QUALITY OF SERVICE AT CHILD WELFARE CLINICS AND ITS IMPACT ON CHILD NUTRITIONAL STATUS IN EAST MAMPRUSI DISTRICT

Abstract

Early and regular child welfare clinic attendance is essential for improved health and nutritional status of children. This study sought to assess the quality of service at child welfare clinics and its impact on the nutritional status of children in the East Mamprusi District. The study population was children attending child welfare clinic and were between the ages of 0-59 months. A child welfare clinic in each of the five sub-districts was selected for the study. A sample size of 423 children was used with the caretakers/mothers as respondents. They were randomly sampled across all the five (5) sub-districts during the data collection. Both qualitative and quantitative methods were used. Eleven (11) Participant observation sessions were done; Fifteen (15) key informant interviews were held whiles both structured and semi-structured 9~estionnaires were used in the qualitative and quantitative data collections. Majority of respondents 78.3% (331) started the ewe attendance in the first week after delivery, 41 (9.7%) of them started a month after birth whilst 39, (9.2%) had their first attendance after forty days with only 15 (3.5) starting after six months. The study found that determinants of ewe usage included educational level (p<0.005), wealth index (p<0.005), available of incentives at the ewe (P<0.05), parity of mother (p<0.005), and prevalence of child deaths in the family (p<0.005). The determinants of child's weight and height found by the study were birth weight, regular ewe attendance, educational level, content of ewe, household wealth index. Bivariate analyses indicated that babies/children who made adequate ewe (early initiation, consistency in attendance and made not less than 20 visits were more likely to have better or normal weight-for-height and height-for-age. Child welfare clinic usage in the east Mamprusi district is universal. All nursing mothers or ewe attendees who were interviewed made child welfare clinics attendance, though sometimes not regular. However, early initiation, and regular attendance of ewe are not encouraging as some mothers still deliver at the home under the supervision of unskilled birth attendant and may start the child welfare clinic attendance at or after forty (40) days which is not helpful in detecting early birth complications for appropriate treatment