Linking Immigrants with Nutrition Knowledge (Project LINK): An Innovative Approach to Improve Cultural Competence in Dietetic Education.

Linking Immigrants with Nutrition Knowledge (Project LINK) was a service-learning cultural competence training programme completed by undergraduate dietetic students enrolled in the University of Saskatchewan's (USASK) nutrition and dietetic programme.This paper evaluates the impact of participation in the programme on students' cultural competence. We conducted a cross-sectional survey and qualitative analysis of reflective essays of 107 participants of Project LINK from 2011 to 2014. Cumulative logistic regression models assessed the impact of the intervention on students' cultural competencies. The Akaike information criterion compared models and Spearman correlation coefficient identified possible correlation among pre- and post-intervention data points. Student reflective essays were analyzed by inductive thematic analysis.All cultural competencies improved comparing pre- and post-participation in Project LINK. Odds of increasing one level of student knowledge were 110 times of that prior to Project LINK. Comparing student competencies before and after Project LINK, the odds of increasing one level of students' skills were six times greater, five times greater for increasing one level of students' ability to interact or encounter, and 2.8 times greater for increasing one level of students' attitude.The results of this study indicate Project LINK has successfully increased cultural competence and underscores the importance of combining opportunities for practical experience in addition to classroom-based training on cultural competence.

The influence of fasting on energy and nutrient intake and their corresponding food sources among 6-23 months old children in rural communities with high burden of stunting from Northern Ethiopia.

BACKGROUND: Limited studies in Ethiopia showed that infants and young children are at high risk of inadequate intake of energy and nutrients. However, inclusive assessment of both nutrient intakes and their food sources are lacking. We aimed at assessing energy and nutrient intakes and their food sources during religious fasting and non-fasting periods among 6-23 months old children in Northern Ethiopia. METHODS: Data for this longitudinal study were collected following repeated multiple-pass 24-h dietary recall technique through face-to-face interviews with primary caregivers. Using a two-stage systematic random sampling method, a total of 570 and 551 children participated respectively in the lent fasting and non-fasting periods. Energy and nutrient intakes were estimated and compared with WHO daily requirements. All foods that a child consumed on the day preceding the date of data collection were recorded and processed with database software. Chi-square and t- tests were used to analyze the data. Non-normally distributed data were analyzed using Wilcoxon signed-rank test and statistical significance was set at p < 0.05. RESULTS: The overall prevalence of child stunting was 41.4%. Almost all of children (99.6%) consumed grains, roots, and tubers. The inadequacy prevalence of energy, protein and eight selected micronutrients (calcium, iron, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin C) intake were 96.2, 44.9, and 95.5%, respectively. Calcium and zinc were the highest (100%) deficits observed across all age groups. Although consumption of animal source foods (ASFs) was very low (dairy 10.1%, meat 2.3% and eggs 23.6%), there was significantly higher consumption of meat and eggs during the non-fasting compared to fasting period (p < 0.001). CONCLUSIONS: Inadequate intake of energy and nutrients was common among 6-23 months old children. Cereals were found to be the main sources of many of the nutrients. The consumption of ASFs among 6-23-month-old children was low which was also affected by the religious fasting period. Hence, strengthening social and behavior change communication, supporting rural households to raise poultry and small ruminants is recommended.

Multiple anthropometric and nutritional deficiencies in young children in Ethiopia: a multi-level analysis based on a nationally representative data.

BACKGROUND: In Ethiopia, child undernutrition and anemia are major public health concerns, resulting in increased childhood morbidity and mortality. Despite progress made to reduce the prevalence of malnutrition (especially stunting) from 50% in 2000 to 38% in 2016, little is known about the magnitude and risk factors for concurrent nutritional deficiencies in Ethiopia. METHODS: Analysis for this study was based on a total sample of 9218 children aged 6-59 months drawn from the Ethiopian Demographic and Health Survey (EDHS) conducted in the year 2016. The study used two outcome variables: Multiple nutrition deficit index formed by combining stunting, underweight, wasting and anemia status; and a concurrent stunting and anemia (CAS) index. Two mixed effect regression models, Poisson and Logistic, were used to identify the key risk factors of the two outcome variables, respectively. RESULTS: The proportion of children with stunting (length-for-age), underweight (weight-for-age) and wasting children (weight-for-length) was 38%, 25.2% and 9.4%, respectively. About 58% of the children had anemia. The prevalence of children with concurrent stunting and anemia children was 24.8%. Our results showed that the risks of multiple nutritional problems were determined by a range of individual, household and behavioral factors including: sex of the child, age of the child, birth order, parity, parental education, religion, household wealth index and type of family structure. The proximate variables (hygiene and sanitation score, feeding practice, and child health service utilization score) were also found to exert a strong influence on the risk of multiple nutritional deficiencies. The likelihood of co-occurrence of stunting and anemia was determined by certain individual and household factors, including sex of the child, age of the child, maternal education, household asset based wealth, religion and household hygiene and sanitation. CONCLUSIONS: This study underscores the importance of improving parental education, household wealth, hygiene and sanitation conditions, promoting feeding practice and child health service utilization. Also, any nutrition sensitive and specific intervention should consider a child's characteristics such as his/her age, gender and birth order.

Disparities in mothers' healthcare seeking behavior for common childhood morbidities in Ethiopia: based on nationally representative data.

BACKGROUND: Childhood morbidities such as diarrhea and pneumonia are the leading causes of death in Ethiopia. Appropriate healthcare-seeking behavior of mothers for common childhood illnesses could prevent a significant number of these early deaths; however, little nation-wide research has been conducted in Ethiopia to assess mothers' healthcare-seeking behavior for their under five children. METHODS: The study used the Ethiopian Demographic and Health Surveys (EDHS) data. The EDHS is a cross sectional survey conducted in 2016 on a nationally representative sample of 10,641 respondents. The main determinants of care-seeking during diarrhea and acute respiratory infection (ARI) episodes were assessed using multiple logistic regression analyses while adjusting for complex survey design. RESULTS: Only 43% and 35% of households sought medical attention for their children in episodes of diarrhea and ARI, respectively, during a reference period of 2 weeks before the survey. The odds of seeking care for diarrhea are lower for non-working mothers versus working mothers. The likelihood of seeking care for diarrhea or ARI is higher for literate fathers compared to those with no education. The place of delivery for the child, receiving postnatal checkup and getting at least one immunization in the past determined the likelihood of seeking care for ARI, but not for diarrhea. The odds of seeking care are higher for both diarrhea and ARI among households that are headed by females and where mothers experienced Intimate Partner Violence (IPV) violence. Religion and types of family structure are also significant factors of seeking care for diarrhea episodes, but not for ARI. CONCLUSIONS: The findings call for more coordinated efforts to ensure equitable access to health care services focusing on mothers living in deprived household environment. Strengthening partnerships with public facilities, private health care practitioners, and community-based organizations in rural areas would help further improve access to the services.

Evaluation of a Social Media Campaign in Saskatchewan to Promote Healthy Eating During the COVID-19 Pandemic: Social Media Analysis and Qualitative Interview Study.

BACKGROUND: The beginning of the COVID-19 pandemic presented many sudden challenges regarding food, including grocery shopping changes (eg, reduced store hours, capacity restrictions, and empty store shelves due to food hoarding), restaurant closures, the need to cook more at home, and closures of food access programs. Eat Well Saskatchewan (EWS) implemented a 16-week social media campaign, #eatwellcovid19, led by a dietitian and nutrition student that focused on sharing stories submitted by the Saskatchewan public about how they were eating healthy during the COVID-19 pandemic. OBJECTIVE: The goal of this study was to describe the implementation of the #eatwellcovid19 social media campaign and the results from the evaluation of the campaign, which included campaign performance using social media metrics and experiences and perspectives of campaign followers. METHODS: Residents of Saskatchewan, Canada, were invited to submit personal stories and experiences to EWS about how they were eating healthy during the COVID-19 pandemic from April to August 2020. Each week, one to three stories were featured on EWS social media platforms-Facebook, Instagram, and Twitter-along with evidence-based nutrition information to help residents become more resilient to challenges related to food and nutrition experienced during the COVID-19 pandemic. Individuals who submitted stories were entered into a weekly draw for a Can $100 grocery gift card. Social media metrics and semistructured qualitative interviews of campaign followers were used to evaluate the #eatwellcovid19 campaign. RESULTS: In total, 75 stories were submitted by 74 individuals on a variety of topics (eg, grocery shopping, traditional skills, and gardening), and 42 stories were featured on social media. EWS shared 194 #eatwellcovid19 posts across social media platforms (Facebook: n=100; Instagram: n=55; and Twitter: n=39). On Facebook, #eatawellcovid19 reached 100,571 followers and left 128,818 impressions, resulting in 9575 engagements. On Instagram, the campaign reached 11,310 followers, made 14,145 impressions, and received 823 likes and 15 comments. On Twitter, #eatwellcovid19 made 15,199 impressions and received 424 engagements. Featured story submission posts had the best engagement on Facebook and the most likes and comments on Instagram. The EWS social media pages reported increases in their following during the campaign (Instagram: +30%; Facebook: +14%; and Twitter: +12%). Results from the interviews revealed that there were two types of campaign followers: those who appreciated hearing the stories submitted by followers, as it helped them to feel connected to the community during social isolation, and those who appreciated the evidence-based information. CONCLUSIONS: Numerous stories were submitted to the #eatwellcovid19 social media campaign on various topics. On Instagram and Facebook, posts that featured these stories had the highest engagement. During this campaign, EWS's social media following increased by more than 10% on each platform. The approach used for the #eatwellcovid19 campaign could be considered by others looking to develop health promotion campaigns.

Scaled-up nutrition education on pulse-cereal complementary food practice in Ethiopia: a cluster-randomized trial.

BACKGROUND: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). METHODS: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers' KAP and anthropometric measurements of the children were taken at baseline, midpoint, and end point. ANOVA and descriptive statistics were used to analyzed data. RESULTS: At baseline and end point, maternal KAP and the dietary diversity score of the children (mean age at end point 18.8 ± 2.9 mo) were assessed. Intervention mothers' KAP improved (p < 0.001) at midpoint and end point compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p = 0.001). CONCLUSIONS: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. TRIAL REGISTRATION: Clinicaltrials.gov # NCT02638571 . Date of registration: 12/18/2015. Prospectively registered.

A Nutrition Education Intervention to Increase Consumption of Pulses Showed Improved Nutritional Status of Adolescent Girls in Halaba Special District, Southern Ethiopia.

This study aimed to determine the effect of a 6-month in-school nutrition education intervention to improve pulse consumption on weight status of adolescent girls in Ethiopia. At the intervention school, 66 girls received bi-monthly lessons that included recipes and tastings. Girls (n = 66) at the control school had usual in-school activities. With pulse-based nutrition education which included discussions and demonstrations, knowledge, attitude and practice scores improved (p < 0.001) in the intervention group while control scores remained low and unchanged. Prevalence of underweight, measured as Body Mass Index (BMI) for age, decreased with the education intervention, from 13.6% to 3% (p = 0.004), while there was no significant change seen in control girls. In Ethiopia, equipping girls in schools with the knowledge and skills to improve food intake by consuming locally grown pulses may mitigate underweight in Ethiopian female adolescents.

Facilitators and Barriers toward Food Security of Afghan Refugees Residing in Karachi, Pakistan.

The present study comparatively assesses how Afghan refugees in Pakistan understand both the factors and barriers affecting their food security status before and after refuge. Through qualitative in-depth interviews with 25 Afghan refugee families, we assess how quality of life, together with perceptions of a balanced meal, food environments both pre- and post-migration and push and pull factors of migration, impact food security and food choices for refugee families. Furthermore, our results reveal that regardless of the length of protracted status for Afghan refugees, food insecurity remains as a consistent condition for refugee families.

The effectiveness of nutrition education: Applying the Health Belief Model in child-feeding practices to use pulses for complementary feeding in Southern Ethiopia.

Complementary foods (CFs) in Ethiopia are cereal based and adding locally grown pulses (legumes) to CF would provide needed nutrients. To assess the effects of nutrition education (NEd) using Health Belief Model (HBM) in promoting pulses for CF, a 6-month quasi-experimental study was conducted in 160 mother-child pairs. Knowledge, attitude, and practice (KAP) questions were given to mothers at baseline, midline, and endline, along with anthropometric measurements of children. NEd involving discussions and recipe demonstrations was given twice monthly for 6 months to the intervention group (n = 80) while control mothers received usual education. At baseline, mothers' KAP scores were low at both sites; at 3 and 6 months of NEd, mean KAP scores of mothers increased (p < 0.05) compared to the control site. Significant improvements in children's mean weight, weight for height, and weight for age occurred in the intervention site only. Nutritional status of children improved after providing mothers with pulse-based NEd.

Determinants of diet for urban aboriginal youth: implications for health promotion.

Overweight and obesity are associated with several life-threating comorbidities, including type 2 diabetes and cardiovascular disease. Obesity is a growing health concern in North America, with some groups experiencing higher levels of obesity than others. One group of particular interest is urban Aboriginal youth because they are a quickly growing population who experience high rates of obesity. Obesity is a complex condition with many contributing factors, diet being one of the primary contributors. In this article, we discuss the findings from an ethnographic study that examined determinants of diet for urban Aboriginal youth. Results revealed two themes: (a) Traditions and Sharing, and (b) The Struggle. The findings with Traditions and Sharing showed that food-sharing networks are often used to acquire traditional food. Traditional foods were believed to be healthy and desired by the participants. The theme The Struggle provides insight into the daily challenges the participants faced with food insecurity. Health promotion professionals need to consider the multiplicity of determinants of diet for urban Aboriginal youth in order to plan and implement culturally appropriate health promotion programs.

A low pulse food intake may contribute to the poor nutritional status and low dietary intakes of adolescent girls in rural southern Ethiopia.

Poor nutrition in adolescent girls poses critical health risks on future pregnancy and birth outcomes especially in developing countries. Our purpose was to assess nutritional status and dietary intake of rural adolescent girls and determine pulse and food intake patterns associated with poor nutritional status. A cross-sectional community-based study was conducted in a traditional pulse growing region of southern Ethiopia on 188 girls between 15 to 19 years of age, with 70% being from food insecure families. Prevalence of stunting (30.9%) and underweight (13.3%) were associated with low food and nutrient intake. Diets were cereal-based, with both animal source foods and pulses rarely consumed. Improving dietary intakes of female adolescents with nutrient dense foods would ensure better health for themselves and for the next generation.

Techniques for toddlers: linear band incision for harlequin ichthyosis with associated compartment syndrome.

Harlequin ichthyosis (HI) is a rare autosomal recessive disorder of cornification in which children are born with an extremely thick stratum corneum that becomes a restrictive circumferential encasement around the orifices, limbs, chest, and abdomen, resulting in limb contractures. We present a neonate diagnosed in utero with HI. The infant was born with encasing bands of thickened skin creating strictures that were causing digital and limb cyanosis (compartment syndrome). We treated the child using a new technique of lysis of the encasing bands that we call linear band incision, using a new escharotomy-like procedure while the infant was undergoing a 3-week course oral acitretin therapy. The technique involved linear incision and lysis of encasements that resulted in reperfusion of the injured limbs and prevention of further digital necrosis. The child is currently a healthy 8-year-old boy with skin manifestations resembling congenital ichthyosiform erythroderma. He has use of all of the limbs that were released in the procedures and is maintained on frequent application of bland emollients. Linear band incision is a potentially life- and limb-saving technique in children with HI.

Nutrition education and introduction of broad bean-based complementary food improves knowledge and dietary practices of caregivers and nutritional status of their young children in Hula, Ethiopia.

BACKGROUND: Nutritious complementary foods are needed in countries where undernutrition and stunting are major problems, but mothers may be reluctant to change from traditional gruels. OBJECTIVE: To test whether a recipe-based complementary feeding education intervention would improve knowledge and practice of mothers with young children in Hula, Ethiopia. METHODS: A baseline survey of 200 eligible, randomly selected mother-child pairs gathered data on sociodemographic characteristics, food security status, knowledge and practices concerning complementary feeding, food group intakes of children aged 6 to 23 months by 24-hour recalls, and children's anthropometric measurements. Twice a month for 6 months, women in the intervention group received an education session consisting of eight specific messages using Alive and Thrive posters and a demonstration and tasting of a local barley and maize porridge recipe containing 30% broad beans. The control group lived in a different area and had no intervention. RESULTS: At 6 months, knowledge and practice scores regarding complementary feeding were significantly improved (p < .001) in the intervention group but not in the control group. The intervention resulted in improvement of children's dietary diversity, as well as mean intake of energy and selected nutrients, compared with children in the control group. Changes in height and weight did not differ between the two groups. CONCLUSIONS: Community-based nutrition education over 6 months that included demonstration of a local porridge recipe with broad beans added improved the complementary feeding practices of caregivers and the nutritional status of their young children.

Pulse-Based Nutrition Education Intervention Among High School Students to Enhance Knowledge, Attitudes, and Practices: Pilot for a Formative Survey Study.

BACKGROUND: Promoting pulse consumption in schools could improve students' healthy food choices. Pulses, described as legumes, are rich in protein and micronutrients and are an important food choice for health and well-being. However, most Canadians consume very little pulse-based food. OBJECTIVE: This pilot study sought to investigate outcomes of a teacher-led, school-based food literacy intervention focused on the Pulses Make Perfect Sense (PMPS) program in 2 high schools in Saskatoon, Saskatchewan. METHODS: Both high schools were selected using a convenience sampling technique and have similar sociodemographic characteristics. The mean age of students was 16 years. The intervention comprised 7 key themes focused on pulses, which included defining pulses; health and nutritional benefits of pulses; incorporating pulses into meals; the role of pulses in reducing environmental stressors, food insecurity, and malnutrition; product development; taste testing and sensory analysis; and pulses around the world. A self-administered questionnaire was used to assess knowledge, attitudes, practices, and barriers regarding pulse consumption in students at baseline and study end. Teachers were interviewed at the end of the intervention. Descriptive statistics and the nonparametric Mann-Whitney U test were used for analysis. RESULTS: In total, 41 and 32 students participated in the baseline and study-end assessments, respectively. At baseline, the median knowledge score was 9, attitude score was 6, and barrier score was 0. At study end, the median knowledge score was 10, attitude score was 7, and barrier score was 1. A lower score for barriers indicated fewer barriers to pulse consumption. There was a significant difference between baseline and study-end scores in knowledge (P<.05). Barriers to pulse consumption included parents not cooking or consuming pulses at home, participants not liking the taste of pulses, and participants often preferring other food choices over pulses. The teachers indicated that the pulse food-literacy teaching resources were informative, locally available, and easy to use. CONCLUSIONS: Despite the improvements in knowledge, attitude, and practice, pulse consumption did not change significantly at the end of the intervention. Future studies with larger samples are needed to determine the impact of PMPS on knowledge, attitude, and practice of high school students.

Contribution of home garden vegetables on reducing stunting among 6- to 23-month-old children in South Tigray, northern Ethiopia.

The study was conducted to analyze the contribution of home garden vegetables in reducing stunting among 6- to 23-month-old children from South Tigray, Northern Ethiopia. The quasi-experimental study design was used. Multistage sampling technique was used to select the districts and study communities. A total of 94 purposively selected vegetable producer (intervention) households and 260 randomly selected non-producer (control) households were included in the study (1:3 ratio). The recumbent length of children was measured using horizontal wooden board to the nearest 0.1 cm. The length-for-age Z-scores were computed using WHO-Anthro 2006 software. Propensity score-matching and difference-in-difference (DID) estimates were used to analyze data using STATA software version 12. Prevalence of child stunting was 19.8 (12.7-29.4) and 21.1 (16.4-26.7)% (baseline) and 43.5 (33.5-54.1) and 46.5 (45.7-47.2)% (end line) among intervention and control groups, respectively. Child stunting was higher for boys and older children from both intervention and control households. DID estimation revealed that there was no significant difference in child stunting between intervention and control households (DID = 1.7, p = .604). However, there was an intervention effect of -0.5, 2.5, and 1.7% in the prevalence of child stunting among females, males, and both sexes, respectively. Vegetable production as an intervention strategy reduced the prevalence of stunting in children aged 6-23 months. However, vegetable production needs to be well integrated with other nutrition-sensitive interventions to realize the objective of reducing child stunting.

Comprehensive compositional assessment of bioactive compounds in diverse pea accessions.

Pea (Pisum sativum L.) is an important legume crop providing a good source of protein, vitamins, minerals and bioactive compounds with health benefits for humans. In this study, an improved method for simultaneous analysis of multiple phytoestrogens among 100 pea accessions was developed. Ipriflavone, (a synthetic isoflavone), was used as an internal standard for the semiquantitative analysis of 17 phytoestrogens including isoflavone aglycones and conjugates, allowing direct analysis of isoflavones in their naturally occurring forms. This comprehensive dataset demonstrated that the isoflavones varied greatly and some accessions tended to have high levels of multiple phytoestrogens among the 100 accessions analyzed. Isoliquiritigenin followed by glycitein were the predominant compounds detected in the accessions and showed the highest correlation with the total phytoestrogens content. Secoisolariciresinol content was consistently higher in yellow cotyledon peas than in green cotyledon peas, whereas the contents of coumestrol, genestein and secoisolariciresinol were significantly correlated with seed coat color. The total phenolics and saponins showed a wide range of variability among the accessions with higher concentrations of total phenolics observed in seeds with pigmented seed coat or yellow cotyledon seeds, suggesting the synthesis of saponins and phenolics are significantly affected by metabolic pathway genes controlling cotyledon color or seed coat color. This study profiled the variability of bioactive compounds of pea seed quality traits in diverse pea accessions and provides an immense resource for continued research, breeding and selection of genotypes for a wide range of applications.

Educational intervention and livestock ownership successfully improved the intake of animal source foods in 6-23 months old children in rural communities of Northern Ethiopia: Quasi-experimental study.

BACKGROUND: Animal source foods (ASFs) are rich in high-quality proteins, including essential amino acids and highly bioavailable micronutrients vital for child growth and cognitive development. But, the daily consumption of ASFs among 6-23 months old children is very low in Tigray, Northern Ethiopia. OBJECTIVE: The study aimed to assess the effectiveness of nutrition education intervention to improve the consumption of ASFs among 6-23 months old children from rural communities with strict religious fasting traditions of avoiding intake of ASFs in Northern Ethiopia. METHODS: A quasi-experimental study was conducted in two food insecure districts namely Samre Seharti (intervention) and Tanqua Abergele (comparison). The mother-child pairs in the intervention group (n = 140) received nutrition education based on the barriers and available resources for optimal consumption of ASFs among children and followed up for nine months. The mother-child pairs in the comparison group (n = 153) received routine nutrition education. The data were collected using a pre-tested structured questionnaire. The baseline and endline data assessment included interviews on socio-demographic and socio-economic status, dietary intake, and child feeding practices. The effectiveness of the intervention was measured using the difference-in-difference (DID) analysis model. RESULTS: At endline, the consumption of ASFs among children was 19.5 percentage points higher in the intervention group compared with the comparison group (p = 0.008). In addition, there was a significant increase in egg consumption among children in the intervention group (DID of 16.9, p = 0.012) from the comparison group. No child was consuming meat at baseline in both the intervention and comparison arms and it was very low at endline (5.2% vs. 7.9%). Overall, the proportion of children that consumed eggs in the intervention group was higher than in the comparison group in households that owned sheep and goats (4.8% vs. 21.4%, p = 0.050) and chicken (6.3% vs. 43.8%, p = 0.002) after education interventions. However, no statistically significant difference was observed between cow ownership and milk consumption among children (p>0.05). CONCLUSIONS: Age-appropriate educational interventions for mothers and owning small livestock in the household can improve the consumption of ASFs and eventually the minimum diet diversity of children in communities with strict religious traditions of avoiding ASFs during the fasting seasons.

Prioritizing gender equity and intersectionality in Canadian global health institutions and partnerships.

Despite governmental efforts to close the gender gap and global calls including Sustainable Development Goal 5 to promote gender equality, the sobering reality is that gender inequities continue to persist in Canadian global health institutions. Moreover, from health to the economy, security to social protection, COVID-19 has exposed and heightened pre-existing inequities, with women, especially marginalized women, being disproportionately impacted. Women, particularly women who face bias along multiple identity dimensions, continue to be at risk of being excluded or delegitimized as participants in the global health workforce and continue to face barriers in career advancement to leadership, management and governance positions in Canada. These inequities have downstream effects on the policies and programmes, including global health efforts intended to support equitable partnerships with colleagues in low- and middle- income countries. We review current institutional gender inequities in Canadian global health research, policy and practice and by extension, our global partnerships. Informed by this review, we offer four priority actions for institutional leaders and managers to gender-transform Canadian global health institutions to accompany both the immediate response and longer-term recovery efforts of COVID-19. In particular, we call for the need for tracking indicators of gender parity within and across our institutions and in global health research (e.g., representation and participation, pay, promotions, training opportunities, unpaid care work), accountability and progressive action.

Inequalities in adherence to the continuum of maternal and child health service utilization in Ethiopia: multilevel analysis.

BACKGROUND: Despite progress made to improve access to child health services, mothers' consistent utilization of these services has been constrained by several factors. This study is aimed at assessing the inequalities in key child health service utilization and assess the role of antenatal care (ANC) on subsequent service use. METHOD: The analysis of the present study was based on the Ethiopian Demographic and Health Surveys, a nationally representative sample of 10,641 children. A health service utilization score was constructed from the affirmative responses of six key child health interventions associated with the most recent birth: ANC service, delivery of the last child at health facilities, postnatal care services, vitamin A intake, iron supplementation and intake of deworming pills by the index child. A mixed effect Poisson regression model was used to examine the predictors of health service utilization and three separate mixed effect logistic regression models for assessing the role of ANC for continued use of delivery and postnatal care services. RESULTS: The results of mixed effect Poisson regression indicate that the expected mean score of health service utilization was lower among non-first birth order children, older and high parity women, those living in polygamous families and women living in households with no access to radio. The score was higher for respondents with better education, women who had previous experience of terminated pregnancy, residing in more affluent households, and women with experiences of mild to high intimate partner violence. Further analysis of the three key health services (ANC, delivery, and postnatal care), using three models of mixed effect logistic regression, indicates consistent positive impacts of ANC on the continuum of utilizing delivery and postnatal care services. ANC had the strongest effects on both institutional delivery and postnatal care service utilization. CONCLUSION: The findings implicated that maternal and child health services appear as continuum actions/behavior where utilization of one affects the likelihood of the next service types. The study indicated that promoting proper ANC services is very beneficial in increasing the likelihood of mothers utilizing subsequent services such as delivery and postnatal care services.

Interprofessional culinary education workshops at the University of Saskatchewan.

Implication Statement If you want to offer your students an enjoyable and worthwhile interprofessional activity to learn about issues in community nutrition, your university can cook up these interprofessional culinary education workshops. Start with a few enthusiastic students from various health professional programs who can organize, promote, and lead. Include faculty and/or staff to support the students and apply for internal funding. Find workshop facilitators (e.g., chefs), and arrange for program evaluation. It is best to choose workshop topics and themes relevant to your local situation. Ensure workshops are structured to facilitate cooperative and experiential learning. Students will find these sessions informative, practical, and enjoyable. Énoncé des implications de la recherche Les ateliers culinaires sont une activité interprofessionnelle agréable et intéressante que votre université peut proposer aux étudiants qui souhaitent se familiariser avec les enjeux de la nutrition communautaire. Il suffit de réunir, pour commencer, quelques étudiants motivés issus de divers programmes de santé pour organiser, promouvoir et diriger les ateliers. Il s'agit ensuite de trouver les enseignants ou le personnel pour les soutenir, et de s'assurer d'un financement interne. Il faut ensuite trouver des animateurs d'ateliers (par exemple, un chef) et planifier l'évaluation du programme. Il est préférable d'axer les ateliers sur des thèmes adaptés à votre milieu. Les ateliers doivent être structurés de manière à faciliter l'apprentissage coopératif et expérientiel. Les étudiants trouveront ces séances instructives, pratiques et agréables.