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ORIGINAL RESEARCH article

Front. Public Health
Sec. Children and Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1331907
This article is part of the Research Topic The Global Health of Orphaned and Disadvantaged Children View all articles

The nutritional and feeding status of children living in selected residential child care facilities in Zambia: implications for programs and policies

Provisionally accepted
Zeina Makhoul Zeina Makhoul 1*Mulemba Ndonji Mulemba Ndonji 2Julie M. Long Julie M. Long 3Carolyn Moore Carolyn Moore 1Edgar Lunda Edgar Lunda 2Watson Mwandileya Watson Mwandileya 2Douglas Taren Douglas Taren 3
  • 1 SPOON Foundation, Portland, United States
  • 2 Other, Lusaka, Zambia
  • 3 Pediatric Nutrition Laboratory, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States

The final, formatted version of the article will be published soon.

    This study aimed to estimate the prevalence of undernutrition and risk of feeding difficulties and describe common feeding practices for children from birth to 10 years of age living in residential care in Zambia.This was a secondary analysis of de-identified cross-sectional data on 397 children living in 22 residential care facilities in four provinces. Child demographics, anthropometrics, hemoglobin levels, risk for feeding difficulties, and facility-level feeding practices were collected by a trained study team using Count Me In, a digital health app. Interviews with staff were conducted at 15 residential care facilities.Results: Around half of the study sample were boys (53.4%) and < 5 years old (55.4%). Special health care needs were reported in 10.3% of the children, with cerebral palsy being the most common (3.5%). Underweight, stunting, wasting (using weight-for-length/height), and anemia were found in 22.4%, 28.0%, 7.1% and 54.7% of children, respectively, with higher rates in children with special healthcare needs and children < 24 months old. Duration of residential care was positively associated with length/height-for-age but not weight-for-age or weight-for-length/height z-scores. A risk for feeding difficulties was found in 41.4% and 26.0% of children with and without special health care needs, respectively. Suboptimal bottle-feeding practices, including the use of altered nipples and poor caregiver-infant interactions, were observed for infants < 12 months old. Residential care staff reported suboptimal diets in their facilities and gaps in knowledge and resources to meet children's nutritional needs.

    Keywords: nutrition, residential care, care reform, Zambia, feeding, Disability, Orphanages, children were classified as normal

    Received: 01 Nov 2023; Accepted: 21 Aug 2024.

    Copyright: © 2024 Makhoul, Ndonji, Long, Moore, Lunda, Mwandileya and Taren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zeina Makhoul, SPOON Foundation, Portland, United States

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