Factors influencing infant and young child feeding practices among children 0- 24 months in Nakivale Refugee Settlement Isingiro District, Uganda

Abstract

Worldwide, suboptimal breastfeeding still accounts for deaths of 1.4 million children aged less than five years. Most refugee assessments do not collect data on factors affecting Infant and Young Child Feeding (IYCF) practices other than rates of exclusive breastfeeding and age at which complementary foods are introduced and type of food introduced. Objectives The general objective of the study was to establish infant and young child feeding practices as well as factors associated with them in Nakivale refugee settlement. Methodology The study was conducted among 831 mothers who were selected using systematic random sampling from 25 villages in Nakivale refugee settlement. An analytical cross-sectional study utilizing both quantitative and qualitative data collection methods was used. Quantitative data were analyzed using SPSS and qualitative information from focus group discussions and key informant interviews was coded into key themes. Results Out of 831 respondents 19.3% (160/831 ) where found to have initiated breastfeeding within one hour of giving birth, practiced exclusive breastfeeding or still practicing it and initiated complementary feeding at six months. Factors that were found to influence infant and young child feeding practices included secondary education level (OR 1.2 95% CI 1.1- 2.1 p= 0.04), having three children (OR 1.7 95% CI 1.1- 2.8, p= 0.03), nutrition education (OR 1.3 95% CI 1.1-21.9. p= 0.01), influence from health workers in the settlement (OR 1.3 95% CI 1.1- 1.9, p= 0.04) and cultural acceptability ( OR= 2.4 95% CI 1.1-5.4 p= 0.03) at bivariate level xii while at multivariate level, significant factors included secondary education level (OR 2.8 95% CI 1.1- 7.1, p= 0.03), influence from health workers ( OR 3.1 95 % CI 1.4- 7.4, p= 0.02) and cultural acceptability ( OR= 2.5 95% CI 1.2-8.6 p= 0.03) in the refugee settlement were found to be significantly associated. Conclusion The proportion of mothers of children 0- 6 months practicing exclusive breast feeding was at 52.1 percent and while a proportion of 8.4 percent of mothers of children 6- 24 months practiced appropriate complementary feeding in Nakivale refugee settlement. The factors that influenced infant and young child feeding practices in Nakivale refugee settlement in Isingiro district included education level of respondents, having three children as individual factors, Attending nutrition education session at the health facility after delivery at both bivariate and multivariate level and Influence from health workers during community nutrition education session was a community factor associated with practicing appropriate infant and young child feeding practices at both bivariate and multivariate level. Recommendations Nutrition education on appropriate infant and young child feeding should be strengthened at facility and community level. Community based breastfeeding and mother to mother support groups should be established in the refugee settlement. Design Information, Education and Communication material for nutrition programs on infant and young child feeding practices that target mothers who are unable to read and write. UNHCR and WFP Support regular nutrition assessments that will provide additional information on factors that influence infant young child feeding practices 1