RESUMO
We examined whether the Maternal, Newborn and Child Health Weeks (MNCHW) in Nigeria would present an opportunity to raise awareness of and demand for the use of zinc and ORS in the treatment for diarrhoea, guided by a conceptual framework designed to assess three theoretical underpinnings (characteristics and performance standard of the health workers, potential reach, and intensity of the intervention), along the impact pathway. Zinc and ORS with education for their appropriate use during the next diarrhoeal episode were delivered as part of the November 2010 and May 2011 MNCHW. On the day of but before participating in MNCHW activities, semi-structured interviews were used for collecting information on knowledge, attitudes, and practice (KAP) relating to diarrhoea from 602 caregivers with children aged less than five years. Forty-eight health workers were also interviewed. Nearly all health workers (98%) correctly mentioned the dosage of zinc while only 58% correctly stated the preparation of ORS. The proportion of caregivers with knowledge on the treatment for diarrhoea increased from 46.4% in November 2010 pre-MNCHW to 71.3% in May 2011 pre-MNCHW interviews (p<0.001). More caregivers correctly mentioned the dosage of zinc (80.9%) and stated the preparation of ORS (88.8%) in the November 2010 exit interview immediately after the MNCHW encounter compared to the levels a few months later in the home follow-up visit (53.1% and 37.4% respectively). After attending both rounds of November 2010 and May 2011 MNCHW, caregivers’ knowledge on the treatment of diarrhoea increased seven times compared to the caregivers who attended the May 2011 MNCHW only (OR=7.0, p<0.001). Additionally, caregivers were 40% less likely to seek advice outside the home in the treatment for diarrhoea if they had attended both the MNCHWs than if they had attended the May 2011 MNCHW only (OR=0.6, p<0.029). We conclude that providing opportunities for caregivers to receive a sample of zinc and ORS and to learn about its use in the treatment for diarrhoea, from trained health workers during MNCHW, has the potential to increase KAP relating to the use of zinc and ORS in the treatment for diarrhoea and for future diarrhoeal episodes.
RESUMO
Bacteria were quantified in samples of drinking-water and in two porridges prepared for infant-feeding [fortified instant soy-rice porridge (SRP) and cooked porridge (Lishe bora, LB)] in 54 households. Bacterial numbers were measured again after the porridges had been held at room temperature for four hours (T4). Findings were benchmarked against bacterial numbers in traditional complementary foods sampled from 120 households. Total bacteria, coliform, and Enterobacteriaceae counts were enumerated using Petrifilm. The mean log bacterial numbers were the lowest for LB at TO (2.24 +/- 0.84 cfu/g aerobic counts) and the highest for SRP at T4 (4.63 +/- 0.56 cfu/g aerobic counts). The total bacteria, coliform and Enterobacteriaceae counts were higher at T4 than at T0 for LB (p < or = 0.001); however, only the coliform and Enterobacteriaceae counts were higher at T4 than at T0 for SRP (p<0.001). Drinking-water, SRP0, traditional foods, and SRP4 all had the mean aerobic counts higher than the acceptable cut-off but the total bacterial count in SRP0 was not significantly (p=0.543) different from drinking-water. However, coliform and Enterobacteriaceae counts in SRPO were higher than in drinking-water (p<0.001). Also, although the aerobic counts of SRP4 were not significantly (p>0.999) different from traditional foods, the coliform and Enterobacteriaceae counts were significantly higher in SRP4 than in traditional foods (p<0.001). It is, therefore, recommended that food safety concerns be addressed when improving complementary foods.