusive breastfeeding under 6 months of age (N = 224)
IMCF Baseline Results - Anika Reinbott -
12.02.2013
93.50%89.50%
69.80%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 to 1 months 2 to 3 months 4 to 5 months
18
3. Results- breastfeeding (WHO indicators)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
Indicator in % n N
Breastfeeding (< 6 months)
Exclusive
Predominant
Poor
83.0
2.2
14.7
186
5
33
224
Early initiation of breastfeeding
(0 – 23 months)
82.4 847 1028
Still being breastfed
(0 – 23 months)
84.8 872 1028
Continued breastfeeding at 1 year
(12 - 15 months)
93.0 173 186
Bottle feeding (< 6 months) 10.2 23 225
19
3. Results – infant and young child feeding indicators (WHO)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
Indicator In % n N
Minimum Dietary Diversity (6-23 months) 43.9 352 801
Minimum Meal Frequency (6-23 months) 69.9 540 773
Minimum Acceptable Diet (6-23 months) 28.3 226 798
Infants who receive solid, semi-solid and
soft foods (6-8 months)
93.9 153 163
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6
3. Results – Child Dietary Diversity Score - 6 to 23 months of age (N = 799)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
0%
5%
10%
15%
20%
25%
30%
0 1 2 3 4 5 6 7
Child Dietary Diversity Score
1. Grains, cereals, tubers (97%)
2. Flesh foods (meat and fish)
(75%)
3. Other fruits/vegetables (50%)
4. Vitamin A rich fruits/
vegetables (45%)
21
3. Results – Nutritional Status of children 0 to 23 months
Z-Score < -3SD < -2SD N
Height-for-age (stunting) 3.6 21.4 1026
Weight-for-height (wasting) 1.1 8.5 1028
Weight-for-age (underweight) 2.8 19.8 1028
IMCF Baseline Results - Anika Reinbott - 12.02.2013 22
3. Results- Stunting (-2SD) prevalences per age group (N = 1026)
IMCF Baseline Results - Anika Reinbott - 12.02.2013
0%
5%
10%
15%
20%
25%
30%
35%
40%
0 to 1
month
2 to 3
months
4 to 5
months
6 to 8
months
9 to 11
months
12 to 17
months
18 to 23
months
23
3. Results on stunting compared with CDHS 2010- Prevalence of stunting among children 0 to 23 months
IMCF Baseline Results - Anika Reinbott - 12.02.2013
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
< 6 months 6 - 8 months 9 to 11
months
12 to 17
months
18 to 23
months
IMCF 2012 CDHS 2010
24
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3. Results- Deworming and Vitamin A supplementation
IMCF Baseline Results - Anika Reinbott - 12.02.2013
Percentage of children under 2 who received
� vitamin A: 76.9 (N = 1016)
� deworming: 34.4 (N = 1012)
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3. Results- Anaemia among children and non-pregnant mothers
IMCF Baseline Results - Anika Reinbott - 12.02.2013
39%
0%
30%
31%
61%
no anemia
severe anemia (Hb < 7g/dl)
moderate anemia (Hb 7-9.9 g/dl)mild anemia (Hb 10.0-10.9 g/dl)
children 3 to 23 months (N = 929)
71%
2%
27%29%
no anemia
moderate anemia (Hb 7-9.9 g/dl)mild anemia (Hb 10.0-11.9 g/dl)
non-pregnant mothers (N = 976)
26
4. Outlook
IMCF Baseline Results - Anika Reinbott - 12.02.2013
Baseline
(cross-sectional)
• Training of Trainers• Cooking
demonstrations• Nutrition education
in Farmer Field Schools
• etc
Nutrition Education
Intervention
on IYCF
2012 2013 2014
Impact Survey
(cross-sectional)
Qualitative Survey
Justus-Liebig University – Research; FAO MALIS – Implementation of activities
27
5. Registration and funding
German Clinical Trial Register (DRKS)
https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do
The research was conducted within the IMCF Project of FAO:
http://www.fao.org/ag/humannutrition/nutritioneducation/70106/en/
which is funded by
IMCF Baseline Results - Anika Reinbott - 12.02.2013 28
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IMCF Project Team
Malawi Cambodia
Food security Project FAO/FICA MALIS
Research Institutions Bunda College of
Agriculture
Dr B Mtimuni
Dr C Masangano
Mahidol University &
NNP
Dr O Kevanna
Dr P Winichagoon
Dr G Charoonruk
PhD students Ms J Kuchenbecker
Ms G Chiutsi Phiri
Ms Anika Reinbott
Mr M Khun
FAO Headquarters
Rome, Italy
Ms E Muehlhoff, Dr G Kennedy and Ms T Jeremias
JLU Giessen, Germany Prof. MB Krawinkel, MD, Dr I Jordan, Dr J Herrmann
IMCF Baseline Results - Anika Reinbott - 12.02.2013 29 IMCF Baseline Results - Anika Reinbott - 12.02.2013
Thank you for your attention.
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