ABSTRACT
The adequacy and timing of complementary feeding of the breastfed child are criticalfor optimal child growth and development.Considerable efforts have been made to improve complementary feeding in the first 2years of life. One of them was the WHO complementary feeding counseling course [CFC].To evaluate the effectiveness of the WHO CFC on knowledge and counseling abilitiesof primary healthcare physicians; on caretaker's knowledge and adherence tophysicians' recommendations and their feeding practices; and on children's growth.A single-blinded randomized-controlled study was carried out in 40 primary healthcarecenters divided into matched pairs according to their location, either in rural or urbanareas, and training of the selected physicians on integrated management of childhoodillness. One center from each pair was selected randomly for its physician to receive CFCtraining in nutrition counseling and the matched center was selected as a control. Fortyprimary healthcare center physicians and 480 mother-child [6-18 months] pairs wereincluded in the study. The mother-child pairs recruited were visited at home within 2weeks, 90, and 180 days after the initial consultation with trained health workers. Specialquestionnaires were used to collect information on healthcare providers' knowledgeof nutrition counseling and practice [counseling skills]; maternal knowledge of basicnutrition-counseling recommendations, maternal compliance with the recommendedfeeding practice; child dietary intake; and gains in weight and length.CFC-trained physicians were more likely to engage in nutrition counseling and to delivermore appropriate advice. This was reflected in improvements in maternal recall ofcomplementary feeding messages, which were higher in the intervention group comparedwith the control group. Six months after the consultation, children in the interventiongroup had significantly greater weight gains compared with the control group [0.96 vs.0.78 kg; P= 0.038]. Children in the intervention group, who were 12-18 months of ageat the time of recruitment, had significantly less faltering in length gain compared with thecontrol group [height/age Z-score; 0.23 vs. 0.04; P= 0.004].Nutrition counseling training improved counseling abilities of primary healthcarephysicians and led to improvements in mothers' knowledge and practicesof complementary feeding. In turn, this led to improved growth of children. Werecommend wide and regular utilization of the CFC course to improve the knowledge andskills of health workers who provide counseling to mothers for complementary feeding