ABSTRACT
Objectives: To assess the impact of hand-washing with soap and nail clipping on the prevalence of anaemia and thinness among school-aged children. Methods: We randomly assigned 369 parasite negative school-aged children to receive both, one or the other, or neither of the interventions. Soap and nail clippers were provided and field workers visited households weekly for six months to encourage hand-washing and do nail clipping. Haemoglobin was determined using a HemoCue spectrometer at the end of the trial. Weight and height were measured following intervention, and children below -2Z scores for BMI-for-age were classified as thin. Analysis was by intention-to-treat. Results: Children that received hand-washing with soap intervention had a 51% lower prevalence of anaemia (OR 0.49, 95% CI: 0.28 to 0.88) and a 46% lower prevalence of thinness (OR 0.54, 95% CI: 0.35 to 0.86) than controls. Compared with controls, finger nail clipping did not result into significant reduction of anaemia (p=0.063) and thinness (p=0.218) prevalence. When looking at the four groups individually, children that received both interventions had a 69% lower anaemia (OR 0.31, 95% CI 0.14 to 0.70) and a 59% lower thinness prevalence (OR 0.41, 95% CI 0.21 to 0.79) than controls. Children in the hand-washing with soap only group had a 60% lower prevalence of anaemia than controls (OR 0.40, 95% CI: 0.18 to 0.87). Prevalence of anaemia and thinness did not differ significantly between children in the nail clipping only group and those in the control group. Conclusions: Hand-washing with soap was effective in reducing anaemia and thinness.
ABSTRACT
The use of growth monitoring and promotion (GMP) has become widespread. It is a potential contributor towards achieving the Millennium Development Goals of halving hunger and reducing child mortality by two-thirds within 2015. Yet, GMP appears to be a prerequisite for good child health but several studies have shown that there is a discrepancy between the purpose and the practice of GMP. The high prevalence of malnutrition in many developing countries seems to confirm this fact. A descriptive qualitative study was carried out from April to September 2011. Focus group discussions and in-depth interviews were conducted amongst mothers and health workers. Data were analyzed using a qualitative content analysis technique, with the support of ATLAS.ti 5.0 software. The results suggest that most mothers were aware of the need for regular weight monitoring while health workers also seemed to be well-aware and to practise GMP according to the international guidelines. However, there was a deficit in maternal knowledge with regard to child-feeding and a lack of basic resources to keep and/or to buy healthful and nutritionally-rich food. Furthermore, the role of the husband was not always supportive of proper child-feeding. In general, GMP is unlikely to succeed if mothers lack awareness of proper child-feeding practices, and if they are not supported by their husbands.