Formula Feeding Practice and Associated Factors Among Mothers Who Visited Health Facilities for Their Infants Aged Below 6 Months in Bahir Dar City, Northwest Ethiopia, 2020.

Background: Even though breastfeeding for infants and young children provides the ideal food for healthy growth and development, nowadays the use of infant formula feeding has increased worldwide. In developing countries, 1.3 million to 1.45 million childhood deaths are attributed to suboptimal breastfeeding practices. Objective: This study aimed to assess infant formula feeding practice and associated factors among mothers who visited health facilities for their infants aged less than 6 months in Bahir Dar city in 2020. Methods: An institution-based cross-sectional study was conducted in March-May 2020. Data were collected from 593 randomly selected mothers with infants less than 6 months of age. A multivariable logistic regression analysis was performed to identify associated factors of formula feeding practice with an a p-value of less than 0.05 and an adjusted odds ratio of 95% confidence interval. Results: The prevalence of infant formula feeding practices was 25%. Maternal age group of 25-34 years [AOR = 2.388; 95% CI: 1.295, 4.406], mother's occupation of private employee [AOR = 6.726; 95% CI: 2.756, 16.413], government employee [AOR = 4.726; 95% CI: 1.895, 8.700] and merchant [AOR = 2.798; 95% CI: 1.066, 7.345], positive attitude to infant formula [AOR = 2.10; CI: 1.09, 4.06], delayed breast milk initiation after delivery [AOR = 3.73; 95% CI: 1.504, 9.252], mothers who had 3 antenatal care [AOR = 2.294; 95% CI: 1.317, 3.997] and source of formula milk information from supermarket/pharmacy [AOR = 6.57; 95% CI: 1.48, 29.16] and from families/friends [AOR = 2.24; 95% CI: 1.24, 4.03] were independent predictors of infant formula feeding practice. Conclusion: This study's findings revealed that one-fourth of mothers fed infant formula before the age of 6 months. Therefore, we recommended promoting behavior change communication, focusing on attitude change in formula feeding practice and its health consequences, promoting exclusive breastfeeding practice, and strengthening ANC service provision.

Behavioral model-guided nutritional counseling could improve the dietary practice and nutritional status of elders in Ethiopia: a quasi-experimental study.

BACKGROUND: Physiological, pathological, and socioeconomic changes occurring in older people negatively influence food intake, utilization, nutritional status, and health. These problems are deeply rooted in low socio-economic settings and could partly be addressed through systematic behavioral change approaches. Hence, this study was to evaluate the effect of behavioral model-guided nutritional counseling on the dietary intake and nutritional status of elders. METHODS: A one-armed pre- and post-test quasi-experimental design was conducted on 293 community-dwelling older adults aged above 60 years from January to May 2022. A health education tool was developed and validated using health beliefs and the theory of behavioral change. The sessions were delivered by trained nurses through home-to-home visits every week lasting 45-60 min for up to two months. Data on nutritional knowledge, dietary intake, and body weight were captured using standardized questionnaires and measurements. The primary outcome was captured using the validated mini-nutritional assessment (MNA) tool and classified accordingly. The data was analyzed using Stata software, where it is presented in tables, graphs, and summary statistics. A paired t-test and the p-value were used to identify statistically significant effects of the intervention. RESULTS: A total of 263 elders were involved in the experiment, and modeled nutritional counseling significantly improved the knowledge score from 7.58 (± 1.05) to 11.6 (± 1.37) (P < 0.001) at the pre- and post-intervention periods. A significant improvement has been shown in the consumption of dairy products, fruits, and animal-source foods and, importantly, in the mean dietary diversity score (p < 0.001). As a result, the burden of malnutrition was significantly lower in the post-intervention period (9.6%: 7.9-11.3) compared to baseline (12.5%: 11.4-13.8). There is a significant increase in the mini-nutrition assessment score (MD = 0.30; p = 0.007). The mean body weight and the body mass index did not change significantly after the intervention (p > 0.05). CONCLUSION: Targeted behavioral model-guided nutritional counseling could help promote perception, diversify dietary consumption, and reduce the risk of undernutrition among elders. Particular attention to older people with the use of participant-centered nutritional behavioral change interventions coupled with livelihood support could help reduce undernutrition among older people. TRIAL REGISTRATION: Clinical Trial Registration-URL: www. CLINICALTRIALS: gov , identifier number: NCT04746664, first released 10/02/2021.

Ethiopian aging policy: A review of existing frameworks in relation to the Madrid International Plan of Action on Aging.

Background: The increasing life expectancy and the growing number of older people are becoming public health challenges, warranting the need for appropriate policy tools. Existing policy frameworks should prioritize and cover the public health demands of elders. However, there is a lack of concrete evidence on the existing policy tools and programs targeting elders in Ethiopia. Objective: This study was to explore the existing policies, programs, and interventions for elderly people in Ethiopia. Study design: A descriptive qualitative study using phenomenological approach and secondary data review wa conducted. Methods: A combination of systematic desk reviews of relevant policy and program documents and key informant interviews (KIIs) was used to capture data. Four purposefully selected interviews, based on their expertise, rich experience, in-depth understanding, and direct involvement in the policy environment, were conducted. Face-to-face interviews with the Audio recorder were employed during KII. The number of KIIs was limited to four, the point of theoretical saturation where no further new and informative themes were identified. Interview audios were transcribed, translated, and analyzed in thematic descriptive analysis. The United Nations Madrid International Plan of Action on Aging was used as a guideline for the data extraction process from relevant documents. Results: A total of 221 documents were retrieved, and 75 met the inclusion criteria. We identified four interconnected main themes and 11 sub-themes of concern for the elderly. Ethiopia recognized old people as vulnerable in various national legal and policy documents, including the constitution, population policy, and development plans. Surprisingly, no government policy exists in Ethiopia to address the health and nutritional problems of the elderly in particular. Conclusion: Though Ethiopia is facing demographic transition, no specific old-age policies, programs, or interventions are being implemented. Hence, the government and relevant stakeholders should strive to design and implement an old-age policy outlining cost-effective interventions for elders.

Prevalence of malnutrition among old age people in Africa.

Background: Improved health care and rising life expectancy are creating a growing pool of old age people all over the world, including Africa. Malnutrition in the old age people is associated with both short- and long-term negative health outcomes. However, the reported burdens of malnutrition are fragmented and inconsistent, where more compiled evidence is warranted to aid decision-makers. Hence, this paper is aimed to estimate the pooled prevalence of malnutrition among old age people in Africa. Methods: A systematic search for research reporting the prevalence of malnutrition among old age people (aged above 60 years) was conducted from HINARI/PubMed and Google Scholar databases using combination keywords. Published articles in English language starting from January 2000 to October 2021 were screened. We presented the results based on the standard for reporting systematic review and meta-analysis of observational studies. A random-effect meta-analysis was done to estimate the prevalence of malnutrition along with the 95% confidence intervals. The publication bias was assessed using the funnel plot. Results: A total of 1,442 studies were retrieved based on the search strategy, where only 36 studies (n = 15,266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2 to 77.3% across Africa. Overall, the pooled prevalence of malnutrition was 18% (95% CI: 15-22; I2 = 98.1; p < 0.001). The prevalence is higher in the Central Africa (3.8%; 95% CI: 3.2-4.4), in the community (3.1%; 95% CI: 2.7-3.7), and among advanced age (3.5%; 95% CI: 2.3-5.4). Conclusion: The prevalence of malnutrition in African old age people is high and differs by setting, assessment tool, and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable, and simple screening tool should be thought of.