Effects of alternative caregivers on infant nutritional status in Manya Krobo, Ghana

Malnutrition remains a significant contributor to child morbidity and mortality. Adequate child care can help to prevent childhood malnutrition and mitigate the deleterious effects of poverty. The overall objective of this study is to gain a better understanding of the use of AC in Manya Krobo, Ghana. The first aim of this research was to identify the sources of AC. The second aim was to identify determinants of use of AC. The third aim of this research is to evaluate the association between the use of AC and child anthropometry. A triangulation of three research methods was used: focus group discussions (n=14), in-person surveys (n=200) and follow-up in-depth interviews with in-home observations (n=17). Participants (mother [greater than or equal to] 18y with a child 9-24 mo) were recruited from two district hospitals and a door-to-door strategy was employed for focus group recruitment. The majority (83%) of women reported using AC; the most common AC was the grandmother (65%). Mothers who used AC tended to be younger (p=0.08) and had a higher income (p=0.02) than those who did not use AC. Although AC freed up time for other household chores and rest, mothers were concerned that AC care could be of poor quality. After controlling for child age and household wealth, AC tended to be positively associated with WAZ and HAZ (p\u3c0.10). When other pertinent determinants (maternal BMI, income, toilet/latrine facilities, and extended family) of child anthropometry were added to the regression model, AC remained positively associated with child anthropometry but was no longer statistically significant. Household and family structure may influence the availability of possible AC and potentially quality of care given to the child. AC are a widely used form of social support and did not compromise child nutritional status. More research is needed to assess the quality of care that the different AC provide and their effects on the household\u27s ability to properly care for children. The wide use of AC in this community presents a new target for infant nutrition intervention at the household level