Ebook Child Care Practices Associated With Positive And Negative Nutritional Outcomes For Children In Bangladesh: A Descriptive Analysis
It is widely acknowledged that socioeconomic development is necessary for improvement in the poverty situation in developing countries such as Bangladesh. Malnutrition is frequently seen in families in poverty. The extent of malnutrition in Bangladesh has been extremely high, but there is evidence of some decline in preschool malnutrition since 1975 (UN/ACC/SCN 1993). Children of this age group have been identified as the most vulnerable among the malnourished population of the country. In 1989/90, around 47.3 percent of preschool-age children were suffering from second degree malnourishment and 6.8 percent were categorized in the third degree or severe malnutrition (BBS 1991).
Household-level interventions that raise household income can have a positive impact on child nutrition, especially if they are well-targeted to needy households. This approach alone, however, is not sufficient to rapidly improve child nutrition to meet the goals set by, for example, the International Summit for Children in 1990 or the International Conference on Nutrition in 1992. Both at the aggregate national level and at the household level, income improvement shows a small, though steady, improvement in children's nutritional status. The absolute level of nutritional improvement depends on the extent to which income gains can be translated into dietary, health, and child care benefits. These are three essential ingredients to good nutrition of children (Figure 1). Improving household income may lead to better food consumption, health, and sanitation, as well as child care. However, both the rate at which child nutrition improves, and the variations in child nutrition explained by income related factors are small.
Child care capacity depends, to some extent, on both food availability in the household and access of the household to health services. It is, however, largely a function of practices and behaviors, which are not necessarily a function of resources. What are some of the crucial caring practices that are beneficial to child growth and survival, and what is the role of public policies in promoting them? Conceptually, nutritionists have used the term "positive deviance" to reflect adaptive responses for satisfactory child growth under harsh economic circumstances, such as food scarcity (Zeitlin, Ghassemi, and Mansour 1990). Conversely, "negative deviance" represents the failure of children to grow satisfactorily, even under good economic conditions. Recent work has refocused attention on these situations in identifying local practices that are conducive to good child nutrition and may be used in national nutrition programs as an adjunct to poverty alleviation efforts.
In this study, positive deviance, negative deviance, and median growth are defined in the context of observed growth patterns in Bangladeshi rural areas, thus eliminating the need for reference to "adequate" or "inadequate" growth based on international child growth standards. An internal reference identifies both better and worse performers nutritionally, based on local patterns of growth.
CONTENTS
Acknowledgments
1. Introduction
2. Conceptual Framework
- The Role of Care in Child Nutrition Outcomes
Caregiving Behavior as a Factor in Nutrition Deviance
Characteristics of Care Behaviors
The Endogeneity of Child Care
Factors Influencing Care Behaviors and Prospects for Interventions
3. Child Care Practices in Bangladesh
- Dietary Restrictions
Breast-feeding
Complementary Infant Feeding
Hygiene
4. Data Sources and Methodology
- Data Sources
Identification of Positive and Negative Nutrition Deviance
Descriptive Analysis
Identification of Key Independent Child Care Variables by Principal
Components Analysis
Multivariate Analysis
5. Results
- Overall Sample Characteristics
Infant Feeding Practices
Maternal Diet, Nutrition, and Physiological Status
Hygiene and Health Care Practices
Quality of Psychosocial Care
Probit Analysis
6. Conclusions
Appendix
Bibliography
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