Evaluation of Complementary Feeding Programme: the case of St. Michael’s and the District Hospitals of Bosomtwe Atwima-Kwanwoma District

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This study was undertaken to assess the extent of coverage, effects and related factors of Complementary Feeding Programme in St. Michael’s and the District hospitals of Bosomtwe-Atwima-Kwanwoma. The study was observational and cross-sectional in design. The sample comprised 100 mothers-and-child pairs. The health staff were 20 in number, selected purposively. Both close and open-ended questions were used in designing the questionnaires, pre-tested and used to collect information from the respondents using mostly face-to-face interview. The information collected was analysed and presented using tables, pie charts and bar charts. Those data that were not easy to quantify were described. The study revealed that majority of mothers (88%) were married and 57% of them had completed Middle/JSS level, whilst 3% had completed secondary education. Also majority of mothers (65%) had little knowledge in complementary feeding. It was however, observed that 93% of them attend child welfare clinics to have their children’s growth monitored and also immunized. The results revealed that mothers have easy access to the clinics, the services are affordable and there is cordial relationship between the health staff and the mothers. The health staff give mothers education in nutrition, check the nutritional status of all the children brought to the clinic and refer mothers with malnourished children to the Nutrition Rehabilitation Centre at St. Michael’s Hospital, Pramso. With respect to complementary feeding practices, the study revealed that the ages at which mothers introduced their children to complementary food ranges from as early as five weeks to as late as eleven months. Mothers observe hygienic practices like washing of utensils with soap and sponge before use, use of clean water, and washing hands with soap before meal preparation and feeding the children. Majority of mothers (90%) personally feed their children and 84% still breastfeed their children. It was further revealed that majority of mothers (46%) do not give their children snacks with the remaining (54%) giving snacks like biscuits, pastries, banana, pawpaw and oranges to their children. The study revealed that although the health personnel are few, they were doing their best under difficult conditions such as low educational levels of the mothers, reflected in non compliance with complementary feeding practices taught and financial constraints. These have contributed to the poor nutritional status (33% underweight, 10% wasted, 14% stunted) of most of the children on complementary feeding in both hospitals. Lack of policy support, inadequate funding, lack of advocacy, irregular supervision, monitoring and evaluation are major factors that militated against the successful implementation of the programme. Therefore there is an urgent need to address these issues in order to make the programme a success. The researcher therefore recommends that there should be national policy on complementary feeding just as there is for breastfeeding. Also enough funds should be channelled into the implementation of the programme, whilst regular monitoring, supervision and evaluation should be intensified. Furthermore, regular workshops should be organized for the health personnel on the programme in order to up-grade their knowledge and be abreast with current nutrition information.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of Master Science degree in Health Services Planning and Management, 2004