Effect of a community-based child health counselling intervention on health-seeking behaviours, complementary feeding and nutritional condition among children aged 6-23 months in rural China: A pre- and post-comparison study.

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government-funded nutrition programme, Ying Yang Bao (YYB; soybean powder-based iron-rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6-23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check-up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check-ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron-rich or iron-fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource-limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education.

Inadequate Nutrition and Associated Factors in Children Aged 6 to 24 Months - 4 Counties, Liangshan Yi Autonomous Prefecture, China, 2018.

What is already known about this topic? Symptoms of malnutrition including anemia, stunting, wasting, and being underweight among children remained one of the major public health problems in poorer areas in China. More research is needed to guide interventions to improve nutrition and health among children in low-income regions. What is added by this report? The prevalences of anemia, stunting, wasting, and being underweight were 51.9%, 25.6%, 14.6%, and 9.5%, respectively, among children aged 6 to 24 months in the poorest areas of Liangshan. Associated factors were gender, age, education level and occupation of mother, breastfeeding, and caregiver knowledge. What are the implications for public health practice? Improving caregiver knowledge of nutrition and child feeding practices is crucial to address malnutrition among children. These findings can help more precisely understand the child health needs in poorer areas in order to develop effective interventions. They also provide evidence-based information to formulate child health promotion strategies in other countries with similar situations.