Academic journal article Journal of Health Population and Nutrition

Index for Measuring the Quality of Complementary Feeding Practices in Rural India

Academic journal article Journal of Health Population and Nutrition

Index for Measuring the Quality of Complementary Feeding Practices in Rural India

Article excerpt


The link between malnutrition and infant-feeding practices has been well-established (1-2). Incidence of malnutrition rises sharply during 6-8 months of age in most countries, which coincide with period of complementary feeding (CF), and deficits acquired at this age are difficult to compensate later in childhood (2-3). In India, only 55% of infants receive semi-solid or solid foods, in addition to breastmilk, during 6-8 months of age, showing faulty CF practices to be a significant problem of public health (4).

Efforts to measure and quantify the CF practices and to assess the strength of their association with child's nutritional status have been very limited till date due to methodological problems. This is because the CF practices encompass a series of inter related behaviours that must be considered simultaneously and are, therefore, difficult to summarize into one or a few variables that accurately reflect these practices (5-6).

In this context, a composite index for a global assessment of infant and young child feeding was conceived in developing countries (5-7). This index summarized the salient young child-feeding practices, using a limited number of variables collected during the Demographic and Health Survey (DHS) in Latin American countries. The aim of the present study was to assess the feasibility of developing a CFI by adapting the index created by Arimond and Ruel (7) and to determine its association with growth of infants, aged 6-12 months, in rural Indian population. The CFI was created for using it as a quick tool to get a composite score of main CF practices of infants and to identify the deficient CF practices for a population, which would be targeted in the improvement intervention of CF practices.


Sample and sample size

A community-based cross-sectional investigation was carried out in rural Uttar Pradesh, India. The site of the study comprised six purposively-selected villages, such as Bhojpur, Gadana, Bhikanpur, Kanoja, Abupur, and Ravli, from three rural community development blocks under the integrated child developmental services of Ghaziabad district, Uttar Pradesh, India. All the infants, aged 6-12 months, from the six villages were enlisted with the help of birth-records and survey-registers of Anganwadi worker (AWW) at each Anganwadi centre (AWC) [Anganwadi means a courtyard play centre, a childcare centre, located within the village itself, over a population of 1,000. The AWC is the focal point for grassroots-level service-delivery of six key services, namely supplementary nutrition, non-formal preschool education, immunization, health check-up, referral services, and nutrition and health education, including growth monitoring and promotion. Each AWC is run by one Anganwadi worker (AWW) and one helper]. In total, 320 infants were enlisted from these six villages. Infants with any congenital problem were excluded from the sample. Fifty percent of the infants were randomly selected for the survey using random number tables. The non-response rate was 5.5% in the sample. Thus, in total, 151 mother-infant pairs formed the sample for the survey.

Data collection

An interview schedule was used for collecting in formation on sociodemographic profile using standard of living index (SLI) (8), maternal characteristics, breastfeeding, CF practices, and morbidity profile of infants. SLI is a composite index for measuring the socioeconomic status of the household. It is a summary household measure and is calculated by adding the scores for type of house, toilet facility, source of lighting, main fuel for cooking, source of drinking-water, separate room for cooking, ownership of house, ownership of agricultural land, ownership of irrigated land, ownership of livestock, and ownership of durable goods. The index is calculated by summing the scores, which have been developed by the International Institute for Population Sciences, Mumbai and has been used in the National Family Health Survey 2, India (8) for measuring the socioeconomic status of households in the national survey. …

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