KNOWLEDGE AND PRACTICES OF MOTHERS ON COMPLEMENTARY FEEDING IN CHILDREN UNDER TWO YEARS IN KATABI MILITARY HOSPITAL YOUNG CHILD CLINIC WAKISO DISTRICT

ABSTRACT

Stunted growth in Uganda affects over two million children who are under two years of age. There has been rampant cases of mothers administering inappropriate quality, quantity, frequency and consistency of complementary foods due to their lack of knowledge about complementary feeding resulting in more children being susceptible to infection, slower in recovery after illness and higher mortality.

The purpose of the study was to assess the knowledge and practices of mothers on complementary feeding in children under two years in Katabi Military Hospital

The study used a cross sectional and a descriptive survey design and employed both quantitative and qualitative data collection methods.

The results indicated that majority of the respondents 16 (53.3%) said they had no knowledge on complementary feeding. Results also showed that most mothers 27 (90%) practice complementary feeding, 21 (70%) said they use a bottle, a cup and a spoon. It was also revealed that due to poor socio-economic status most of the respondents 12 (40%) move long distances over 4 km to the health center since majority of them 10 (37.1%) earn between 50,000 -100,000 shs per month and also half 15(50%) said they support themselves with the complementary feeding.

The study concluded that most respondents had no knowledge about complementary feeding leading to poor complementary feeding practices like use of a bottle and this was due to poor social economic status which couldn’t allow them to seek information, buy clean bottles and long distances from health centers.

The study recommended that the women in rural areas should be sensitized through their local leaders and at health Centers about complementary feeding of their children. The study further recommends that most women should be encouraged to practice complementary feeding of their children because at 6 months, exclusive breastfeeding is no longer sufficient to meet all energy and nutrient needs by itself, and complementary foods should be introduced to make up for the difference.

COPY RIGHT

Copyright © (2017) by (Nambi Harriet)

AUTHORIZATION

RULES GOVERNING USE OF STUDENT’S WRITTEN WORK FROM PUBLIC HEALTH NURSES COLLEGE

Unpublished research report submitted to Public Health Nurses College, Kyambogo are deposited in the library, are open to inspection but are to be used with regard to the rights of the authors. The author and the school of nursing grant privilege of loan or purchase of microfilm or photocopy to accredited borrowers provided credit is given in subsequent written or published work.

Author Sign…………………………………… Date……………………………..

Nambi Harriet

Jinja district

Supervisor Sign.…………………                              Date: …………………………

Ms Irene Nangosha

Public Health Nurses Colleg

Principal’s Sign …………………                             Date: …………………………

Kasujja Lwanga Gertrude (Mrs)

Public Health Nurses College, Kyambogo

DEDICATION

I dedicate this report to my beloved Mother Ayazika Victo for the instrumental support she has offered to me throughout my academic endeavor.

DECLARATION

I, Nambi Harriet, declare to the best of my knowledge that this is my original work, done by myself and has never been submitted to this institution or any other institution for any academic award or grant and is being submitted with the approval of my supervisor. All literature included from other researchers and authors has been referenced.

Signature………………………………………………………..Date……………………………………………

NAMBI HARRIET

(RESEARCHER)

ACKNOWLEDGEMENT

I wish to acknowledge the contribution of all those who in one way or the other assisted to the progress of my academic work. The list was too long to be individually thanked. However, I would like to acknowledge my Supervisor Ms Irene Nangosha for her tireless guidance towards this research, my Husband Kwagho Salem, my son Levi and my mother Ayazika Victoria

I would also like to acknowledge Katabi military hospital for allowing me to carry out this research at their facility

Sincere thanks go to the staff of PHNC for giving me that knowledge successfully thought out this course. May god bless you all.

.
TABLE OF CONTENTS

ABSTRACT.. i

COPY RIGHT.. ii

AUTHORIZATION.. iii

DEDICATION.. iv

DECLARATION.. v

ACKNOWLEDGEMENT.. vi

LIST OF TABLES. xi

LIST OF FIGURES. xii

DEFINITION OF KEY TERMS. xiii

CHAPTER ONE INTRODUCTION.. 1

1.1 Background. 1

1.2 Problem Statement 3

1.3 Purpose of the study. 4

1.4 Specific Objectives. 4

1.5 Research questions. 5

1.6 Justification of the study. 5

CHAPTER TWO: LITERATURE REVIEW… 7

2.1 Introduction. 7

2.2 The knowledge of mothers on complementary feeding in children under two years. 7

2.3 The complementary feeding practices of mothers with children under two years. 9

2.4 The social economic factors affecting mothers who are on complementary feeding with children under two years. 11

CHAPTER THREE: METHODOLOGY.. 13

3.1 Introduction. 13

3.2 Study Design and rationale. 13

3.3 Study setting and rationale. 13

3.4 Study Population. 14

3.4.1 Sample Size Determination. 14

3.4.2 Sampling Procedure. 14

3.4.3 Inclusion criteria. 15

3.5 Definition of Variables. 15

3.6 Research Instrument 15

3.7 Data Collection Procedure. 15

3.7.1 Data analysis and management 16

3.8 Ethical Consideration. 16

3.9 Limitations of the study. 16

3.10 Dissemination of results. 17

CHAPTER FOUR: RESULTS. 18

4.1 Socio-demographic Characteristics of the respondents. 18

4.2 Level of knowledge of mothers about complementary feeding in children under two years  22

4.3 Complementary feeding practices of mothers with children under two years. 26

4.4 Social economic factors affecting mothers carrying out complementary feeding with children under two years. 28

CHAPTER FIVE: DISCUSSION OF FINDINGS, CONCLUSION, RECOMMENDATION IMPLICATION FOR NURSING PRACTICE AND AREAS OF FURTHER STUDY   33

5.0 Introduction. 33

5.1 Discussion of findings. 33

5.1.1  Socio-demographic Characteristics of the respondents. 33

5.1.2 The complementary feeding practices of mothers with children under two years. 36

4.1.3 The social economic factors affecting mothers with children under two years. 37

5.2 Conclusion. 40

5.3 Recommendation. 41

5.3.1 Recommendation to the government 41

5.3.2 Recommendation to the health workers. 41

5.3.3 Recommendation to the community. 41

5.4 Implication to the nursing practice. 42

5.4 Areas of further study. 42

APPENDICES. 47

APPENDIX I: CONSENT FORM… 47

APPENDIX II: QUESTIONNAIRE.. 48

APPENDIX III: INTRODUCTION LETTER.. 54

APENDIX IV: MAP OF UGANDA SHOWING WAKISO DISTRICT.. 55

APPENDIX V: MAP OF WAKISO DISTRICT SHOWING KATABI MILITARY HOSPITAL   56

LIST OF TABLES

Table 1 Marital status of respondents. 19

Table 2 Showing occupation of respondents. 19

Table 3 Showing the level of education of respondents ………………. 20

Table 4 showing what age should a child require complementary feeding. 23

Table 5 Showing the importance of complementary feeding to a child. 24

Table 6 Showing respondents practice complementary feeding on your children. 26

Table 7 Showing how often complementary foods are given to children. 26

Table 8 Table 8 Showing why some mothers do not practice complementary feeding. 27

Table 9 Showing the distance of the health center from the respondents’ homes 28

Table 10 Showing the amount earned by respondents per month ………. 29

Table 11 Showing if the respondents administer complementary feeding themselves…         31

Table 12 Showing who helps the respondents practice complementary feeding…….32

LIST OF FIGURES

Figure 1 Showing age category of respondents. 18

Figure 2 Showing marital status. 20

Figure 3 Showing Religion of respondents  21

Figure 4 Showing educational level of respondents ………………. 21

Figure 5 Showing knowledge of complementary feeding 22

Figure 6 Showing the Source of Information about complementary feeding. 23

Figure 7 Showing whether respondents have ever been sensitized about complementary  25

Figure 8 Figure 8 Showing how complementary feeding is administered. 27

Figure 9 Showing whether respondents have jobs. 29

Figure 10 Showing who supports the respondents handle complementary feeding of the children         30

Figure 11 Showing at what age range did the respondents have their first child. 31

Figure 12 Showing why respondents are not able to administer complementary feeding to their children themselve   32

DEFINITION OF KEY TERMS

Complementary Feeding:    Is the process of feeding that starts when breast milk

alone is no longer sufficient to meet the nutritional

requirements of infants, and therefore other foods and

liquids are needed, along with breast  milk which

covers the period from 6 – 24 months of age, even

though breastfeeding may continue to two years of age

and beyond.

Breast feeding:                      Breastfeeding is the normal way of providing young

infants with the nutrients they need for healthy growth

and development

Knowledge:                            The information and understanding that a person has

gained through learning or experience

Practice:                                 these are acts of doing something over and over again

Perceptions:                           This is the ability to see, here or become aware of

Something through the senses.
ABBREVIATIONS AND ACRONYMS

CBOs                          : Community-Based Organizations

KNBS                         : Kenya National Bureau of Statistics

MoH                           : Ministry of Health

UBOS                         : Uganda Bureau of Statistics

UDHS                         : Uganda Demographic and Health Survey

UNICEF                    : United Nations Children’s Fund

USAID                       : United States Agency for International Development

WHO                          : World Health Organization

PHNC                         : Public Health Nurses College

UNMEB                     : Uganda Nurses and Midwives Examination Board

CHAPTER ONE

INTRODUCTION

Introduction

This chapter presents the background, specific objective, problem statement, purpose of the study, research questions and justification for the study.

 1.1 Background

According to Sethi, R. (2017), complementary feeding is the process that starts when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk which covers the period from 6 – 24 months of age, even though breastfeeding may continue to two years of age and beyond. Complementary feeding is needed to provide energy and essential nutrients required for continued growth and development.eg Soya beans Oranges, Tomatoes, Cabbage, Liver carrots Pumpkin sweet potatoes among others.

Globally, complementary food nutrients complement those in breast milk. At 6 – 24 months of age, a child’s growth at this stage during which nutrient deficiencies and illnesses contribute globally to higher rates of stunted growth among children under two years of age (Neufeld, L. M, et al, 2016).

According to Amosu, A, et al (2011), babies feeding from birth up to the first years of life influences an individual’s whole life. It is common knowledge that breastfeeding is important for optimal infant feeding. Breast milk alone can be used for feeding babies in the first six months of life, but from then on, complementary feeding is necessary. The nutritional adequacy of complementary food is essential for the prevention of infant morbidity and mortality, including malnutrition and overweight. Malnutrition is one of the most widespread conditions affecting child health (Zar, et al 2014). The ‘germ’ of malnutrition ‘infects’ a fetus in the intra-uterine life due to lack of sufficient antenatal care on part of the mother Akhter, M. (2016). The condition deteriorates further when after birth the infant is deprived of complementary feeding.

An estimated 35% of global under-two deaths, and 50-70% of diarrhoeal diseases, measles, malaria and lower respiratory infections in developing countries are attributable to child Stunted growth. Undernourished children are prone to poor mental, physical and physiological development, and are at increased risk of infections and death (Apprey, C. 2015)

Globally, 16.4 million (25%) children under five years of age are under weight, 100.7 million stunted, 51.5 million wasted and 42.6 million are overweight according to (Mercdes et al 2012). It has been estimated that 684000 child death occur worldwide every year and this could be prevented by increasing access to vitamin A and Zinc according to (Ruel, M. T., et al, 2013)

In sub-Saharan Africa, at least 1 in 3 children under 5 years are stunted in 2011, hence affecting their cognitive development and learning ability later in life according to Forsyth, S., et al  (2017), Paul, S.et al  (2015) states that in sub-Saharan Africa poor knowledge and practices of complementary feeding especially by the mothers has been responsible directly or indirectly for 60% of the 9.7 million deaths annually among children under 2 years, where three quarters of these deaths are associated with inappropriate feeding practices in the first year of life (Meleko, A., et al, 2017).

In order to reduce child mortality and achieve the fourth Millennium Development Goal i.e., to reduce child mortality rates (United Nations Development Group, 2008), there is need to improve the feeding practices of the children, since child feeding is one of the most neglected determinants of young child nutrition in spite of the importance in growth pattern of the child.

In Uganda, early childhood malnutrition rates have been estimated at 40% of the children under five years of age and this has been attributed to improper infant feeding practices eg food insecurity, and lack of access to health care as among the problems (Asiki, G., et al, 2016).

1.2 Problem Statement

Stunted growth in Uganda affects over two million children who are under two years of age. According to USAID, 2010), Karamoja has the highest rate of acute malnutrition recorded to be 13.1%. the district remains above critical level with children 6-23 months being most affected with a minimum of 22.6%  and a maximum of 75% according to the district health officer.

Despite the complementary food program and health education on proper nutrition given to mothers during and after attending the child care clinic, there has been rampant cases of mothers administering inappropriate quality, quantity, frequency and consistency of complementary foods due to their lack of knowledge about complementary feeding resulting in more children being susceptible to infection, slower in recovery after illness and higher mortality that is prevalent in Katabi Military hospital, (Nankumbi, J et al, 2015).

Therefore it’s against this background that the researcher sought to investigate the knowledge and practices of mothers on complementary feeding in children under two years in Katabi Military Hospital

1.3 Purpose of the study

To assess the knowledge and practices of mothers on complementary feeding in children under two years in katabi military Hospital in an effort to assist in devising means of improving the use of complementary feeding methods or practices and in the event reduce levels of malnutrition and stunted growth among children.

1.4 Specific Objectives

1. To assess the level of knowledge of mothers on complementary feeding in children under two years in katabi military Hospital
2. To establish  the complementary feeding practices of mothers with children under two years in katabi military Hospital
3. To identify the social economic factors affecting mothers  with children under two years undergoing complementary feeding in katabi military Hospital

1.5 Research questions.

1.  What is the level of knowledge that mothers have on complementary feeding in children under two years in katabi military Hospital?
2. What are the complementary feeding practices do mothers with children under two years have in in katabi military Hospital?
3. What are the social economic factors affect mothers carrying out complementary feeding in children under two years in katabi military Hospital?

1.6 Justification of the study

The findings from this study will be used by  the Ministry of Health, Non-Governmental Organizations, Community-Based Organizations (CBOs) in improving complementary feeding practices by identifying the potential areas which still require improvements in funding, development and national sensitization with regard to need and importance of ensuring proper complementary feeding by mothers.

The study will also provide a valuable point of reference for researchers carrying out similar studies in future and will also contribute to the available body of literature on the factors affecting complementary feeding

Results of the study will improve on the knowledge of health workers and mother mothers attending Katabi Military hospital in understanding the determinants of complementary feeding to young children and this will service an important tool for any possible intervention aimed at improving the levels of complementary feeding with in the area

The research will help the researcher attain a diploma in nursing

CHAPTER TWO

LITERATURE REVIEW

2.1 Introduction

This chapter highlights the literature review cited by other scholars about the knowledge and practices of mothers on complementary feeding in children under two years. The literature is presented in sequence of the specific objectives thus level of knowledge, practices and social economic factors affecting mothers who carry out complementary feeding.

2.2 The knowledge of mothers on complementary feeding in children under two years

Feeding practice has a lot of implication for the nutritional status of the child. Mothers‟ knowledge about nutritious meals for the children influences how the child is fed. In many developing countries infants and young children are most vulnerable to malnutrition because of lack of knowledge on how to feed a child (WHO, 2013). Many observational studies show that maternal knowledge of optimal child feeding practices like exclusive breastfeeding for six months, continued breastfeeding and the timely transition to adequate complementary food is basic to keep health of a child (WHO, 2010). In Ethiopia, majority of all under-five deaths are highly associated with abrupt cessation of breastfeeding and infectious diseases, but it is closely linked to gap of knowledge on how to feed appropriately (Central Statistical Authority Ethiopia and ORC Macro. 2012). Mother‟s nutritional knowledge is considered to have a great impact on the child feeding practices as she has the capacity to take diet related conscious decisions for the child.

A study by Hellen Keller International (2010) in Baitadi District, Nepal showed that majority of mothers had the perception that children of 6-12 months should not be fed on eggs and flesh meats, this translated to only 2.1% and 4.4% of their children being fed on eggs and flesh meats respectively. Scientific knowledge demonstrates that maternal knowledge on complementary feeding may positively influence practice or may lead to no change in feeding practices.

In India, an interventional study where nutritional education was given to mothers to improve awareness about infant feeding in the variety, quantity, quality and consistency of complementary feeding showed that, Majority of complementary feeding practices were inadequate in quality, quantity, frequency and consistency (Sethi et al., 2013). In a similar study in south India, mothers were counseled about the choice of appropriate complementary foods and feeding frequency. The intervention group had improved feeding practices such as avoiding feeding bottles and improved on dietary diversity and the types of complementary foods (Hague et al., 2012).

On the contrary, knowledge may not translate to practice. A study by Subedi et al. (2012) on infant and young child feeding practices in Chepang communities in Nepal showed that, only some of the mothers had knowledge about breastfeeding initiation within one hour, 62% had known about exact time for exclusive breastfeeding and majority of mothers had knowledge about appropriate time for introduction of complementary feeding and total time for

2.3 The complementary feeding practices of mothers with children under two years

A study by Qiong et al (2013) in Wuyi county, China among children aged 6-23 months showed similar results to those of Nisha (2012) which indicated that, their dietary diversity was quite poor as only one out of ten children (10.0%) was fed with foods from at least four food groups. Similarly, a study by Nisha (2012) on inadequate feeding of infants and young children in India revealed that although 92% of children were between the ages 12 and 18 months, only 17% of them were fed adequately from four or more food groups.

A study in the slums of Dhaka City showed that although complementary feeding is started early by some mothers, majority started at 6 months, as (64%) mothers started complementary feeding at 6-7 months while only 19.2% started at 4-5 months (Akhtar, et al.,2012). In Kenya, 60% of children aged 4-5 months are given complementary foods (KNBS and ICF Macro, 2010), and by 6 months 84% of the infants are already receiving complementary feeds (MOPHS, 2007-2010). This is an indication that majority of the mothers in Kenya practice early complementary feeding in contrast to the (Burns, J., et al, 2016) recommendation (introduction of solid, semi-solids and soft foods at 6-8 months).

According to (WHO 2010), breastfed children 6-8 months old be fed 2 times per day and those 9-23 months old be fed 2-3 times per a day while the non-breastfed ones be fed 4 times per day (Wyatt, A. J., et al (2015). In Kenya, the minimum meal frequency is low as per WHO recommendations, the Kenya Demographic and Health Survey of 2008-09 revealed that of all the children 6-23 months, only two thirds were fed the minimum number of times (KNBS and ICF Macro, 2010).

In Kenya, minimum acceptable diet is not achieved by many children. According to the KDHS (KNBS and ICF Macro, 2010), only 54% of the children 6-23 months had the minimum dietary diversity. A nutrition survey in Marsabit County (MOPHS/UNICEF, 2011), showed that only 34.9% of the children 6-23 months were fed with the minimum dietary diversity (≥4 food groups). This gives an indication of inadequate diversity of foods among the children.

Complementary foods should be given using a spoon and cup/ glass (Foterek, K., et al, 2016). Baby feeding bottles should be avoided because, in addition to being an important source of contamination for the infant, they interfere with oral dynamics (WHO, 2010). The tendency to use the bottle increases in relation to child’s increasing age.

A study by Shamin et al (2009), about infant feeding practices including the use of bottle and their determinants, from economically underprivileged mothers in a Peri-urban area of Karachi, Pakistan, showed that only 17% of the infants under the age of 3 months were offered bottle, 69% between 4 to 6 months increased to 76% in infants from 7 months to 1 year. The continued practice of bottle feeding is a concern because of the possible contamination leading to higher morbidity rates in children.

WHO recommends exclusive breastfeeding for 6 months and introduction of complementary foods at 6 months of age with continued breastfeeding (PAHO/WHO, 2013).The time of introduction and type of complementary food given to an infant are very important for the child’s nutritional status. According to current recommendations (Locks, L. M., et al, 2015), complementary feeding should be introduced into the child’s diet at the age of 6 months. Early introduction of complementary foods increases infant morbidity and mortality while late introduction of complementary foods is harmful to the health of the baby, because infant growth stops or slows down and the risk of malnutrition and micronutrient deficiency increases (Mekbib, E., et al, 2014).

2.4 The social economic factors affecting mothers who are on complementary feeding with children under two years

Study by Camara, S., et al (2015) found that mothers’ educational status  and insufficient antenatal care  visits were significant factors affecting mothers in carrying out complementary feeding. According to, literate mothers are more likely adhere to complementary feeding rules than the illiterate ones.

Camara, S.et al (2015) further reported that the occupation of the mothers can prevent them from properly administering complementary feeding of their children. Nutrition Officers in Tanzania reported the infants born to working mothers were more likely to consume processed food due to their mothers’ work. Such mothers end up leaving their children with caretakers like aunties, young brothers or sisters and sometimes maid who are not well trained to administer complementary feeding to their young children.

The number of children born to one single woman also can affect complementary feeding of the mother. According to most mothers trust their other children to administer complementary feeding especially when they leave for work or go to the garden. It is common for mothers to leave a little cash with the caregiver who are usually children too, so they can buy food from local groceries or vendors to feed themselves and the young baby. There are also some home-cooked meals at home, but caregivers (elder sibling, neighbor, elderly relative/kin) are generally ªunableº to properly feed young children below to years of age because they lack knowledge about nutrition and hygiene needs (Gardner, H, et al 2015).

Nestle, M. (2013) states that though young mothers are generally aware of the nutritional value of different kinds of food, appropriate feeding times, and hygiene practices, they are often inconsistent about feeding their children accordingly because they are away from home due to their school work or employment. Young mothers that are engaged in a variety of cash-earning activities that make taking care of their children difficult cooking at home difficult.

CHAPTER THREE

METHODOLOGY

3.1 Introduction

The chapter focused on methodology which includes the study design, study setting, study population, sample size determination, sampling procedure, inclusion criteria, definition of variables, research instruments, data collection procedure, data management, data analysis, ethical consideration, limitation of the study and dissemination of results.

3.2 Study Design and rationale

The study design was a cross sectional and a descriptive study was employed with both quantitative and qualitative data collection methods. This design was used because it assists the researcher in easy access to the required data for the study.

3.3 Study setting and rationale

The study was conducted in Katabi military hospital which is located in Entebbe town council Katabi village. Entebbe sits on the northern shores of Lake Victoria, Africa’s largest lake. The town is situated in Wakiso District, approximately 37 kilometres (23 mi) southwest of Kampala, Uganda’s capital and largest city. The municipality is located on a peninsula into Lake Victoria, covering a total area of 56.2 square kilometres (21.7 sq mi), out of which 20 km² (7.7 sq mi) is water. The coordinates of Entebbe are: 0°03’00.0″N, 32°27’36.0″EEntebbe has a population of 69,958 people according to the national population census (2014).   Katabi military hospital is located in Katabi Sub-county Division A 3Km From Entebbe municipality near the sub county headquarters. The Hospital offers the following services to its clients: HAART services; ANC, PNC, OPD, Nutrition, Deliveries, Immunization services, Family Planning, radiography services  and many others to mention but a few.  The study area was selected because of the prevalence of the study problem.

3.4 Study Population

The study population included the women attending young child clinic in Katabi Military Hospital with children under 2 years of age who are carrying out complementary feeding

3.4.1 Sample Size Determination

The study consisted of 30 women having children who are under two years of age, and attend Katabi military hospital.

3.4.2 Sampling Procedure

The researcher used simple random sampling procedure to get the required respondents for the study. In this procedure, the researcher wrote two words YES and NO on different pieces of paper folded them put in a box and shook then respondents were told to pick one per person and this enabled the researcher select all the respondents with minimal bias , the selected respondents were those who picked yes and voluntarily consent to participate. This was done until a total of 30 respondents were obtained.

3.4.3 Inclusion criteria

The study targeted mothers who attend katabi military hospital young child clinic and are carrying out complementary feeding and  health workers who were  available at the hospital during data collection, and were free and willing to voluntarily consent to participate in the study.

3.5 Definition of Variables

The independent variables for the study included:

Knowledge and practices influencing the use of complementary feeding of children below two years of age

3.6 Research Instrument

The researcher collected data using questionnaires which were developed and pre-tested for the study, this was used because most of the respondents knew how to read and write. It had both closed and open-ended questions written in English.

3.7 Data Collection Procedure

The researcher administered the self-administered questionnaires to respondents from their various wards or departments where they were being provided services. This was done to increase efficiency and privacy during data collection.

3.7.1 Data analysis and management

The study data was analyzed manually for completion of questionnaire, edited and after the data will be transferred to Microsoft Excel 2010 for the graphical presentation of results and was presented in both figures and tables.

3.8 Ethical Consideration

A letter of introduction was obtained from Public Health Nurses College, introducing the researcher to the administration of katabi hospital seeking permission to carry out the study. After permission was granted, the Health Centre administrator introduced the researcher to the in charge who then introduced the researcher to the respondents. The study commenced after the objectives of the study had been clearly and well explained to participants and the researcher they understand and voluntarily consented to participate in the study. Respondents were assured of maximum confidentiality of all the information they give and numbers were used instead of respondents’ names.

3.9 Limitations of the study

The researcher might encounter financial constraints in gathering information from the internet and libraries as well as printing and transport costs.

The researcher might encounter language barrier from some of the mothers who can’t speak English therefore the researcher sought for a local interpreter who helped interpret some of the questions for them.

The researcher encountered time constraints in the course of the study, balancing the research study and other demanding course works.

During the study some respondents feared to be interviewed but the research told them that the research was strictly for academic purposes and therefore they should not fear.

3.10 Dissemination of results

The results will be forwarded to the following bodies:

Uganda Nurses and Midwives Examinations Board (UNMEB),

Public Health Nurses’ College Kyambogo

The administration of Katabi Military Hospital

The research had a copy for further references.

CHAPTER FOUR

RESULTS

This chapter describes presentation of the study results in tables, figures and text. Data was collected from 30 respondents using a questionnaire.

4.1 Socio-demographic Characteristics of the respondents

Figure 1 Showing age category of respondents                          (n=30)

According to figure 1 above, most of the respondents 13 (43.3%) were in the age bracket of 26-35 years of age while the least 2 (6.7 %) were above 45 years

Table 1 Marital status of respondents

(n=30)

The study from table 2 above indicates that majority of the respondents 17 (56%) were married, while minority 1 (3.3%) were widowed and separated

Table 2 Showing occupation of respondents

(n=30)

According to the findings in table 2 above most of the respondents 10 (33.3%) didn’t have a specific profession, while the least 1(3.3%) were peasant farmer.

Figure 2 Showing marital status

(n=30)

According to the findings in figure 2 above, majority of respondents 21 (70%) were married while minority 1(3.3%) were divorced and separated.

Table 3 Showing the level of education of respondents                            (n=30)

According to the results in table 3 above majority of the respondents 12 (40%) had finished secondary school education, while minority 1(3.3%) never went to school.

Figure 3 Showing Religion of respondents                                 (n=30)

The findings from figure 3 above indicates that majority of the respondents 18 (60%) were Christians while minority (3.3%) mentioned other religion.

Figure 4 Showing educational level of respondents                       (n=30)

The findings in figure 4 above indicates that majority of the respondents 13 (43%) were secondary school dropouts, while minority 1 (3.3%) had never attended school.

4.2 Level of knowledge of mothers about complementary feeding in children under two years

Figure 5 Showing knowledge of complementary feeding       (n=30)

According to the results in the figure 5 above majority of the respondents 16 (53.3%) asserted that they had no knowledge on complementary feeding, while 14(46.7%) of them had knowledge on complementary feeding.

Figure 6 Showing the Source of Information about complementary feeding

(n=30)

According to the results in figure 6 above of the most of the respondents 15 (50%) said that they got information regarding complementary feeding from social media, while the least 1(3.3%) mentioned other sources.

Table 4 showing what age should a child require complementary feeding

(n=30)

According to the findings in the table above, majority of the respondents 13 (43.3%) of the respondents have 1-6 months children, while a minority 8 (26.7%) said 6 -12 months.

Table 5 Showing the importance of complementary feeding to a child

(n=30)

According to table 5 above majority of the respondent 19 (63, 3%) said that the importance of complementary feeding to a child is to provide essential nutrients while minority 1(3.3%) mentioned other uses.

Figure 7 Showing whether respondents have ever been sensitized about complementary

(no=30)

According to figure 7 above, majority of the respondents 16 (53.3%) asserted that they have never been sensitized about complementary feeding while minority 14 (46.7%) said that they have ever been sensitized.

4.3 Complementary feeding practices of mothers with children under two years

Table 6 Showing respondents practice complementary feeding on your children

(no=30)

According to the results in table 6 above majority of the respondents 27 (90%) asserted that they practice complementary feeding with their children, and minority 3 (10%) disagreed.

Table 7 Showing how often complementary foods are given to children

(n=30)

The table 7 above indicates that the majority of the respondents 15(55.6%) said that they give complementary food at least twice a day or every time the baby is hungry. While no one admitted to giving complementary food once a day.

Table 8 Table 8 Showing why some mothers do not practice complementary feeding

The table 8 above shows that majority of the respondents 2(66.7%) couldn’t afford complementary feeding while minority 1(33.3%) said they are always at work.

Figure 8 Figure 8 Showing how complementary feeding is administered.

(n=30)

The figure 8 above shows that majority of the respondents 21 (70%) said that they administered complementary feeding through a bottle, cup and spoon, while none mentioned other ways.

4.4 Social economic factors affecting mothers carrying out complementary feeding with children under two years

Table 9 Showing the distance of the health center from the respondents’ homes no=30

According to table 9 majority of the respondents 12 (40%) said the move long distances over 4km to the health center unlike the minority 3 (10%) who said they move just 1km to the health center.

Figure 9 Showing whether respondents have jobs.

Majority of the respondents 20(70%) said that they have jobs while minority 9(30%) of the respondents do not have jobs.

Table 10 Showing the amount earned by respondents per month                      (no=30)

According to the findings in table 10 above, majority of the respondents 10(37.1%) earn between 50,000 -100,000shs per month while minority 3(11.1%) earn between 100,000-150,000shs every month.

Figure 10 Showing who supports the respondents handle complementary feeding of the children                                                                                        (n=30)

The results in figure 10 above half of the respondents 15(50%) said they support themselves with the complementary feeding of their children. While minority 3(10%) have support from their husbands.

Figure 11 Showing at what age range did the respondents have their first child

(no=30)

According to results in figure 11, majority of the respondents 12(40%) had their children between the age of 25-29 while minority 3(10%) gave birth between the age of 15-19.

Table 11 Showing if the respondents administer complementary feeding themselves.                                                                                     (n=30)

Table 12 above shows that majority of the respondents 20(66.7%) said that they don’t administer complementary feeding themselves while the minority 10(33.3%) do.

Table 12 Showing who helps the respondents practice complementary feeding.                                                                                                                                                                                                                                                          (n=30)

According to table 13 above, half of the respondents 15 (50%) said their elder children help them to practice complementary feeding while minority 3(10%) said the get help from other sources.

Figure 12 Showing why respondents are not able to administer complementary feeding to their children themselves                                                   (n=30)

Figure 12 above shows that most of the respondents 12(40%) said they have elder children who can help administer complementary feeding while least of them 3 (10%) mentioned other reasons.

CHAPTER FIVE

DISCUSSION OF FINDINGS, CONCLUSION, RECOMMENDATION IMPLICATION FOR NURSING PRACTICE AND AREAS OF FURTHER STUDY

5.0 Introduction

This chapter presents discussion of the findings, conclusion, recommendations of the study implication to nursing practice obtained from data analysis.

5.1 Discussion of findings

5.1.1  Socio-demographic Characteristics of the respondents

The results in the study revealed that, majority of the respondents 13 (43.3%) were in the age bracket of 26-35 years of age and the least was 2 (6.7 %) who were above 45 years. This indicates that most of the respondents were in child bearing age and were carrying out complementary feeding

The results also indicated that majority of the respondents 17 (56%) were married, while minority 1 (3.3%) was widowed and separated. This result shows that respondents had families and were having children who needed complementary feeding.

The results in the study showed that most of the respondents 10 (33.3%) didn’t have a specific profession, while the least 1(3.3%) was a peasant farmer. This shows that the professional respondents were health workers but the rest had no specific profession

The study results showed that majority of the respondents 12 (40%) had finished secondary school education, while minority 1(3.3%) had never gone to school. This implies that most of the respondents had attained basic education and had some information about complementary feeding

The results also show that majority of the respondents 18 (60%) were Christians, while minority 1 (3.3%) were from other religion. This implies that the Christian faith was dominant among the respondents

5.1 .2 Knowledge about complementary feeding practices

According to study findings which revealed that majority of the respondents 16/30 (53.3%) asserted that they had no knowledge on complementary feeding, while minority 6(20%) of them had knowledge on complementary feeding. This is in line with WHO, (2013), which revealed that mothers’ knowledge about nutritious meals for the children influences how the child is fed but in many developing countries, infants and young children are most vulnerable to malnutrition because of lack of knowledge by mothers and care takes on how to feed a child and yet feeding practices have a lot of implication for the nutritional status of the child.

The results of the study revealed that most respondents 15 (50%) said that they got information regarding complementary feeding from social media while the minority 1(3.3%) mentioned other sources. This is in line with Hague et al., (2012), who in their interventional study in India where nutritional education was given to mothers by health workers to improve awareness about infant feeding in the variety,     quantity, quality and consistency of complementary feeding showed that, Majority of complementary feeding practices were inadequate in quality, quantity, frequency and consistency (Sethi et al., 2013). In a similar study in south India, mothers were counseled about the choice of appropriate complementary foods and feeding frequency. The intervention group had improved feeding practices such as avoiding feeding bottles and improved on dietary diversity and the types of complementary foods.

The results of the study revealed that majority of the respondent 19 (63, 3%) said that the importance of complementary feeding to a child is to provide essential nutrients while minority 1(3.3%) mentioned other uses such as proper growth, boosts immunity among others. This is contrary to WHO (2010) that laments that mothers should understand the importance of exclusive breastfeeding for 6 months confers several benefits to the infant and the mother herself. Chief among these is the protective effect against gastrointestinal infections, which is observed not only in developing but also in industrialized countries.

According to the results of the study, majority of the respondents 16 (53.3%) asserted that they have never been sensitized about complementary feeding while minority 14 (46.7%) said that they have ever been sensitized which implies that most of the responds had no knowledge about complementary feeding. These results re in line with Blattman, et al (2015) who in his study in Porkpa District of Liberia, about infant feeding among 38000 mothers, 68% had not been sensitized about complementary feeding.

5.1.2 The complementary feeding practices of mothers with children under two years

According to the results in the study, majority of the respondents 27 (90%) asserted that they practice complementary feeding with their children, and only 3 (10%) disagreed.  Which corresponds with Qiong et al (2013) who carried out a study in Wuyi county, China and found out that mothers practiced complementary feeding among children aged 6-23 months showed that, their dietary diversity was quite poor as only one out of ten children (10.0%) was fed with foods from at least four food groups. Similarly, a study by Nisha (2012) on inadequate feeding of infants and young children in India revealed that although 92% of children were between the ages 12 and 18 months, only 17% of them were fed adequately from four or more food groups

According to the results of the study, majority of the respondents 15(55.6%) said that they give complementary food at least twice a day or every time the baby is hungry. While no one admitted to giving complementary food once a day. This is in line with (WHO 2010), which stated  breastfed children 6-8 months old be fed 2 times per day and those 9-23 months old be fed 2-3 times per a day while the non-breastfed ones be fed 4 times per day. KNBS and ICF Macro, (2010) further commends that , the minimum meal frequency in Kenya  is low as per WHO recommendations, the Kenya Demographic and Health Survey of 2008-09 revealed that of all the children 6-23 months, only two thirds were fed the minimum number of times. Another study that is in line with this finding A study done in rural Utter Pradesh (Kumudha et al, 2010) on the frequency of feeding showed higher number of children (63%) aged 6-23 months who were given the minimum recommended number of feeds.

The study further that majority of the respondents 21 (70%) said that they administered complementary feeding through a bottle, cup and spoon, while none mentioned other ways. This is in line with Shamin et al (2009), who argued that about infant feeding practices including the use of bottle and their determinants, from economically underprivileged mothers in a Peri-urban area of Karachi, Pakistan, showed that only 17% of the infants under the age of 3 months were offered bottle, 69% between 4 to 6 months increased to 76% in infants from 7 months to 1 year. The continued practice of bottle feeding is a concern because of the possible contamination leading to higher morbidity rates in children.

4.1.3 The social economic factors affecting mothers with children under two years

According to the table most of the respondents 12 (40%) said that they move long distances over 4 km to the health center unlike the minority 3(10%) who said they move just 1km to the health center. This corresponds with Porter, G. (2011) who explained that most villages in sub Saharan Africa are so remote that women move very long distances in order to access a health center where they can access complementary feeding information.

Majority of the respondents 21 (70%) said that they have jobs while minority 9(30%) of the respondents do not have jobs. this resonates with Camara, S.,et al  (2015) who reported that the occupation of the mothers can prevent them from properly administering complementary feeding of their children. Nutrition Officers in Tanzania reported the infants born to working mothers were more likely to consume processed food due to their mothers’ work. Such mothers end up leaving their children with caretakers like aunties, young brothers or sisters and sometimes maid who are not well trained to administer complementary feeding to their young children.

(Nestle, M. 2013) further states that although young mothers are generally aware of the nutritional value of different kinds of food, appropriate feeding times, and hygiene practices, they are often inconsistent about feeding their children accordingly because they are away from home due to their school work or employment. Young mothers that are engaged in a variety of cash-earning activities that make taking care of their children difficult.

According to the findings in the study, majority of the respondents 10 (37.1%) earn between 50,000 -100,000 shs per month while minority 3(11.1%) earn between 100,000-150,000shs every month which indicates that most respondents were low income earners and so they could hardly afford proper complementary feeding of their children. This is in line with Cleland, J., et al (2016) who argued that most families in rural Uganda are low income families that survive on less than a dollar a day. He explains that most women only survive on subsistence farming.

According to the findings of the study, majority respondents 15(50%) said they support themselves with the complementary feeding of their children. While minority 3(10%) have support from their husbands. This implies that majority of the fathers are not involved with the complementary feeding of their children. All the complementary feeding practices are left for the women. This is in line with Nestle, M. (2013) who laments that in most African countries men don’t get involved in taking care of their children. They leave all the work to the women.

According to the findings of the study most of the respondents 12(40%) had their children between the age of 25-29 while minority 3(10%) gave birth between the age of 15-19. Which implies most mothers are mature enough to take care of their children meanwhile there exists teenage mothers too who can’t take care of their children. This contradicts with Meekers, D. (2012) who in his study revealed that most women start giving birth when they are still teenagers due to cultural and religious factors.

The study shows that majority of the respondents 20 (66.7%) said that they don’t administer complementary feeding themselves while the minority 10 (33.3%) agreed that they do. Which is in line with Gardner, H, et al (2015) who revealed that most mothers trust their other children to administer complementary feeding especially when they leave for work or go to the garden. It is common for mothers to leave a little cash with the caregivers who are usually children too, so they can buy food from local groceries or vendors to feed themselves and the young baby. There are also some home-cooked meals at home, but caregivers (elder sibling, neighbor, elderly relative/kin) are generally unable to properly feed young children below two years of age because they lack knowledge about nutrition and hygiene needs.

5.2 Conclusion

The study concludes that the women in rural areas should be sensitized through their local leaders and at health Centers about complementary feeding of their children.

The study further concludes most women should be encouraged to practice complementary feeding of their children because at 6 months, exclusive breastfeeding is no longer sufficient to meet all energy and nutrient needs by itself, and complementary foods should be introduced to make up the difference.

The study concludes that social economic factors like unemployment, long distances from the health center, poverty, do affect the complementary feeding of young children.

5.3 Recommendation

5.3.1 Recommendation to the government

The study recommends that government should support women to access credit and use it to  engage in income generating activities  like agriculture poultry farming market vending  which will provide employment opportunities to the women so that they can be able to handle complementary feeding costs.

The study also recommends that the government should expand the health facility so that it could accommodate the growing number of mothers who seek information about complementary feeding.

5.3.2 Recommendation to the health workers

The study recommends that that health workers should advocate for the sensitization of the local population about the benefits of complementary feeding and encourage ladies to attend training session at health centers in order to acquire information about complementary feeding.

The study further recommends that health workers should increase on their efforts to sensitize mothers about the befits of complementary feeding and even carry out fieldwork education e.g. home visits and train those who can’t access the health center about complementary feeding.

5.3.3 Recommendation to the community

The study recommends that community leaders should mobilize their subjects to adhere to the advice given to them by health workers about complementary feeding and practice them effectively as per health worker prescription.

5.4 Implication to the nursing practice

Registered nurses play a major role in health education of patients, families and communities about how to complementary feeding

Health workers are also in a position to help mothers embrace the modern way of grooming a health child and refute myths and other misinformation. While its best to show respect for their opinions.

Nurses can guide those mothers who are biased about which type of food should be given as a complementary food and those that are not.

5.4 Areas of further study

The study recommends the following areas of further study;

• The influence of complementary feeding to the health of children
• Challenges in administering complementary feeding among mothers in the rural areas
• Influence of poverty on the health of children

REFERENCES

Akhter, M. (2016). Study on prevalence of pregnancy complication and patient’s awareness at Dhaka city in Bangladesh (Doctoral dissertation, East West University).

Amosu, A. M., Atolomah, N. O. S., Thomas, M. A., Olanrewaju, M. F. and Degun, A. M. (2011). Child care practices and the nutritional status of infants of working mothers in a day care centre in Oshun State, Nigeria. Annals of biological research 2(5): 140-148

Apprey, C. (2015). Nutritional intervention in children undergoing chemotherapy for cancer (Doctoral dissertation).

Asiki, G., Newton, R., Marions, L., Seeley, J., Kamali, A., & Smedman, L. (2016). The impact of maternal factors on mortality rates among children under the age of five years in a rural Ugandan population between 2002 and 2012. Acta Paediatrica, 105(2), 191-199.

Burns, J., Emerson, J. A., Amundson, K., Doocy, S., Caulfield, L. E., & Klemm, R. D. (2016). A Qualitative Analysis of Barriers and Facilitators to Optimal Breastfeeding and Complementary Feeding Practices in South Kivu, Democratic Republic of Congo. Food and nutrition bulletin, 37(2), 119-131.

Camara, S., de Lauzon-Guillain, B., Heude, B., Charles, M. A., Botton, J., Plancoulaine, S. & Lioret, S. (2015). Multidimensionality of the relationship between social status and dietary patterns in early childhood: longitudinal results from the French EDEN mother-child cohort. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 122.

Forsyth, S., Gautier, S., & Salem Jr, N. (2017). Dietary Intakes of Arachidonic Acid and Docosahexaenoic Acid in Early Life-With a Special Focus on Complementary Feeding in Developing Countries. Annals of Nutrition and Metabolism.

Foterek, K., Buyken, A. E., Bolzenius, K., Hilbig, A., Nöthlings, U., & Alexy, U. (2016). Commercial complementary food consumption is prospectively associated with added sugar intake in childhood. British Journal of Nutrition, 115(11), 2067-2074.

Gardner, H., Green, K., & Gardner, A. (2015). Infant feeding practices of Emirati women in the rapidly developing city of Abu Dhabi, United Arab Emirates. International journal of environmental research and public health, 12(9), 10923-10940.

Gyampoh, S., Otoo, G. E., & Aryeetey, R. N. O. (2014). Child feeding knowledge and practices among women participating in growth monitoring and promotion in Accra, Ghana. BMC pregnancy and childbirth, 14(1), 180.

Locks, L. M., Pandey, P. R., Osei, A. K., Spiro, D. S., Adhikari, D. P., Haselow, N. J., … & Nielsen, J. N. (2015). Using formative research to design a context‐specific behaviour change strategy to improve infant and young child feeding practices and nutrition in Nepal. Maternal & child nutrition, 11(4), 882-896.

Mekbib, E., Shumey, A., Ferede, S., & Haile, F. (2014). Magnitude and factors associated with appropriate complementary feeding among mothers having children 6–23 months-of-age in Northern Ethiopia; A Community-Based Cross-Sectional Study. J Food Nutr Sci, 2(2), 36.

Meleko, A., Bekele, Y., Sileshi, S., Daniel, A., & Addisu, A. (2017). Magnitude of Stunting and its Determinants among Children Aged 06-59 Months in Semen Bench Woreda, Genja District-A Community Based Cross-Sectional Study in South West Ethiopia, 2017. Pediatr Ther, 7(329), 2161-0665.

Nankumbi, J., & Muliira, J. K. (2015). Barriers to infant and child-feeding practices: a qualitative study of primary caregivers in Rural Uganda. Journal of health, population, and nutrition, 33(1), 106.

Nestle, M. (2013). Food politics: How the food industry influences nutrition and health (Vol. 3). Univ of California Press.

Osendarp, S. J., Broersen, B., van Liere, M. J., De-Regil, L. M., Bahirathan, L., Klassen, E., & Neufeld, L. M. (2016). Complementary Feeding Diets Made of Local Foods Can Be Optimized, but Additional Interventions Will Be Needed to Meet Iron and Zinc Requirements in 6-to 23-Month-Old Children in Low-and Middle-Income Countries. Food and Nutrition Bulletin, 37(4), 544-570.

Paul, S. K., Roy, S., Islam, Q. R., Islam, M. Z., Akteruzzaman, M., Rouf, M. A., … & Afroza, S. (2015). Barriers of Appropriate Complementary Feeding Practices in Under-2 Children. Journal of Bangladesh College of Physicians & Surgeons, 33(4), 195.

Ruel, M. T., Alderman, H., & Maternal and Child Nutrition Study Group. (2013). Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?. The Lancet, 382(9891), 536-551.

Sethi, R. K., Padhy, S., & Raju, D. V. (2017). Knowledge, attitude and practices regarding complementary feeding among mothers of children 6 to 24 months of age in Konaseema region. International Journal of Contemporary Pediatrics, 4(2), 394-398.

Wyatt, A. J., Yount, K. M., Null, C., Ramakrishnan, U., & Webb Girard, A. (2015). Dairy intensification, mothers and children: an exploration of infant and young child feeding practices among rural dairy farmers in Kenya. Maternal & child nutrition, 11(1), 88-103.

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APPENDICES

APPENDIX I

CONSENT FORM

My name is Nambi Harriet student nurse of Public Health Nurses College, I am carrying out a study about knowledge, and practices of mothers on complementary feeding in children under two years in Katabi military Hospital YCC Wakiso District.

Objectives: to assess the knowledge, establish the complementary feeding practices and identify the socio-economic factors affecting mothers with children under two years

Privacy and Confidentiality. You are requested voluntarily to consent and participate in the study and numbers will be used instead of names to ensure that the information given will be kept confidential.

Time to be taken for interview. The interview will take 15 minutes.

Right not to participate. All respondents have the right not to participate in the study.

Monetary benefits. Once you participate in this study there is no any payment

I have explained the purpose and objective of the study to the participant and they have understood and voluntarily consented to participate in the study.

Researcher’s  signature……………………………Date………….

The topic and objectives of the study have been explained to me and understood and voluntarily agreed and consented to participate in the study.

Respondents’ Signature………………………………Date……………

 APPENDIX II:

 QUESTIONNAIRE

My name is NAMBI HARRIET, a student Nurse of Public Health Nurses College and I am carrying out a study to investigate the knowledge and practices of mothers on complementary feeding in children under two years in Katabi Military Hospital. You have voluntarily consented to participate in the study and all the information you give will be kept confidentially.

Instructions

Please respond to all questions as accurately as possible by filling in the box provided

Section A: Demographic and Social Characteristics

• Gender
  1. Male [   ]
  2. Female [   ]
• Age
  1. 18 – 20 years [   ]
  2. 21 – 25 years [   ]
  3. 26 – 35 years [   ]
• Religion
  1. Catholic [   ]
  2. Protestant [   ]
  3. Moslem [   ]
  4. Others (specify)………………………………
• Occupation

1. Self-employed [   ]
2. Student [   ]
3. Unemployed [   ]
4. Others (specify)………………………………………

• Marital status

1. Single [   ]
2. Married [   ]
3. Others (specify)……………………………………………………

• What is your current level of education?

1. Never went to school [   ]
2. Primary [   ]
3. Secondary (O/ A level) [   ]
4. Vocational                                                             [   ]

• How many children do you have
  1. 1-3 children [   ]
  2. 4-5 children [   ]
  3. 6 and above [   ]

Section B: Level of knowledge of mothers about complementary feeding in children under two years

• Do you have any knowledge about complementary feeding?
  1. Yes [   ]
  2. No                                                                         [   ]
• If yes, what is complementary feeding?

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

• Where did you get the information concerning complementary feeding?

1. Social Media             [   ]
2. Health Center             [   ]
3. Friends and Relatives [   ]
4. Others …………………..

• If yes, at what age should a child require complementary feeding?
  1. 1-6 months [   ]
  2. 6 -12 months [   ]
  3. 12-18 months [   ]
  4. All the above [   ]
• What is the importance of complementary feeding to a child?
  1. Provide energy [   ]
  2. Provide essential nutrients [   ]
  3. All the above [   ]
  4. Other please specify………………………………………………………………
• Have you ever been sensitized about complementary feeding?
  1. Yes                                                                         [   ]
  2. No [   ]
• If yes, how should complementary feeding be carried out?

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Section C: Complementary feeding practices of mothers with children under two years

• Do you practice complementary feeding on your children?

1. Yes [   ]
2. No [   ]

• If yes how often do give commentary foods to your children.
  1. Once a day [   ]
  2. Twice a day [   ]
  3. Every time the baby is hungry [   ]
  4. All the above [   ]

Other please specify…………………………………………………

• If no why
  1. I can’t afford [   ]
  2. Always at work [   ]
  3. Other please specify………………………
• How do you administer complementary feeding?

1. through a bottle [   ]
2. through a cup & spoon [   ]
3. All the above [   ]
4. other please specify [   ]

Section D: Social economic factors affecting mothers carrying out complementary feeding with children under two years

• How far is a health center from your home

1. 1KM [   ]
2. 2KM [   ]
3. 3KM [   ]
4. 4 and above KM [   ]

• Do you have a job?

1. Yes [   ]
2. No [   ]

• If yes how much do you earn per month

1. 10000-50000 thousand [   ]
2. 60000-100000 thousand [   ]
3. 110000-150000 thousand [   ]
4. 160000-200000 thousand                                                 [   ]
5. 200000 and above [   ]

• If no in question 21 above who supports you to handle complementary feeding?

1. My husband [   ]
2. My parents & Relative                                                 [   ]
3. No one             [   ]
4. Other please specify [   ]

• In what age range did you have your first child?

1. 15-19             [   ]
2. 20-24             [   ]
3. 25-29             [   ]
4. 30 and above             [   ]

• Do you administer complementary feeding yourself?
  1. Yes             [   ]
  2. No             [   ]

25) If No who does it for you

1. a) A house maid [ ]
2. b) My mother [ ]
3. c) My elder children [ ]
4. d) Other please specify…………………………………………………………..

26) Why are you unable to administer complementary feeding of your child yourself?

1. a) Too much work [ ]
2. b) I don’t know what to do [ ]
3. c) I have other elder children who can help [ ]

Other please specify ……………………………………………………………..

Thank you

APPENDIX III: INTRODUCTION LETTER

APENDIX IV

MAP OF UGANDA SHOWING WAKISO DISTRICT

APPENDIX V

MAP OF WAKISO DISTRICT

SHOWING KATABI MILITARY HOSPITAL