Assessment of child care practices and malnutrition status in children under five years of AGE in Mulago Hospital, Kampala, Uganda

ABSTRACT JALIA NAMUGGA, Dokuz Eylül University Estitute of Health Sciences Public Health Department Assessment of child care practices and malnutrition status in children under five years of age in Mulago Hospital, Kampala, Uganda Introduction: Malnutrition in children is the leading cause of illness and death in developing countries. Presently, malnutrition causes about 3.5 million deaths, with 35% of the disease burden being in children under five years. Despite significant developments in Uganda, malnutrition has become a major concern affecting all regions and most of the population. The current levels of malnutrition hinder Ugandan's social and economic development. This study aimed at assessing child care practices (nutrition, vaccination, health seeking behaviour, hygiene, and health status) associated with malnutrition in children under five years of age in comparison with healthy children. Methods: A case-control study was conducted at Mulago Hospital between April and June 2018. The required sample size was calculated using the OpenEpi program; based on the assumption moderate effect size (W=0.30), 5% margin of error, with a power of 80%, thus the final sample size in each group was at least 87 children. Taking into account the non-response rate (10%), the sample size was determined as at least 98 cases and 98 controls. A questionnaire including child care practices (demographic and socioeconomic characteristics, breastfeeding, nutrition, hygiene, and mother's care search behaviour) was used to collect data by interviewing mothers or caregivers of these children. The collected data were analysed with SPSS 22.0 package program; Chi-square and logistic regression analysis were used for evaluation. Results: 102 malnourished and 102 well nourished children under five were included in the study. The mean age of the children in the case and control groups was 13.95 ± 9.34 and 15.32 ± 11.50 years, respectively; 45.1% of the cases and 46.1% of the controls were girls. After logistic regression analysis, the risk of malnutrition significantly increased with low birth weight 15.05 (95% CI: 2.39-94.78), low monthly income 10.84 (95% CI: 3.41-34.47), no longer breastfeeding 6.95 (95% CI: 2.34-29.64), insufficient hand washing behaviours of mothers 4.38 (95% CI : 1.65-11.66), the presence of fever in the last two weeks 3.64 (95% CI: 1.36-9.76), and incomplete /not being immunised 10.80 (95% FL; 2.59-45.00). Conclusion: In this study, it was found that malnutrition in children under five years of age was associated with low birth weight, low monthly household income, lack of breastfeeding, presence of fever in the last two weeks, insufficient hand washing habits and incomplete or not being immunised. In Uganda, at the individual and community level, in general, strategic initiatives aiming to improve child nutrition should be prioritized. Keywords: Malnutrition, child-care practices, children under five, case-control study