Care-Group Model Effect on Nutritional Status of Children Under Five in Chiredzi District

Abstract

Stunting amongst under-fives remains a challenge globally. About, 27% of all children under five are stunted in Masvingo province alone whilst 27.3% are stunted in Chiredzi. The Care Group Model was introduced to address food and nutrition insecurity for stunting reduction through addressing identified nutrition-related health issues in a focused way per district. Despite the positive expected outcomes of the Care Group Model for Chiredzi, it is unfortunate there are no robust evaluations of the impact of the Care Group Model in reducing rates of stunting in Chiredzi. This study was therefore aimed at determining the effect of the Care Group Model on nutrition status of children under five in Chiredzi District. A mixed methods approach which includes both qualitative and quantitative approaches was used. An unmatched case-control (1:4) was done reaching 234 participants (52 cases and 182 controls). A line list in which participants were systematically selected was obtained from four health facilities. Cases for the study were defined as Any child aged 6 to 23 months who was stunted (HAZ < - 2SD). Data was collected for a period of 2 months. The results showed that there was low uptake of the Care Group Model by caregivers in the Chiredzi District with only 22 percent enrolled with most caregivers enrolled being female (80%). Sex of child (p= 0.049) and age of child (p=0.012) were found to be significantly different between the cases and controls. Caregivers of children with overall good knowledge (OR= 0.1; 95%CI: 0.02 – 0.4; p<0.010) were 90 percent less likely to develop stunting than those with poor knowledge. The main barriers for the implementation of the Care Group model were drought and food insecurity, low population coverage and poor stakeholder involvement. Enhancers were having a needs assessment research, social cohesion and human capital and resources. there was a significant association between access to safe sources of drinking water and stunting (OR=0.2; 95%CI: 0.1 – 0.4 ; p=0.040). Results also showed no association between stunting and child feeding practices. Being in the Care Group Model positively influenced overall knowledge, attitudes on EBF, access to safe drinking water as well as MAD. Being in the care group and having overall good knowledge (OR=0.2; 95%CI: 0.0 – 0.9) and being in the care group and access to safe sources of drinking water (OR= 0.4; 95%CI: 0.3 – 0.9) were both associated with stunting. Children with caregivers participating in Care Groups are 80 percent less likely to develop stunting compared to those with parents who are not participating. Care Groups in Chiredzi facilitated stunting reduction in children under five through giving knowledge and behaviour change in terms of WASH especially use of safe drinking water. There is need for strong collaborating with MOHCC and other government stakeholders throughout implementation for the purposes of sustainability and continuity of the program.