Dietary and nutrition screening for children seeking curative care in health facilities in Botswana
KeywordsDietary screening, nutrition assessment, Child Survival Programs, malnutrition, under-fives
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AbstractThe extent to which nutrition and dietary screening performed in children seeking curative care in health facilities in Botswana was investigated using a cross-sectional survey design. Dietary screening, illness status, demographic and anthropometric data were obtained from a random sample of 522 children in 13 health facilities through structured interviews and actual anthropometric measurements. Amongst these, caregiversof children seeking curative care (n =174) completed a nutrition and dietaryscreening checklist designed to establish the proportion of ill children screened. Additionally, a self-administered questionnaire was used to examine the knowledge, attitudes, and perceptions of providers in the study clinics about nutrition and dietary screening and the types of indicators routinely used. Data were collected from all providers (n = 39) on duty. The results show that malnutrition was prevalent, with 13. 7%, 11.3 % and 3.9 % of children estimated to be stunted, underweight and wasted respectively. The prevalence of stunting and underweight was higher (p &lt; .05) in olderchildren (37&ndash;60 months), children perceived as sickly, or raised in&nbsp; households with periodic shortage of food compared to children under one year of age, children perceived as healthy or raised in households with adequate amounts of food at all times. Less than 20 % of children who sought curative care were screened for possible compromised dietary intake or nutritional status. Only 18 % of children had their weight measured during consultations. Only 10.8 % of providers were reported to havediscussed the children&rsquo;s growth indicators with care-givers. Similarly, few providers specifically discussed the feeding recommendations (10.8%) and feeding frequency (7.8 %) of children with care-givers. The providers&rsquo; knowledge about nutrition and dietary screening was low. Most providers (70 %) perceived their didactic training to be adequate and over half of them were satisfied with their skill level in assessing the dietary intake (53 %) and nutritional status (57.9 %) of children. Fewer providers wereable to correctly list three indicators of nutritional status (35.9 %) or dietary intake (12.8 %). Study observations show that a large proportion of children seeking curative care in the health clinics are rarely screened for possible compromised dietary intake and nutrition status. Also, a large number of health providers are not satisfied with their skill level in dietary and nutrition screening. Since nutritional problems are often juxtaposed to health problems, efforts should be taken to integrate nutrition screeninginto the medical care for under-fives.