MATERNAL EMPLOYMENT, CHILDCARE AND NUTRITIONAL STATUS OF CHILDREN 0-2 YEARS OF AGE IN THE KASSENA-NANKANA DISTRICTS IN THE UPPER EAST REGION OF GHANA

ABSTRACT

Background: Child undernutrition and poor childcare still remain a great concern in Ghana. Maternal employment has increased rapidly due to the demand of increased household income thus giving mothers a double burden of responsibility as income earners and primary child caregivers. These multifaceted roles by mothers could adversely affect the nutritional status and the overall health status of the child.

Objective: To assess the relationship between maternal employment, child care and nutritional status of children 0-2 years in Kassena- Nankana districts in the Upper East Region of Ghana.

Methods: A cross-sectional mixed methods study was conducted with 128 mothers-child pairs in the Kassena-Nankana Districts in the Upper East Region of Ghana. A semi-structured questionnaire was used to gather quantitative data from the participants. Anthropometric measurements and dietary intake data (24 hours and 7 days food frequency tools) were taken from the children for nutritional status assessment. Focus group interview guide was also used to gather qualitative data from mothers. Logistic regression was used to predict factors for child nutritional status (stunting, underweight and wasting) and childcare practices indexes (infant and child feeding practice index and preventive health seeking index) and Data gathered from focus group discussion were transcribed and translated into English. Content analysis was used in the data analysis where data were organised into main themes and sub themes.

Results: The mean age of the mothers and children were 26.9±6.7 years old and 10.4±6.7 months old respectively. Majority of employed mothers (60%) worked for 4-8 hours a day and 82.7% of employed mothers worked 4-6 days in a week. All (100%) children had ever been breastfed, 78.9% were introduced to breastmilk within one hour of birth and almost all (93.8%) of mothers breastfed on demand. The mean age of cessation of breastfeeding was

xiii

16.6 months and 88.9% of mothers introduced complementary feeding at six months. Prevalence of wasting, underweight and stunting among the study children were 24.2%, 22.7% and 15.6%, respectively. Maternal employment was associated with child feeding practices such as snacking (Adjusted OR = 7.94; 95% CI: 2.25-27.94), bottle feeding (AOR= 7.38; 95% CI: 2.02-27.04) and no prelacteal feeding (AOR= 16.09; 95% CI: 1.10-219.8). Maternal employment was also associated with underweight (AOR= 0.16; 95% CI: 0.04-0.86) but not wasting, stunting, child feeding index and preventive health seeking index. From the focus group discussion, challenges of child feeding practices as reported by mothers included, poverty, no feeding places at offices, traditional food beliefs and taboos.

Conclusion: Prevalence of malnutrition still persists among children in the study area. Maternal employment status was associated with underweight and some feeding practices among children 6-24 months in the two Kassena-Nankana districts. There is the need to develop a comprehensive nutrition intervention programme due to the high prevalence of malnutrition in the districts.