EFFECT OF TRAINING ON COMPLEMENTARY FEEDING, KNOWLEDGE AND PRACTICES AMONG MOTHERS ATTENDING IMMUNIZATION CLINICS AT ADEOYO MATERNITY TEACHING HOSPITAL, IBADAN, NIGERIA

Abstract

The World Health Organization recommends that infants from age 6 months should be introduced to complementary foods, with continued breastfeeding, to meet their nutritional needs. However, malnutrition among infants in Nigeria has been reportedly high due to inappropriate feeding practices among nursing mothers. Therefore, this study was designed to assess the effect of training on knowledge and practices of complementary feeding among nursing mothers attending the immunization clinic of Adeoyo Maternity Teaching Hospital (AMTH) Ibadan, Oyo state. A quasi-experimental study, involving two phases was conducted in two immunisation clinics: AMTH, Yemetu, Ibadan as the Experimental group (EG) and Adeoyo State Hospital, Ring Road as the Control group (CG). The first phase was a baseline survey which employed a 3 stage sampling technique to recruit 240 mothers of infants, aged ≥ 6 months (120 each from the two immunisation clinics). A validated semi-structured questionnaire was used to obtain information on knowledge, attitude and practice of mothers on complementary feeding. The second phase consisted of a day training intervention for the EG which was designed using the results of the baseline survey. Systematic random sampling method was used to select 30 mothers from the EG for the training and 30 mothers for the CG. Both groups completed a pre and post-test questionnaire which assessed the knowledge (22 points), attitude (9 points) and practice (12 points) of mothers on complementary feeding. Knowledge score of ≥14 was categorized as poor, 15-16 as fair and ≥17 as good. Attitude score of ≤ 6 was categorized negative and ≥7 as positive. Practice score of ≤ 6 was categorized as poor, 7-8 as fair and ≥9 as good. Hand washing and food preparation were accessed using observational checklists before, during training and after a 6 week follow up. Demonstration was repeated using same checklist with 6-points for hand washing and 5-points for food preparation. Data were analyzed using descriptive statistics and student t-test at 5% level of significance. Ages of EG (28.7±3.5 years) and CG (30.0±5.2 years) were not significantly different. Marjority of the participants were secondary school certificate holders (EG: 60%, CG: 56.7%). Pre-intervention scores for knowledge (EG:13.1 ± 2.6 vs CG: 12.1±2.7), attitude (EG:5.5 ± 1.0 vs CG: 5.0±1.4) and practice (EG:10.2 ± 2.4 vs CG:9.3±1.3) were not significantly different. At post-test, the EG had higher scores than CG for knowledge (19.7±2.4 vs 12.1 ±2.7), attitude (6.7±1.7 vs 5.0±1.4) and practice (11.8±2.2 vs 9.3±1.3). Practice score were significantly different for hand washing at pre-training (3.2±0.2 points) compared to hand washing at post training (4.5±0.2 points). Similarly, food preparation at pre-training compared to post training was significant (2.8±0.1 points) vs (4.4±0.2 points). At follow up, hand washing and food preparation practices were not significantly different. Training intervention significantly improved the mother's knowledge, attitude and practices relating to complementary feeding. Periodic training for mothers on nutritional care of their infants is recommended.