School
School of Public Health
Document Type
Dissertation
Department (new version)
Public Health
Date of Award
2002
Degree Name by School
Doctor of Public Health (DrPH) School of Public Health
Abstract
The primary goals of nutrition rehabilitation centers (NRCs) are to recuperate malnourished children and improve caretakers' child feeding practices. Children ( N = 116) and caretakers ( N = 108) newly enrolled in four NRCs in Accra, Ghana were recruited and studied longitudinally at four time points: admission, interim, exit and postexit . Data collection included observations of activities at the NRCs, anthropometry, interviews, dietary assessments, and weighing of NRC foods. Caretaker/child pairs attended the NRCs 33% ± 21% of their total stay, and the majority (78%) discontinued participation before being officially discharged. At exit , ≥60% of children had weight-for-height (WHZ), weight-for-age (WAZ) and height-for-age (HAZ) Z-scores below −2. Mean WHZ and WAZ increased significantly ( p < 0.05) between admission and exit but not between exit and postexit . Children with improved HAZ at exit were significantly ( p < 0.05) more likely to have been officially discharged. Caretakers participated in NRC cooking activities on average less than 35% of the attended days. Except for attendees at one NRC, caretakers perceived participation at the NRCs as voluntary. The proportions of children's recalled and observed food intakes that contained foods promoted by the NRCs were low overall, but highest at points of contact with the NRCs. Purchased street foods in the children's diet increased between admission and postexit ( p < 0.01). At postexit , street foods comprised ≥50% of children's food intakes. Reasons for not adopting NRC recommendations included lack of access and preparation knowledge, economic constraints, and child preferences. Dietary regimens were inconsistent across NRCs and inadequate to support accelerated catch-up growth in children. Criteria for discharge were undefined, and children left the program still malnourished. Improving retention of NRC beneficiaries may enhance effectiveness relative to children's recovery. Information on street foods needs to be incorporated into education efforts directed at caretakers. Orientation procedures for new caretakers and routines to encourage their participation are needed to effectively convey expectations and to enhance participatory learning. Standard procedures for day-to-day management of the NRCs will facilitate continuity of appropriate practices during personnel transitions. Policy and administrative efforts to adequately train, motivate, and encourage resourcefulness among NRC staff are necessary for the effectiveness of the program.
ProQuest Publication Number
ProQuest ID
3058741
ISBN
978-0-493-73983-0
Recommended Citation
Colecraft, Esi Komeley, "An evaluation study on nutrition rehabilitation centers in Accra, Ghana" (2002). All ETDs from UAB. 7219.
https://digitalcommons.library.uab.edu/etd-collection/7219
Comments
DrPH