The Latin America and Caribbean region exhibit some of the lowest undernutrition rates globally. Yet, disparities exist between and within countries and countries in the region increasingly face ...other pressing nutritional concerns, including overweight, micronutrient deficiencies and inadequate child feeding practices. This paper reports findings from a regional analysis to identify the determinants and drivers of children's diets, with a focus on the complementary feeding window between the age of 6-23 months. The analysis consists of a narrative review and descriptive data analysis, complemented with qualitative interviews with key informants in four countries: Guatemala, Paraguay, Peru and Uruguay. Findings indicate that poverty and inequality (disparities within countries by wealth and residence), unequal access to services, inadequate coverage of social programmes and lack of awareness on appropriate feeding practices are important drivers for inadequate diets. We conclude that countries in the region need to invest in policies to tackle overweight and micronutrient deficiencies in young children, considering inequalities between and within countries, enhance coverage of social protection programmes, improve coordination between sectors to improve children's diets and expand the coverage and intensity of awareness campaigns on feeding practices, using iterative programme designs.
Abstract only
In Peru, exclusive breastfeeding (EBF) in urban areas decreased from 64.5% in 2007 to 59.9% in 2010 despite a national infant feeding policy to protect, promote and support ...breastfeeding (BF). Health care providers (HCPs) play an essential role in influencing mothers’ feeding decisions. This study examined infant feeding advice provided by HCPs in government health services (N=3) in a peri‐urban area of Lima using a case‐study methodology. Semi‐structured interviews were conducted with 16 HCPs and 11 mothers of infants < 6 months of age. Seven mothers participated in two focus group discussions. The health service environment and educational activities were observed. Advice was provided via growth monitoring and medical visits, nutrition counseling sessions, home visits and talks. HCPs recommended EBF for 6 months but did not provide practical advice to address common problems. Barriers to providing adequate BF counseling by HCPs included heavy client load, inadequate in‐service training, poor counseling skills, and formula industry influence. Barriers to EBF among mothers included employment, perceived breast milk insufficiency, and infant formula promotion. Improved training of HCPs, stronger monitoring of compliance and implementation of national policy are needed in government health services to protect BF behaviors.
Funding: CIHR GBH‐87063; McGill University
The Latin America and Caribbean region exhibit some of the lowest undernutrition rates globally. Yet, disparities exist between and within countries and countries in the region increasingly face ...other pressing nutritional concerns, including overweight, micronutrient deficiencies and inadequate child feeding practices. This paper reports findings from a regional analysis to identify the determinants and drivers of children's diets, with a focus on the complementary feeding window between the age of 6-23 months. The analysis consists of a narrative review and descriptive data analysis, complemented with qualitative interviews with key informants in four countries: Guatemala, Paraguay, Peru and Uruguay. Findings indicate that poverty and inequality (disparities within countries by wealth and residence), unequal access to services, inadequate coverage of social programmes and lack of awareness on appropriate feeding practices are important drivers for inadequate diets. We conclude that countries in the region need to invest in policies to tackle overweight and micronutrient deficiencies in young children, considering inequalities between and within countries, enhance coverage of social protection programmes, improve coordination between sectors to improve children's diets and expand the coverage and intensity of awareness campaigns on feeding practices, using iterative programme designs.
In Peru, exclusive breastfeeding (EBF) before six months of age decreased in urban areas (from 64.5% in 2007 to 59.9% in 2010) and the coastal region (from 60.1% in 2007 to 52.8% in 2010) despite a ...national infant feeding policy to protect, promote and support breastfeeding (BF). Health care providers (HCP) play an essential role in influencing mothers' feeding decisions. This study examined infant feeding promotion and support provided by government health services in Lima. Semi-structured interviews were conducted with 16 HCP and 11 mothers of infants < 6 months of age. Seven mothers participated in two focus group discussions. The health service environment and educational activities were observed. A case study approach was used and patterns established using cross-case analysis. HCP gave advice via growth monitoring and medical visits, nutrition counseling sessions, home visits and group sessions. HCP recommended EBF for six months but did not provide practical and tailored support to address common problems. Barriers to providing BF counseling by HCP included heavy client load, inadequate in-service training, poor counseling skills, and formula industry influence. Barriers to implementing EBF among mothers included employment, perceived breast milk insufficiency and infant formula promotion. Improved training of HCP and stronger monitoring of compliance with the national infant feeding policy are needed in government health services to protect BF behaviors.
Au Pérou, les taux d'allaitement maternel exclusif (AME) chez les enfants de moins de six mois ont diminué dans les zones urbaines (de 64.5% en 2007 à 59.9% en 2010) et dans la région côtière du pays (de 60.1% en 2007 à 52.8% en 2010) malgré l'existence d'une politique nationale visant la protection, la promotion et le soutien de l'allaitement maternel. Les professionnels de la santé (PS) jouent un rôle essentiel en influençant les mères concernant l'alimentation de leurs enfants. Cette étude a examiné les conseils offerts par les services de santé gouvernementaux concernant l'alimentation des nourrissons dans une région périurbaine de Lima. Des entrevues semi structurées ont été menées avec 16 PS et 11 mères de nourrissons de moins de six mois. Sept mères ont participé à des groupes de discussion. L'environnement des établissements de santé ainsi que les activités éducatives qui s'y déroulaient ont été observés. Une méthodologie de type etude de cas a été utilisée et une analyse thématique a été adoptée pour analyser et comparer les cas. Les conseils ont été donnés aux mères lors des rencontres pour le contrôle de la croissance, des visites médicales et nutritionnelles, des visites à domicile ainsi que des sessions de groupe. Les PS recommandaient l'AME pendant six mois mais ne fournissaient que rarement des conseils pratiques et adaptés à chaque mère pour surmonter leurs problèmes d'alimentation. La surcharge de travail, une formation continue inadéquate et de faibles habiletés à conseiller ont été identifiées comme barrières à des recommandations en matière d'allaitement. Le travail des mères, leur perception d'insuffisance de lait maternel ainsi que l'influence de l'industrie des formules de lait constituaient les principales barrières à l'AME. Une meilleure formation des PS ainsi qu'un suivi plus serré de la conformité à la politique nationale de l'allaitement maternel au sein des services de santé gouvernementaux sont nécessaires afin de protéger l'allaitement maternel.
PDF