Date of Conferral

2018

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Patrick Tschida

Abstract

Inadequate nutrition during infancy and early childhood seriously interferes with brain development, leading to neurological and behavioral disorders. Such effects are detrimental to children under 2 years of age. The purpose of this cross-sectional study was to better understand the quality of nutrition services offered to children and pregnant women in Ntungamo District in southwestern Uganda. The cross-sectional design facilitated comparison of different variables, using a research-question-driven approach, assessing existing secondary data from SPRING Uganda database. Stepwise, backward multiple logistic regression was used to identify the independent variables that influenced the provision of quality nutrition assessment, counseling, and support (NACS) services to clients. Only the independent variables with p < 0.05 were retained in the final model. Odds ratios with 95% confidence intervals were used to estimate the strength of association between the independent variables which are: 1) training of health workers with different nutrition packages, 2) availability of nutrition assessment equipment at varied service delivery points, 3) availability of nutrition supplies for preventing and treating acute malnutrition, 4) availability of nutrition treatment protocols and IEC materials functionality of quality improvement teams, and 5) supervision and motivation of health workers. The dependent variables were indicated by percentage of children and pregnant women who were provided with appropriate NACS in outpatient departments, young child clinics, antenatal clinics, postnatal clinics and antiretroviral therapy (ART) departments in the past 3 months. Statistical analysis was performed with IBM SPSS 25.0. All associations with p < 0.05 were considered statistically significant. All surveyed facilities offer maternal health services, a positive indication that a greater percentage of the facilities in western Uganda realize the importance of nutrition assessment of pregnant mothers and children. Of the sampled health facilities supported by SPRING Uganda, 56.3% had functional nutrition assessment equipment like mid-upper arm circumferences (MUAC) tapes and weighing scales. This study showed that different nutritional services offered to pregnant and lactating mothers and children could either positively or negatively affect the quality of nutrition in Ntungamo District.

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