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Background: In genera self declared female headed-households in most developing countries tend to be poorer, own less and have less access to job opportunities., Objective: To assess the nutritional status of pre-schoolers by gender differentiation of heads of households., Design: A cross-sectional descriptive study carried out in February 2003., Setting: Four beneficiary villages registered under the Ethio-Danish joint community development programme in North Ethiopia., Subjects: A total of 144 heads of random systematically selected households regrouped as male-headed (n = 96) and female-headed households (n = 48) with their respective preschoolers., Main Outcome Measures: Nutritional status of two groups of children categorised by gender of the head of household., Results: The number of pre-schoolers from male-headed households was 1.54 as opposed to the female-headed households (1.08). The proportion of stunted and underweight pre-schoolers was significantly higher in female headed-households than in the male-headed households while the prevalence of wasting was practically similar. The proportion of vaccinated and breastfed children, although not statistically significant, was higher in male headed households while the practice of colostrums feeding, giving water and butter, vitamin A and appropriate weaning was better in female headed households. The difference noted in prevalence of feeding colostrums was significant. The energy, protein and vitamin A intake in almost all of the households was below the recommended daily allowances; showing a nutrient adequacy ratio of 50.2%, 48.8% and 17.9% respectively whereas iron intake exceeded 100%. The energy, protein, vitamin A and iron intake was better in the male-headed households than in female-headed households. The difference, however, was statistically significant for energy only., Conclusion: This study delineated that chronic child under-nutrition is not only higher among female children but also in female headed households and hence the implication of gender biased violation of the right to nutrition security. Other important implication of this study is that apart from gender issues alternative livelihood options that promote healthy behaviours, such as, improving the provision of health services and curbing the harmful traditional practices that may have a dual impact on the well being of mothers and children is recommended.

Objective: To identify the factors associated with childhood under-nutrition in North Wollo, Ethiopia., Design: A cross-sectional study., Setting: Four purposefully selected rural villages (kebeles) in North Wollo zone of the Amhara Region, Ethiopia., Subjects: One hundred-forty four sampled households with under five year old children (n=200) comprising of 96 male-headed, 24 female-headed and 24 landless with children aged between six and 59 months., Main Outcome Measures: Determinations of anthropometric measurements and various socio-economic factors., Results: The overall prevalence rate of under nutrition as determined by stunting, underweight and wasting was 44.5%, 25.0% and 9.0% respectively with more preponderance among the toddlers. The proportion of under nutrition was higher in female-headed households. Shortage of farmland, lack of irrigation, dispossession of livestock, shortage of non-farm employment options, parental illiteracy, high number of children, water inadequacy, food taboos and wrong eating habits of families, poor child feeding practices, deprivation of health nutrition education as well as maternal attributes such as young motherhood, low body mass index and short stature of mothers influenced the nutritional status of the children. The prominent risk factors for undernutrition among children were dispossession of livestock, child food taboos and wrong eating habits of families, deprivation of health/nutrition education, short stature and early marriage of mothers., Conclusion: This study led to the conclusion that improvement of household resources through promotion of irrigation and initiation of income generating livelihood options can reverse the nutrition situation for better. Health and nutrition education focusing on appropriate child feeding, eradication of harmful traditional practices such as early marriage and inequitable intra-household food distribution, encouragement of family planning and nutrition interventions including food diversification is recommended.

Objective: To evaluate the impact of daily and weekly iron supplementation on serum zinc status among anaemic lactating mothers., Design: A randomised iron intervention controlled trial., Setting: Seven urban slum communities of Addis Ababa., Subjects: Phase one of the study involved 207 anaemic lactating women assigned into two intervention groups; the daily (N=71) and weekly (N=71) Iron supplemented and the control group (N=68). Supplementation with 60 mg tablet containing 300 microg ferrous sulphate and 400 microg folic acid was done for three months while the control group was n otsupplemented. Phase two involved 53 participants systematically drawn from phase one., Main Outcome Measures: Haemoglobin from all subjects and serum zinc and ferittin levels following three months supplementation. Zinc status based on serum zinc value of less than 10.7% micromole/L., Results: The mean baseline characteristics and serum zinc of the women at baseline were similar, overall marginal zinc deficiency prevalence was 11.3% and no zinc deficiency was detected. Following supplementation, zinc deficiency was detected in the supplemented groups but not in the control group. The mean serum zinc significantly changed in both supplemented groups while no change was observed in the control group. The reduction in the mean serum zinc was significantly higher in the daily than in the weekly supplemented group., Conclusion: Iron supplementation impacts negatively on serum zinc status (exacerbates zinc deficiency) and hence, its contribution to zinc deficiency deserves further investigation especially in the context of the on-going promotion of double fortification strategies that involve iron.

Objective: To determine and compare the socio-economic characteristics, childcare and feeding practices among children aged 6-59 months of households participating in a World Vision Kenya programme with non-participants., Design: A comparative cross-sectional survey., Setting: A World Vision Kenya project area (Kimundi and Yinthungu sub-locations) and a non-project area (Thavu and Yeekanga sub-locations) both in Kathonzweni division, Makueni district., Study Population: A random sample of 320 children aged 6-59 months and their respective households. A sub-sample (n=60) was assessed for dietary intake., Results: A significantly higher proportion of children in the non-project area (63.8%) than in the project area (37.5 %)(p=0.00) were introduced to complementary foods within the first three months. The first main food given to children in both areas was unenriched cereal porridge. In both areas, grandmothers were reported to be the main alternative caregivers though most of the mothers prepared food for the children while other caretakers did the actual feeding., Conclusion: No significant difference was noted in the childcare practices in the two areas contrary to what may have been expected since the programme aimed at promoting appropriate childcare and feeding practices hence the expected difference.

Most nutrition education programmes in Kenya operate on the premise that nutritional knowledge can have an impact on children's nutritional status. It has, however, been argued that nutritional knowledge among low income groups is unlikely to have an impact, hence, the need to establish whether there is a relationship between nutritional status and maternal nutritional knowledge. In a cross-sectional survey carried out in a Nairobi slum (Kibera), nutritional status of 363 children aged six to 24 months was measured and nutritional knowledge of their mothers assessed. Makina village was randomly selected as the study site and all consenting households were involved in the study. The study established that most mothers (97.5%) have access to nutrition education. Prevalence of stunting (86.2%) and underweight (58.4%) was high but that of wasting (1.9%) was low. There was no significant relationship between the nutritional status of children and overall nutritional knowledge. Unexpectedly, a negative relationship was found between nutritional status and mothers' ability to recognise clinical signs of malnutrition, knowledge in the weaning process and dietary management during sickness. Knowledge on frequency of feeding was, however, positively related to nutritional states. In conclusion, nutritional knowledge alone is inadequate in ensuring young children's nutrition security and, hence, for nutrition education programmes to have a positive impact, facilitational strategies must be incorporated.

Assessments of nutritional status of semi-arid population in Kiambu District comprising 1042 persons from 260 households showed that 64.2% of the households had at least one malnourished person. The main aim of the study was to establish whether patterns of households malnutrition were distinguishable by specific risk indicators. Fourteen patterns of household malnutrition were established by classifying malnourished people according to age vis-a-vis nutritional status of other members of that household and six risk indicators were found to be related to malnutrition at the household level. Although partial relation was found between patterns and some indicators, no risk was found to be exclusively related to a specific pattern but failure to establish such a relationship was attributed to sample size.