ABSTRACT
@#Introduction: The refeeding programme in government hospitals is aimed at improving the nutritional status of malnourished children with weight-for-height z-score (WHZ) below -2.0, using special therapeutic food. However, there is a lack of data on the nutritional status of indigenous (Orang Asli) children when they return to the community after hospital discharge. Case Presentation: A 3-year-old Temiar boy residing in a tribal village in Hulu Perak was visited to determine his nutritional status following discharge from a refeeding programme in a government hospital. He was admitted to the hospital with a weight of 10.0 kg, height of 85.5 cm and WHZ of -2.09. The boy was later discharged weighing 11.0 kg, and with height unchanged at 85.5 cm and WHZ of -0.87. During our visit to the child’s home three months after discharge, his weight was 9.5 kg, height 86.0 cm, and WHZ –2.91. Discussion: The management of the case in the hospital was based on the Malnourished Orang Asli Protocols of the hospital. Household food insecurity, feeding and care practices, unhealthy household environment and the lack of communication between hospital and community health services were all identified as risk factors for malnutrition. Conclusion: The recurrence of malnutrition in this child, after successful improvement during hospital stay, highlights the importance of identifying factors that may affect nutritional status after hospital discharge. This knowledge will be beneficial in planning specific interventions, especially for Orang Asli children, living in remote villages
ABSTRACT
The beliefs of mothers on myths or misconceptions on breastfeeding were found to be influencing their acceptance to exclusively breastfeeding their infants. Therefore, this study was aimed to develop an educational tool in the form of leaflet entitled “Guide on breastfeeding: Facts vs myths.” This study involved three phases; phase I were surveying and needs assessment; phase II was the development of printed educational material and phase III was the process evaluation of the printed educational material by 41 Malay pregnant women. A total number of 41 subjects were involved in phase III through calculation of sample size by using program G*Power and the power of study were 0.8. In phase III, pre-test knowledge questionnaire was given to subjects to assess the level of knowledge on breastfeeding and it was collected immediately once they have completed it. The subjects were given one week to read and understand the leaflet and then answer the post-test knowledge questionnaire and the evaluation form of the leaflet. In phase III, the findings showed that all subjects (100.0%) understood the contents of the leaflet. While 95.1% (n = 39) of subjects felt that pictures were important to increase the attractiveness of the printed educational material and around 75.6% (n = 31) subjects stated that the pictures in the leaflet given were attractive. Majority of subjects (97.0%) had intention to give exclusive breastfeeding for six months to their infants after reading the leaflet. Subjects’ mean percentage knowledge scores increased significantly (p < 0.001) from 83.1 ± 13.1% during pre-test to 94.3 ± 6.7% during post-test with t = 5.58 and large effect size, d = 1.13. In conclusion, the developed printed educational material was rated positively and effective in increasing the level of knowledge on breastfeeding among pregnant mothers. In this regard, designed leaflet can be used as a teaching tool to educate mothers about breastfeeding