Factors associated with uptake of recommended infant and young child feeding guidelines by caretakers accessing outpatient child health services from health facilities in Kawempe Division, Kampala District: A cross sectional study

Abstract

Introduction: Exclusive breast feeding for the first 6months, continued breast feeding for 2 years and appropriate complementary feeding can reduce child mortality by over 13%. Though millennium development goals were set for 2015, Uganda still struggles with relatively high levels of malnutrition, child morbidity and child mortality. To address these concerns, recommended Uganda Infant and Young Child Feeding guidelines were developed and implemented. However, their uptake is still low as evidenced by poor child survival indicators hence the reason for this study. Objective: Study aimed at determining uptake levels and factors associated with uptake of recommended child feeding guidelines. Methods: This was a facility based cross sectional study conducted in Kawempe Division, Kampala district during May 2013. One health facility was sampled per parish and hospitals were prioritized. Determining sample per facility was based on principle of probability proportionate to size. Participants were caretakers with infants and pediatrics’ health workers. Semi-structured questionnaires were administered and key informant interviews conducted. An index for uptake of guidelines was adapted based on 6 questions. Data was entered into EpiData and analyzed using STATA version 12. Frequencies, Odds ratio and p-values were computed to test for association between uptake of guidelines and associated factors at 0.05level of significance Logistic regression was run for significant variables. Qualitative data was analyzed and presented by sorting into themes and quotations added. Results: Of the 254 caretakers interviewed only 1.97% were males. Uptake of guidelines was 46.06%. Caretakers with children below 6months (p: 0.000), attendance of child feeding counselling (p: 0.021) and males’ participation in child feeding (p: 0.001) were associated with high uptake of guidelines. Heavy workload for health workers was associated with low uptake of guidelines while maternal workload and length of maternity leave were not associated with uptake. Conclusion/ Recommendations: Uptake of recommended child Feeding guidelines was low in Kawempe. Caretaker attendance of child feeding counseling and male partner involvement in child feeding were associated with high uptake of guidelines. Therefore boosting health workers’ morale, emphasizing attendance of child feeding counseling and male partner involvement in child feeding can promote uptake of recommended infant and young child feeding guidelines.