Family medicine employees working in the Southeastern Anatolia Region (Diyarbakır-Şanlıurfa-Mardin) and parents of 0-5 age group children; evaluation of knowledge, attitude-behavior and awareness levels of malnutrition, nutrition and transition to supplementary food in children between 0-5 years old

Introduction and Purpose: Malnutrition is defined as changes in normal body composition that can be prevented or treated due to nutritional deficiency. In children 0-5 years of age, when breastfeeding and receiving supplementary food after breast milk, inadequate access to food sources and inability to meet daily energy needs cause malnutrition, also known as nutritional deficiency. Our aim in this study is to evaluate the knowledge, attitude-behavior and awareness levels of family medicine workers and parents of 0-5 years old children about malnutrition, nutrition and transition to supplementary food, subsequently, the training to be given to family medicine employees is to increase the knowledge, attitude-behavior and awareness. Materials and Methods: Our study started, after the necessary permissions were obtained, with the training and meeting of opinion leaders from Diyarbakır, Mardin and Şanlıurfa in February 2020 in Şanlıurfa. Meetings were held with family medicine employees in Şanlıurfa and Mardin on March 2020. Family Medicine Employees Malnutrition questionnaire was applied to the participants in the meetings after their consent was obtained before the training. The sociodemographic information questionnaire and the iowa scale were administered to parents with children aged 0-5, both online and by face-to-face interviews, by family medicine staff who participated in our study. The collected data were entered into the computer and evaluated using an appropriate statistics program. Results: 74 family medicine employees, including 59 physicians and 15 midwives and nurses and 314 parents with children aged 0-5 years participated in our study. The average level of satisfaction of family medicine employees with their professions was 6.37 ± 1.98 (min: 1, max: 10). According to family medicine workers, the estimated average malnutrition in the 0-5 age group of the population belonging to their unit was found to be 8.07 ± 8.90 percent. It has been determined that 79.7% (n: 59) of family medicine employees have detected malnutrition in children aged 0-5 at the institutions they are currently affiliated to, albeit at least once at any time. As the age of family medicine workers increases, the rate of detecting malnutrition increases (p=0,019). Participants who stated that they detected malnutrition, spend more time for each one child patient follow-up / examination. The estimated malnutrition percentages of the participants who stated that they detected malnutrition were found closer to the actual data. The rate of detecting malnutrition is higher among family medicine workers who stated that they used any method to detect malnutrition (especially percentile tracking). 14% (n: 44) of the mothers participating in the second part of our study are not literate, 41.1% (n: 129) are primary school graduates, and 44.9% (n: 141) have high school and above education. It was found that 82.2% (n: 258) of the children were breastfed within the first hour, and 86% (n: 270) received breast milk as the first food immediately after birth. 48.7% of the children (n: 153) were found to be born by normal birth. The mean total attitude score of the parents participating in our study about infant nutrition was found to be 64.01 ± 7.14 (min: 34, max: 84). According to the baby nutrition attitude scale score, as the education of mothers and fathers increases, the tendency to breastfeed increases (p <0.001, p = 0.013, respectively). A significant difference was found between infant nutrition and the working status of mothers and fathers, and it was found that civil servants were more prone to breastfeeding (p = 0.001, p = 0.001, respectively). As the monthly income level of families increases, the tendency to breastfeed increases (p <0.001). Also, it was found that parents who delivered by cesarean section were more prone to breastfeeding (p = 0.001). Conclusion: Malnutrition is an ongoing problem worldwide, especially among children. Primary healthcare professionals encounter children under the age of five quite often. Primary healthcare professionals will be able to make early diagnosis and treatment of malnourished children in this age group by having a good command of nutrition and malnutrition in children. For the healthy development of children, family medicine employees have to be very careful about growth monitoring and breastfeeding and be very educative towards parents. In addition, it is thought that increasing the education level of parents will improve their awareness and attitudes towards infant feeding. The major role of family physicians in primary health care is to contribute to family education, to improve the knowledge, skills and attitudes of families on infant nutrition and malnutrition, and thus to contribute to the formation of healthier societies.