Complementary Infant Feeding Practices in Afghanistan

Complementary Infant Feeding Practices in Afghanistan by Hasibullah Niayesh MPH, Johns Hopkins University, 2009 MD, Shaikh Zahid University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Program Walden University February 2018 Abstract Children are at greater risk of malnutrition in Afghanistan than they are in many other countries. Malnutrition impairs the mental and physical growth of more than 50% of children in Afghanistan. It also exacerbates the risks of mortality by 45% in infants and children in Afghanistan. The purpose of this study was to determine the association between mothers’ knowledge, attitudes, and practices regarding complementary feeding and malnutrition in children in Afghanistan. The precaution adoption process modelChildren are at greater risk of malnutrition in Afghanistan than they are in many other countries. Malnutrition impairs the mental and physical growth of more than 50% of children in Afghanistan. It also exacerbates the risks of mortality by 45% in infants and children in Afghanistan. The purpose of this study was to determine the association between mothers’ knowledge, attitudes, and practices regarding complementary feeding and malnutrition in children in Afghanistan. The precaution adoption process model served as a theoretical framework in this quantitative cross-sectional research study. Data analyzed were collected from 306 mothers and children at 6 randomly selected hospitals in Kabul Province. The results of logistic regression models indicated that mothers’ knowledge, attitudes, and practices regarding complementary feeding were statistically significant predictors of stunting in children, χ2 (9, N = 306) = 45.33, p < . 001; χ2 (9, N = 306) = 26.71, p < . 01; and χ2 (9, N = 306) = 56.97, p < . 001 respectively. The strongest predictor was mothers’ practicing responsive feeding, where mothers who did not practice responsive feeding were 7.1 times more likely to have stunted children than mothers who practiced responsive feeding. Moreover, the results indicated that mothers’ knowledge, attitudes, and practices of complementary feeding were statistically significant predictors of underweight in children, χ2 (9, N = 306) = 37.49, p < . 001; χ2 (9, N = 306) = 41.15, p < . 001; and χ2 (9, N = 306) = 44.64, p < . 001. The implications for positive social change include reviewing nutrition policies, investing in nutrition programs, and operationalizing nutrition education and behavior change interventions for promoting appropriate complementary infant feeding practices in Afghanistan. Complementary Infant Feeding Practices in Afghanistan by Hasibullah Niayesh MPH, Johns Hopkins University, 2009 MD, Shaikh Zahid University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Program Walden University February 2018 Dedication Every accomplishment requires commitment, hard work, and guidance of the mentors, family members, and friends. I extend my due respects to all my teachers and instructors whose long-lasting support and guidance have enabled me to earn the degree of doctor of philosophy in public health. I dedicated my efforts to my beloved wife, caring mother, and entire family whose love, affections, and support made it possible to accomplish the honor of becoming the doctor of philosophy in public health. Acknowledgments I would like to seize the opportunity to thank Prof. Aman Refaat and Prof. Hadi Danawi for their valuable support and guidance in the process of accomplishing my Ph.D. degree. It would not have been possible for me to complete my doctoral degree in public health without their scholarly advice and support. I would also like to thank Prof. Ahmad Najim Dost for his endless support and encouragement. Behind every successful man, there is a woman. My wife is a great source of motivation and support for me. I extend my acknowledgment and appreciations to my family members, especially my beloved wife whose support was instrumental in the process of accomplishing this honor. Without my wife’s support, I would not have owned the title of doctor of philosophy in public health. I would like to extend my sincere appreciations to the leadership and staff of the Ministry of Public Health in Afghanistan. Above all, I am grateful to my Almighty Allah, the lord of soul and wisdom, for his countless mercy and grace in my life.