Home stimulation, development, and nutritional status of children under 2 years of age in the highlands of Madagascar.

BACKGROUND: The Vakinankaratra region of Madagascar has a high burden of child undernutrition which, in addition to poor psychosocial stimulation, is a strong risk factor of poor child development. However, there are limited studies evaluating the relations between developmental deficits, child nutrition outcomes, and home stimulation in the region. The purpose of this study was to assess the development of children aged 11-13 months in relation to their nutritional status and to examine parental home stimulation attitudes and practices in the Vakinankaratra region. METHODS: Cognitive (n = 36), language (n = 36), motor (n = 36), and socioemotional (n = 76) development were assessed using the Bayley Scales of Infant and Toddler Development III. Household stimulation environment was evaluated using the family care indicators survey. Stunting (length-for-age z-score < - 2) and underweight (weight-for-age z-score < - 2) were determined using the 2006 WHO growth standards. Perceptions of and barriers to greater home stimulation for children were collected using focus group discussions among parents and in-depth interviews with community nutrition agents. RESULTS: Almost all mothers reported that parent-child interaction with talk and play was very important. Alarmingly high stunting rates (> 69%) were observed in this subsample. Limited time and tiredness were the major barriers to home stimulation mentioned by parents and confirmed by key informants. Children had a very limited variety of play materials, and most of the mothers used household objects (75%) and materials from outside the house (71%) as children's toys. Composite cognitive [mean (SD): 60 (10.3)], motor [61.9 (13.4)], language [62 (13.2)], and socioemotional [85.1 (17.9]) scores were low. Fine motor, cognitive, and receptive and expressive language scores were correlated [0.4 < r < 0.7, p < 0.05]. CONCLUSIONS: The very high stunting rates and very low performance on cognitive, motor, language, and socioemotional development assessments of children in the Vakinankaratra region require urgent attention.

Fathers' involvement in child care activities: Qualitative findings from the highlands of Madagascar.

Few studies have investigated fathers' roles in child care in Madagascar. This study explored the perceptions, attitudes, and practices regarding fathers' involvement in child care using qualitative methods. Ten focus group discussions were conducted among parents of children aged 6-23 months; seven were among mothers, and three among fathers. In-depth semi-structured interviews (n = 8) were also conducted with key informants. Discussions and interviews were audio-recorded and the verbatim transcripts in Malagasy were translated into English. Data were analyzed using the thematic analysis approach. Provision of financial and material support as well as teaching and playing with the child were the main perceived roles of fathers. In practice, fathers spent their time alone with their children playing and holding them when the mother was unavailable. Busy schedules and separation due to work were major barriers to fathers' involvement. Traditional gender roles for child care in which the mother is seen as primarily responsible for the child were salient across the data. Consequently, men involved in child care activities and their wives were often criticized by the community. Nevertheless, there was self-reported interest from both mothers and fathers in involving men more in child care. Interventions aimed to increase fathers' involvement in child care may be more successful when they focus on shifting the community perceptions on the division of responsibilities between fathers and mothers.

Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study.

BACKGROUND: Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar. OBJECTIVES: This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6-23 mo in the Vakinankaratra region of Madagascar. METHODS: Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than -2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach. RESULTS: Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers' workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding. CONCLUSIONS: Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.

Malagasy Dye Plant Species: A Promising Source of Novel Natural Colorants with Potential Applications - A Review.

Due to the potentially harmful effects of some synthetic dyes, there is an increasing demand for natural colorants. Recent literature has emphasized the necessity of investigating new sources of dyes. This review discusses the biological sources of dyes derived from the rich plant diversity of Madagascar. As one of the first contributions on the use of these dyestuffs for dyeing textiles, it provides an overview of 128 dye plant species with other potential applications for coloring materials in industry. A detailed description of the botanical and chemical properties of these dyestuffs is given. We believe that the Madagascar plant diversity may be a promising source of novel colorants not yet investigated. We considered it worthwhile to carry out a thorough scientific study of a set of Malagasy plants carefully selected for their coloring properties together with their potential use and valorization in specialized industries where use of natural colorants would be a particular interest.

Fatty Acid Composition of Baobab Seed and Its Relationship with the Genus Adansonia Taxonomy.

Baobab seed oil contains specific fatty acids. Most of the studies on baobab fatty acids have been carried out singly and in isolation from each other, making it difficult to compare results through different species. The objective of the present study is to establish the seed fatty acid composition of each Adansonia species in order to evaluate and understand the relationships between the oil chemical compositions, the baobabs' taxonomy and, the ecological and geographical origin of each seed lot. The seed oils have been analysed using gas chromatography (GC). The oils of all baobab species contain three major fatty acids: palmitic, oleic and linoleic acids. They also contain specific fatty acids such as cyclopropenic and cyclopropanic acids, which are characteristic of the Malvaceae family seed oils. It was possible to distinguish three sections through principal components analysis using the eleven fatty acids identified by GC. The Adansonia section contains high rates of oleic acid (± 35%), the Brevitubae section is rich in palmitic acid (± 42%) and the Longitubae section contains high levels of dihydrosterulic acid (± 5%). The oil fatty acid composition, however, does not enable a definitive characterization of profiles according to species. The fatty acid composition is not significantly influenced by the geographical, soil and climate conditions of the collection sites.